Posts Tagged ‘vaginitis’

Problems “Down There” That Affect Your Sex Life

September 11, 2012

One of life’s greatest pleasures is intimacy with your partner. Nothing can put the ice on that relationship faster than when there is pain and discomfort for either a man or a woman associated with sexual intimacy. This article will review the most common causes of vaginal pain and what can be done to make the ouch go away.

Vaginitis
The itching, burning, and pain associated with vaginitis results from a disruption in the natural balance of bacteria that live in every healthy vagina. There’s no single cause. Common culprits include hormonal changes due to birth control, menopause, or pregnancy as well as chronic medical conditions, such as HIV and diabetes, which weaken the immune system. Frequent sexual intercourse and sex with multiple partners can be to blame as well. Bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age. Women with BV may have a copious, thin grayish-white discharge. BV is easily treated with oral or vaginal antibiotics.
Yeast infections are caused by the overgrowth of one of several strains of Candida, a fungus that lives normally in the vagina. Women may notice a thick white discharge with a slight odor. However, many women complain of genital itching, soreness, or irritation. Treatment consists of a vaginal cream or an oral antifungal medication, Diflucan.
Treatment is painless and easy; most women simply insert at bedtime a prescribed cream or an ovule (a soft suppository) — generally soothing but messy — or they can take a prescription oral antifungal such as Diflucan. You’ll avoid the mess, but relief might take a few days longer.

Atrophic vaginitis is a result of a decrease in estrogen levels and the lining of the vagina becomes thin and easily irritated. Treatments such as estrogen creams or a vaginal estrogen ring can help.

Trichomoniasis, a sexually transmitted infection, can cause a greenish-yellow frothy discharge, with some itching and burning. This infection is easily treated with oral or vaginal antibiotics.

Vulvodynia

Vulvodynia is a condition where the pain so severe you can’t sit comfortably let alone have intercourse. The cause is unknown, but possible contributors include injury to nerves in the vulva, hypersensitivity to Candida, and pelvic floor muscle spasms. Treatment options include estrogens, oral antifungal medication, topical steroid creams, and physical therapy to loosen the muscles causing the spasms.
Vaginismus
This is a rare condition that fewer than 2% of women, which causes the muscles surrounding the vagina to contract so tightly that a woman can’t have sexual intercourse or even insert a tampon. The cause is unknown, but like vulvodynia, vaginismus responds to physical therapy. Now doctors are using Botox to relax the muscles and prevent spasms for up to six months.

Stress Incontinence
Stress incontinence occurs when there’s increased pressure or stress on the bladder or lower abdomen, such as when sneezing, when coughing, or during intercourse. This is a source of great embarrassment to a woman who loses urine during sexual intimacy. The cause is usually due to multiple vaginal childbirths, estrogen deficiency, obesity, and chronic constipation with the chronic straining to have a BM.
The easiest solution is for a woman to use the bathroom prior to sexual intimacy in order to empty her bladder. Kegel exercises can help build up the pelvic muscles that support the bladder and the urethra. Now there are minimally invasive surgical procedures that can help restore continence that can be done on an outpatient basis with immediate results.

Bottom Line: If you think you have any of these, see your doctor. Over-the-counter creams will often make the problem worse. The diagnosis is easily made in the doctor’s office and treatment can begin immediately and you will put the icing back on your sexual cake.

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You Don’t Have to Depend on Depends-Menopause and Bladder Control-

March 10, 2010

Some women begin to have problems with their bladder and experience overactive bladder (gotta go, gotta go right now) and urinary incontinence or loss of urine at inopportune times at the time or shortly after menopause.

Does Menopause Affect Bladder Control?

Yes. Some women have bladder control problems after they stop having periods (menopause or change of life). If you are going through menopause, talk to your health care team.

After your periods end, your body stops making the female hormone estrogen. Estrogen may help keep the lining of the bladder and urethra healthy. A lack of estrogen could contribute to weakness of the bladder control muscles.

Pressure from coughing, sneezing or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence.

Although there is no evidence that taking estrogen improves bladder control in women who have gone through menopause, small does may help thicken the bladder lining and decrease the incontinence.  Your doctor can suggest many other possible treatments to improve bladder control.

What Else Causes Bladder Control Problems in Older Women?Sometimes bladder control problems are caused by other medical conditions. These problems include:

Infections

Nerve damage from diabetes or stroke

Heart problems

Medicines

Feeling depressed

Difficulty walking or moving

A very common kind of bladder control problem for older women is urge incontinence. This means the bladder muscles squeeze at the wrong time and cause leaks.

If you have this problem, your doctor can prescribe medication that can certainly alleviate that problem.

What Treatments Can Help You Regain Bladder Control?Your doctor may recommend limiting foods or fluids, such as caffeine, which are bladder irritants and increase the desire to go the rest room.

There are also pelvic exercises that can strengthen the muscles in the urethra and the vagina.   Life’s events, like childbirth and being overweight, can weaken the pelvic muscles.

Pelvic floor muscles are just like other muscles. Exercise can make them stronger. Women with bladder control problems can regain control through pelvic muscle exercises, also called Kegel exercises.

Exercising your pelvic floor muscles for just five minutes, three times a day can make a big difference to your bladder control. Exercise strengthens muscles that hold the bladder and many other organs in place.

Two pelvic muscles do most of the work. The biggest one stretches like a hammock. The other is shaped like a triangle. Both muscles prevent leaking of urine and stool.

Pelvic exercises begin with contracting the two major muscles that stretch across your pelvic floor. There are three methods to check for the correct muscles.

1. Try to stop the flow of urine when you are sitting on the toilet. If you can do it, you are using the right muscles.

2. Imagine that you are trying to stop passing gas. Squeeze those same muscles you would use.

3. Lie down and put your index finger inside your vagina. Squeeze as if you were trying to stop urine from coming out. If you feel tightness on your finger, you are squeezing the right pelvic muscle.

Do your pelvic exercises at least three times a day. You can exercise while lying on the floor, sitting at a desk or standing in the kitchen.

Be patient. Don’t give up. It’s just five minutes, three times a day. You may not feel your bladder control improve until after three to six weeks. Still, most women do notice an improvement after a few weeks.

Other treatments include inserting a device, a pessary, directly into the vagina to lift the urethra and the base of the bladder to its proper position behind the pubic bone.  And finally, if the conservative methods of medication, exercises, and dietary modification don’t work, then you should talk to your doctor about one of the surgical procedures that can lift the bladder into the proper position to prevent leakage

Bottom Line: No one needs to suffer the embarrassment of urinary incontinence.

Dr. Neil Baum is a physician at Touro Infirmary and can be reached at (504) 891-8454 or through his website, http://www.neilbaum.com