Sassy Chat

 

I was watching television this evening and an advert came on that caught my attention. It was an ad for Poise. A woman sneezing, picking up a child and doing aerobics, the message being that if you have urinary incontinence or leaking then wear a Poise panty liner.

Well, That is one option, yet I couldn't help thinking... why not get to the source of the problem?  A weak pelvic floor muscle stems from using the incorrect muscles when lifting, poor toilet position especially straining the bowel, excessive exercising without correct pulling in and tightening of the pelvic muscles.  Many women tightening the waist muscles and ' suck in' , rather than finding their core balance and learning to squeeze and hold the pelvic floor muscle correctly.

There is a great book available called " Hold it Sister" written by Mary O'Dwyer, Physiotherapist and Pelvic Floor Coach. This book has illustrations which help you get a visual of what is required, as well as a chapter on exercise that will assist strenthening you pelvic floor muscles. Watch and listen to what she has to say about pelvic floor strength in the clip below.

 Often learning to exercise the correct muscles is aided by using a resistance device which is inserted into vagina.

 The Vaginal Barbell is a weighted barbell made of medical grade stainless steel which really helps with clenching exercises.  It ensures you are using the correct muscles.

 For busy women on the go, the Luna Beads from Lelo are a great options.  The set contain two lots of weighted balls, one lighter than the other.  As your pelvic strength increases then you can move to the heavier set.

There are also the Fun Factory Teneo Duo balls which are another set of pelvic floor exercisers to assist with developing good pelvic floor habits.

As with anything, the easiest way out is not always the healthiest.  In order to ensure pelvic floor health slipping on a Poise  pad is a band aid, and is not going to solve your problem.

Wouldn't you rather do Pelvic Floor Exercises and use a resistance device than wear a pad for the rest of your life? I know which option I'm choosing.

 

Vulvodynia is a name given to chronic and intense pain in the area pertaining to the vulva. This pain consists of extreme sensitivity, burning, stinging, throbbing, irritation and rawness. Sadly, there are many women experience and put up with this condition for many years before it is finally diagnosed. It would seem that public awareness of this condition is limited, with many women living with Vulvodynia leading a life of discomfort and pain, limited daily activities, sexual dysfunction and psychological distress.  According to the amazing interview (shown below) originating from New Zealand, medical help that was sought in this interview did not lead to any further understanding.  It would appear there was/is very limited knowledge amongst health professionals and scanty information made available through various sectors of sexual health. Accordingly, it is not unusual for many women with this condition to consult several physicians before being diagnosed.

Vestibulitis Syndrome is a common form of Vulvodynia that has been described as one of the most common causes of genital and sexual pain in women. The vulvar vestibule is the area within the inner labia surrounding the vaginal opening.

Upon diagnosis of Vulvodynia, the painful tissue may look essentially normal under examination, or it may whiten when swabbed with a vinegar solution. Biopsy may show chronic, nonspecific inflammation. Whatever the initial cause, it seems possible that for some people pain pathways are activated that do not deactivate when the source of irritation has been removed or ameliorated.

Awareness of aspects of daily life that may be contributing to this condition have been known to reduce the severity of pain, such as taking precautions with clothing, wearing cotton underwear and loose fitting long pants.  It is possible that various foods may contribute to sensitivities, especially when stinging is apparent after urinating.  Washing the entire area of the vulva with water after urinating may help and it is paramount to avoid the use of scented soaps and toilet paper.  It is also clear that laundry powder can be problematic, as well the use of bubble bath, shaving gels and body washes, especially those containing high amounts of fragrance, glycols, parabens, alpha-hydroxy acids such as malic acid, glycolic acid and lactic acid as well as  alcohol.

Deactivating the pain pathways is possible using anaesthetic gels (lidocaine), topical steroid creams pain medications, even low doses of antidepressant (sometimes given with an antispasmodic) have all been used.

Dr Glazer, a Clinical Associate Professor at Cornell University Medical College/New York Presbyterian Hospital, has discovered that there is a relation to abnormal muscle function in the pelvic floor area that relates to Vulvodynia.  Through measuring the break down in muscle function with electromyography, which is non invasive, the depth of abnormality can be measured.  Then through a series of individual programs using electromyographic biofeedback, Dr Glazer corrects muscle abnormalities.

With increased blood flow there can be a restoration of vulvar tissue which then leads to pain relief.  Dr Glazer's treatments have resulted in massive reductions of ongoing pain in 80% of the women who have used this process finding relief from Vulvodynia.  A much better option possibly, than steroid creams, anti depressants and anaesthetic gels!

Take a look at this amazing interview. It is a powerful documentary because of the openness and honesty of the woman who is interviewed. Prepare to be moved and at the same time filled with admiration for a woman who has been to hell and back living with Vulvodynia. The shocking thing though in this documentary is that so many health professionals seemed to be ignorant to this condition.

http://tvnz.co.nz/20-20-news/v-word-13-19-video-4232132

Any comments and feedback would be appreciated.

 

What is Vaginismus?

Vaginismus is sexual dysfunction experienced by women where there is an involuntary contraction of the pelvic floor muscles that surround the vagina. This involuntary contraction of the pelvic floor muscles causes makes any type of vaginal penetration including sexual intercourse very difficult or completely impossible and occurs at the anticipation of vaginal penetration or the perception that intercourse is going to be difficult or painful.

Vaginismus is the most common reason for relationships remaining unconsummated due to the introitus, or entrance to the vagina clamping shut completely.  Some women with Vaginismus are unable to insert tampons, tolerate a pelvic exam or any type of penetration to the vagina.

Sexual arousal is possible when a woman has Vaginismus, however when penetration is attempted, the vagina clenches and shuts making sex difficult or impossible.  This can add to the frustration women feel when they are suffering from Vaginismus.

There are two types of Vaginismus:

• Primary –where a woman has never had successful intercourse, either from pain or inability to have penetration. Woman who have Primary Vaginismus may not even be aware they have it until they try to have penetrative sex, insert tampons or have their first pelvic exam.
• Secondary-where a woman has previously had successful intercourse and penetration but is currently unable to.

How common is Vaginismus?

Statistics on Vaginismus vary, probably because many cases go unreported due to embarrassment of the women. Currently sex therapists report between 5-47% of women who seek sex therapy are diagnosed with Vaginismus.

What are the symptoms of Vaginismus?

Aside from the involuntary pelvic floor contractions that make penetration difficult to impossible, symptoms of Vaginismus can vary between women. Other symptoms can include:

• Burning or stinging during intercourse.
• Painful intercourse. This usually results in the woman having to stop sex before completion.
• Unconsummated relationship.
• Avoidance of sex
• Difficulty or inability to insert tampons.
• Difficulty or inability to undergo a pelvic exam.
• Pain with sexual intercourse that has no known origin.

 

How is Vaginismus diagnosed?

Vaginismus is usually diagnosed by a gynaecologist when a woman goes in for a pelvic exam. Sometimes she goes for the exam because she is experiencing problems having sex and sometimes she is just going in for a routine or first pap smear and exam. During the exam the vagina clamps down and makes completion of the exam impossible. Some women are so anxious during the exam they shut their legs and become very emotional further making performing the exam difficult for the doctor.

What are the causes of Vaginismus?

There are three categories for the causes of Vaginismus, physical, psychological and a combination of both physical and psychological.

Physical causes of Vaginismus can include:

• Childbirth-pain or complications from difficult vaginal deliveries, c-sections or miscarriages.
• Urinary tract infections or other urinary problems.
• Yeast infections.
• Vaginal prolapse.
• Cysts or tumors on reproductive organs.
• Pelvic inflammatory disease.
• Sexually transmitted diseases.
• Age related changes such as menopause, hormonal changes, atrophy of the vagina, and vaginal dryness.
• Pelvic surgery or trauma.
• Lack of foreplay/not enough vaginal lubrication.

Psychological causes of Vaginismus can include:

• Partner of relationship issues/
• Fear. Fear of intercourse and anticipation of pain, getting pregnant, of tissue damage.
• Anxiety. Performance anxiety, past unpleasant sexual experiences.
• Unhealthy sexual emotions or feelings of guilt and shame about sex.
• Feelings of guilt and shame about your body.
• Teachings of childhood, “Sex is bad” “your body and genitals are dirty and should not be touched.”

Sexual Trauma, Assault or Abuse

Unfortunately one of the most common causes of Vaginismus is sexual trauma, assault or abuse. Flashbacks of past sexual trauma or assault can cause an unconscious reflex of the vagina clenching shut. This is usually an unconscious defense mechanism that happens as a woman tries to protect herself from more trauma.

Physical and Psychological Causes Combined

One of the most important things to remember about Vaginismus is that it is not the woman’s fault. The pelvic floor muscle contractions, clenching of the vagina and inability to have penetration are all involuntary. They cannot be controlled or stopped by the woman.

Even when Vaginismus has a physical cause, there are psychological effects that go along with it. A cycle develops between the physical and psychological and if left untreated, will continue endlessly.

For example, a woman who has had previous incidents of Vaginismus  will become so filled with anxiety because of it, the next time she tries to have sex it will occur again due to her anxiety and anticipation that the sex will be painful.

The result looks like this:

Fear/anticipation of painful intercourse/anxiety →Unconscious clenching of vagina/tightening of muscles →Clenching/Vaginal tightness makes penetration impossible→ Unsuccessful/disappointing/upsetting sexual encounter → Anxiety over sexual encounter → Decision to attempt sexual activity again → Back to fear/anticipation of painful intercourse/anxiety.

 

The cycle can be emotionally draining and often women will try to avoid intimacy, dating and sexual activity so they do not experience this turmoil. Sometimes when they do enter a relationship, the pressure to have successful penetration is felt so keenly they only experience more anxiety, which of course, results in another episode of Vaginismus. Sexual partners are often unaware of the problem, women withdraw emotionally and sexually from the relationship and the relationship as a whole, suffers. 

Vaginismus can affect sexual self esteem and the emotional triggers such as sexual assault and feelings of guilt and shame about sex can cause women to feel they are in a deep well of sexual failure they cannot climb out of. The truth is, Vaginismus does not mean a woman is incapable of sexual activity, or experiencing pleasure, or does not love her partner and does not want to have penetrative sex.

There is no evidence to support the idea that Vaginismus decreases sex drive, or arousal. In fact, many women are still able to enjoy sexual play and orgasm through clitoral stimulation. Women who experience Vaginismus report the desire for penetrative sex but the fear of painful intercourse and the emotional toll, based on previous experiences, deters them and they are thrown right back into the cycle above.

Both partners can be frustrated at the deterioration of their sex life. Emotions can range from disappointment, embarrassment, guilt and shame, feeling “defective” to an emotional disassociation with one’s sexuality. 

PART TWO: covers treatment for Vaginismus 

Endometriosis is a painful gynecological disorder that leaves many women and doctors puzzled. It is truly a medical enigma in that every case is different and no two women have the same symptoms. Plus, these rogue endometrial tissues (uterine lining cells) tend to wreak havoc in the abdomens of over 70 million women and girls who have endometriosis worldwide. Endometriosis grows much like a cancer, taking over everything it touches, mainly the organs and surrounding tissues – bladder, peritoneum, fallopian tubes, ureters, and the intestines.

A toxic overload on the system is created from the continual cycle of endometrial tissue building up and breaking down. The surrounding tissues and organs need to absorb this excess blood and tissue causing a proliferation of decaying cells throughout the abdomen. The affected areas still need to function regularly and this process is very taxing on the body. Fatigue and exhaustion are a constant side effect for many women with this condition.

Contemporary ways of dealing with endometriosis are typically hysterectomies and hormone pills or shots; all of which have a plethora of side effects. These dramatic procedures may be appropriate for many cases, but some women need and want other options. Additionally, anti-inflammatory and analgesic medications may seem completely necessary for most women living with this condition, but there are other more natural options available for pain management like homeopathy and herbs.

Alternative and natural medicine has been ripe with methods for dealing with women’s problems since the time of Hippocrates. Many of these protocols and modalities are still available today. The World Health Organization (WHO) estimates that almost 80 percent of the world still practices culturally traditional medicine for most of their health concerns.

There are several proven modalities that are deemed helpful in cases of endometriosis. A choice selection of natural health theories and medications worthy of looking into further can all be categorized under the umbrella of Complimentary and Alternative Medicine (CAM).


Complementary Approach

CAM is an East-meets-West approach to healthcare that has been beneficial to many who suffer from chronic diseases such as endometriosis. Some modern medical options have proven beneficial to the health of women with this condition; whereas other modern methods can cause some women more pain and suffering. In the opposite manner, there are age-old holistic healing methods that work well for some women, while for others they are not effective at all. But using them together in synchronicity is where most success stories appear.

A long-term commitment to personally healing is required for any natural or less aggressive modality to work.  With CAM using the healing power of nature and modern science together with proper diet and lifestyle habits, have universally proven to be a successful method of treating endometriosis.

An example of this concept may be seen with the use of 5-hydroxy-tryptophan (5HTP), which is a neuropeptide that has been synthesized in the lab. Many people affected from autoimmune disorders and their related depression issues, have utilized this supplement with positive results; both mental and physical improvements have been documented.  5HTP is not a prescription and is widely available on the market. This key element aids the body in regulating serotonin levels in the brain, and it helps balance the central nervous system, effecting overall health.


Naturopathic Medicine

Through the use of nutrition, supplements, and lifestyle adjustments, naturopathic practitioners can balance a women’s physical and mental state of health. Hydration, cleansing and external treatments (creams and heat compresses) may also be used for the relief of pain and swelling in the abdomen in particular. Most naturopaths take a broad-spectrum approach to healing and will consider all facets of the traditional healing arts for treatment plans when they are dealing with endometriosis. They tend to stand behind the theory that “we are what we eat”; working closely with vital nutrient intake through nutrition therapy and dietary adjustments.

A naturopathic doctor can also order a series of tests to determine the seriousness of the condition. These may include tests that look for toxins in the hair or blood, and a panel of hormones to rate the progesterone/estrogen levels. This helps them make an effective treatment plan that may include hormone replacement therapy.


Natural hormones

Many women living with endometriosis are finding great success with the use of natural progesterone creams. Traditional and natural doctors alike are currently suggesting this topical hormone replacement method.

The effectiveness of these creams comes from a laboratory extracted and synthesized natural progesterone from wild Mexican yams. Note: wild yam creams are not the same thing. The active hormone does not occur in these, nor does the body assimilate and convert the agents into progesterone, as some brands claim to happen. Only laboratory-synthesized hormones are bio-available.

To be effective, a hormone cream must contain a minimum of 400mg of natural progesterone per ounce. The continued use of these has helped many women reduce the severity of their condition. Additionally, there are minimal side effects compared with the use of conventional hormone replacement options such as pills, shots and internal devices like the cervical ring or IUDs.


Traditional Chinese Medicine (TCM)

TCM is considered to be one of the most effective alternative measures for dealing with endometriosis outside of mainstream medicine. With the combined use of ancient herbal remedies and acupuncture, the stagnated energy (chi), blood and tissues are mobilized through the lymphatic system; then any underlying symptoms of the condition are diagnosed and treated. The Chinese herbal formulas prescribed can have up to 15 to 20 herbs each, and they are customized to the individual woman based on their various symptoms and endometrial growth cycles. TCM does usually require a certain level of commitment for it to work well though.

Stress

An important mediator of inflammation for women with endometriosis is stress. Both physical and mental stresses take their toll on the body through the mechanism of the inflammatory response.

In times of stress, the adrenal glands release cortisol and other stress-related hormones (fight-or-flight syndrome) preparing our muscles for action as a survival tactic. In today’s busy world though, many people are caught in this constant state of stress, creating messages that are constantly sent to the immune system, effectively telling it to shut down. These instinctive signals are also sent to the skin producing an inflammatory response; this chain-reaction plays a key role in endometriosis growth, swelling and pain cycles.


Inflammatory Response

Over a long period of time this inflammatory response becomes toxic to the body, destroying brain cells and elevating our blood sugar; causing damage to the immune system as a whole. This makes a person more susceptible to infections, diseases and cancers.

The inflammatory response responds well with a natural approach towards healing.  Most holistic modalities used for endometriosis promote dealing with chronic stress and symptoms of the condition through diet, exercise and stress reduction.


Pain Relief Through Movement

Yoga, Pilates and Tai Chi are all low impact exercise options for delicate people. On extremely painful days, women with endometriosis can still manage to do a modified version of a work out.

The heart rate is increased with both Tai Chi and Pilates since they are more active, and they can be considered a cardio workout. Whereas yoga would be great for stretching, moving the lymph through the body, keeping limber and eliminating fluid buildup that is associated with endometriosis. Plus, all of these are very calming activities that are wonderful for the mental health of any woman that is in chronic pain.

There are many yoga poses that can help reduce abdominal inflammation and pain. An example of a beneficial yoga pose for women with endometriosis is the Legs-up-the-wall pose (Viparita Karani); it can help balance the endocrine and nervous systems while increasing blood flow to your pelvic region.  This position is held for 5 minutes while lying on the floor with both feet up on the wall. A bolster needs to be put under the lower back to raise the buttocks a few inches off the floor. For the duration of the pose, knees are bent and the legs are held crossed.

Pilates with a ball is a great low-impact full-body workout that is appropriate for someone with an abdominal disorder like this. One good exercise for endometriosis is to bounce on the ball to waist height, reaching both hands up to the ceiling and landing balanced on the ball; repeating 20-50 times. Also, when the midsection hurts all the time, doing crunches on the ball is a much lower stress workout than conventional sit-ups or crunches would normally be.

Tai Chi is an ancient exercise that is perfect for women living with endometriosis, because it is known to strengthen the muscles and tone the internal organs. The precise fluid movements of Tai Chi can also boost the immune system by moving stagnant lymph through the body, aiding in the healing process. A great workout is the traditional “8 Pieces of Silk Brocade” which is a short series of movements that have been done by monks for centuries; each one targets a system of the body bringing them into balance by the end of the exercise session.


Homeopathy

Homeopathy is a healing art that involves an in-depth look into an individual’s symptoms and underlying conditions. Each formula or remedy is considered for a quantity of reasons, allowing the wide variety of symptoms associated with endometriosis to be effectively treated for some women. A few common homeopathics used for this debilitating condition are Arnica montana (topically and internally), Aconitum napellus, Hypericum perforatum and Hystaminum hydrochloricum.


Herbs

There are several herbs that have proven effective for treatment of the multitude of symptoms related to endometriosis, like bloating, swelling, hormone imbalances, psychological and physical and pain.

St John’s wort, Black cohosh and Vitex agnus castus are among the most widely studied herbs with documented success within the scientific community, for women with gynecological disorders like endometriosis. Either of these can be found readily in the open market in several forms.

Some other herbs that can help to support the various needs of someone with this condition are ocotillo, sarsaparilla, yarrow, dandelion, marshmallow, mother’s wort, and horsetail. They are all noted herbs that have been used by many healers for balancing hormones and toning the gynecological organs.


Nutrition considerations

Eating a diet that includes a rainbow of foods provides a variety of nutrients that are needed for a healthy immune system and level blood sugars. These are two main areas of focus for an endometriosis diet.

Nutrient rich foods that should be incorporated into a vigorous healing diet are high in antioxidants, omega fatty acids, and large doses of essential vitamins and minerals. Increasing the intake of the following will be beneficial to a woman with endometriosis - raw foods, whole grains, high fiber foods, nuts and seeds, red and blue berries, dark greens, citruses and orange foods.

Watching the amount of hormones in dairy and meats is crucial to avoiding an estrogen overload.  This can be devastating to women with a hormonal disorder, since it may be a leading factor in the presence of extra endometrial tissue growing in the first place.

Avoiding high levels of soy protein is also recommended because the phytoestrogens they contain will aggravate the condition, since endometrial lesions feed on estrogen.

Getting enough fibre is essential for keeping the bowels moving. This is important not only to metabolism and absorption rates, but it prevents gas, bloating and constipation which all complicate the pain and swelling associated with endometriosis.

It is a good idea to shy away from simple sugars (high-glycemic foods), as they release large amount of insulin into the bloodstream and increase inflammation. Carbohydrates that quickly convert into sugar are things like potatoes, breads, pastas, pastries, juices, chips, and white rice.

Glucose molecules that stay in the blood stream unused tend to glue themselves to collagen, making the cells stiff and inflexible in almost every part of our body. Also, excess glucose tends to deteriorate our cellular reproduction rate, making repairs and healing virtually impossible.

Another dietary factor to consider is the inflammatory action of gluten in food. Gluten is a protein found in wheat, rye and barley and it is known to trigger an autoimmune response that causes inflammation and digestive issues. Avoiding gluten can be very helpful in preventing or eliminating flare-ups in women with endometriosis.

Copyright© 2011  Marie-Elise Allen.  Permission is granted to copy and redistribute this article on the condition that the content remains complete and intact, and that full credit is given to the author (s), that a link is provided to the author (s) website and that the information is distributed freely. http://www.sassyvibes.com.au


Sources


Perricone, Nicholas; The Perricone Promise; Warner Books; New York, NY; 1997

“Yoga RX: Endometriosis”
http://www.naturalsolutionsmag.com/article-display/14932/subTopicID/11/Yoga-RX-Endometriosis

“Endometriosis - the enigmatic disease of the modern age!“
http://www.endo-resolved.com/endometriosis.html

Hudson, Tori; Women's Encyclopedia of Natural Medicine; McGraw hill; New York, NY; 2008

What is Endometriosis?

Each month during her reproductive years, hormones cause the lining of the uterus to grow and become thick in anticipation of a fertilized egg implanting. This thick lining of the uterus is called the Endometrium.  If a fertilized egg does not implant, the uterus sheds the lining and the woman has a period.

When the endometrial cells form and grow outside the uterus, the condition is called Endometriosis. The endometrial tissue can grow on the outside of the uterus, the ovaries (most common), even on the bowel, rectum and bladder. The endometrial cells that grow outside the uterus and cause Endometriosis do not shed like they do in the uterus. Instead they continue to grow and can cause scar tissue to form in the fallopian tubes, ovaries and other abdominal organs.

What are the symptoms?

The main symptom women experience with Endometriosis is pain. Sometimes women who have Endometriosis have no pain and sometimes women who have very mild Endometriosis experience severe pain. Pain can occur in any of all of the following places or circumstances:
•    Painful menstrual periods.
•    Pain during sexual intercourse.
•    Pain following sexual intercourse.
•    Pain with bowel movements.
•    Lower pelvic pain or pelvic cramps that can be experienced a week or two before the woman’s period.
•    Abdominal pain that may be mild, moderate or severe during the woman’s period.
•    Lower back or pelvic pain that happen at any time during the menstrual cycle.
•    Painful urination.

Other symptoms women may experience include:
•    Constipation.
•    Long periods with a heavy flow of blood and clots.
•    Fatigue.
•    Headaches.
•    Diarrhea and bloating.
•    Spotting before a period.
•    Fever

What causes Endometriosis?

The exact causes of Endometriosis are still up for debate. While no one specific cause has been identified, there are some factors that seem to increase a woman’s chances for getting Endometriosis.
Some of these factors are:
•    Estrogen level. Endometriosis appears to be estrogen dependent which is why women who are in their reproductive years are more prone to getting it.
•    Retrograde Menstruation. Retrograde Menstruation occurs when for some unknown reason some of the endometrial lining that is shed during menstruation does not completely leave the uterus. Instead it backs up into the fallopian tubes and the pelvic cavity. Once there, the endometrial cells implant and grow causing endometriosis.
•    Genetics. Research studies suggest that if a woman’s Mother or sister have endometriosis, she is up to 6 times more likely to have it than a woman with no family history.
•    Women who have never had children are more likely to have Endometriosis.
•    Women who have early onset of menses-the start of menstruation are more likely to have Endometriosis.
•    Scar tissue from abdominal surgery.
•    Immune System problems. One theory is that women who have problems with their immune system lack the ability of the body to recognize and destroy endometrial cells when they grow outside the uterus.  



Women with Endometriosis sometimes experience one of more of the following complications:
•    Pelvic cysts.
•    Adhesions.
•    Internal scar tissue.
•    Bowel obstruction
•    Chocolate cysts-cysts filled with brown fluid and old blood.
•    Ruptured cysts.
•    Urethral obstruction.

Infertility

One of the most common complications women experience from Endometriosis is Infertility. Scar tissue can block fallopian tubes and ovaries and make the ability of the mature egg to travel from the ovary down the fallopian tube impossible.  Another cause is the production of hormones that block ovulation, fertilization and implantation of an egg. With successful treatment infertility problems are often resolved. However, the longer treatment is delayed and the Endometriosis progresses the more difficult resolving infertility becomes.  An estimated 20-50% of women experiencing infertility issues have Endometriosis.  Women with mild Endometriosis can usually conceive with no intervention. Women with more severe Endometriosis usually require treatment for the Endometriosis as well as assisted reproduction techniques and fertility treatments to achieve pregnancy.   

Impact on Everyday Life

Some women who have severe Endometriosis and experience debilitating pain have different aspects of their life affected. Aside from the obvious impact on her sexuality, activities of daily living may also prove difficult. The pain may cause her to miss school, work, and social activities. This can contribute to depression which is certainly associated with Endometriosis.

How is Endometriosis Diagnosed?

Most cases of Endometriosis are diagnosed in women between the ages of 25-35 as Endometriosis is a disease of the reproductive years. While rare, there are cases of Endometriosis in post menopausal women and also young girls. The exact number of women with Endometriosis is not known because many women do not experience any symptoms but it is estimated that over one million women in the United States alone are affected by Endometriosis.
Diagnosis of Endometriosis starts with a pelvic exam. Often the pelvic exam is painful because of the Endometriosis and that in itself is an indicator. Sometimes the doctor can feel the nodules and endometrial tissue growing outside the body during the manual part of the exam when one finger is inserted into the vagina and the abdomen is palpated.
Use of ultrasound can be helpful by ruling out other pelvic diseases and sometimes can distinguish endometrial tissue.
Unfortunately, neither a pelvic exam, or ultrasound can really be counted on for a concrete diagnosis of Endometriosis. In order to really be sure a woman has Endometriosis biopsy of the cells and tissue growing outside the uterus is needed as well as a visual inspection of the tissue.
Biopsy and visual examination is performed either through laparoscopic or open incision surgery.

How is Endometriosis Treated?

Several factors are considered when determining treatment for Endometriosis. These include:
•    Age of the woman
•    Whether future pregnancy is desired
•    Severity of symptoms
•    Severity of the Endometriosis.

Treatment for the pain associated with Endometriosis is often the first line of treatment for Endometriosis.  Anti inflammatory drugs such as ibuprofen are tried to relieve pelvic pain and menstrual cramps. These drugs to nothing to reduce the growth of endometrial tissue and is really helping the symptoms not curing the problem. However, if pain is relieved very often no other medical intervention is warranted.

Another medical intervention is the use of oral contraceptives, or birth control pills. This can interrupt the normal hormone production of the ovaries and prevent the growth of endometrial cells.

Other estrogen suppressing drugs such as Gonadotrophin-releasing hormone analogs have been effective in reducing the size of endometriosis and in treating the pain. These drugs stop menstruation so the body mimics menopause.  Hot flashes, irregular bleeding and vaginal dryness can be side effects of this treatment. Usually the plan with GnRH agonist treatment is to gradually add back estrogen and progesterone which helps minimize the side effects and allows the treatment to still work.

Surgery

If medical treatment doesn’t work, pain is still severe or the growth of the Endometriosis is causing impediment on some other organ like a bowel obstruction, surgical intervention is often warranted. The conservative surgical approach is to perform a laparoscopic procedure and laser off the endometrial tissue which preserving the ovaries, fallopian tubes and uterus.  If the Endometriosis is extensive, a hysterectomy may be performed to remove the uterus and sometimes the ovaries.  

It is important to remember that these treatments are for the symptoms of Endometriosis and most importantly to manage the pain. There is no true “cure” except for complete hysterectomy including the ovaries. Otherwise, there is a high probability that the Endometriosis will return as the cells and tissue start to grow again.

How does Endometriosis Affect Sexuality?

Endometriosis can cause painful intercourse. This alone will make a woman avoid intimacy.  Especially if she has always suffered from painful intercourse. For some women who have Endometriosis, it is hard to imagine a world or sexual encounter without it.
The pain, constipation, headaches, fatigue and other symptoms associated with Endometriosis can certainly affect the sex drive. The decrease in libido may be experienced by the woman’s sexual partner as well as they may fear hurting the woman during sex.  
If the choice of treatment includes medication that makes your body mimic menopause, vaginal dryness may impact sexual activity. Using a liberal amount of lubricant can help with vaginal dryness and help make sex more comfortable.
Emotional issues regarding Endometriosis can also impact sexuality. For example, women who have a hysterectomy sometimes emotionally feel that they are less of a woman since they have lost their uterus and can no longer have children. Counselling can help a woman work through these issues and recognise having a uterus does not make her a woman or a sexual being.

Treating the symptoms and side effects can help make sex less painful and more fulfilling. However, good communication between partners is vital.

As is good communication between doctor and patient. Any time a woman has pain with intercourse it is a sign there is a problem. It may or not may not be Endometriosis but the first step a woman should take to determine the cause of the pain and resolve the problem should be to consult with her health care professional. With correct diagnosis and care she should be able to treat the Endometriosis and have a much better quality of life.

Copyright©2008-2011  Marie-Elise Allen.  Permission is granted to copy and redistribute this article on the condition that the content remains complete and intact, and that full credit is given to the author(s), that a link is provided to the author(s) website and that the information is distributed freely. http://www.sassyvibes.com.au