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Thursday, December 18, 2014

Sex Hurt? You May Have Infection, But You May Not

Painful sex is a seldom talked about, but frequent problem in women. Generally speaking painful sex, also called dysparunia,  as women age is due to VVA, the most prominent symptom of what is now more accurately called genitourinary syndrome (GUS) of menopause. It is due to lower levels of estrogen, and decreasing male hormones, even those of the adrenal gland. Making use of the fact that adrenal hormones themselves can affect the vaginal tissue, and the fact that some of the male hormones are converted to estrogen there is now a new treatment, DHEA that has been shown to be effective according to a new study published in Menopause. The pH of the vagina and the lining of the vagina are the first things to change, and in fact there can be secondary frequent infections that can be causing the actual quick onset of significant pain with sex. To some extent the routine treatments for infection will offer some help won't work as well unless the underlying hormonal problem of VVA is treated, If you are around the age of menopause or beyond and you have painful intercourse you have about a 50% chance of getting this condition and if untreated some women report significant decrease in intercourse frequency. Younger women may have other conditions such as vulvar vestibulitis or vaginismus. Estrogen during the premenopausal years is important for walls of the vaginal and the tissues of the vulva to remain healthy. It is important for the whole urogenital tract to remain healthy, so even the urethra and the tissues near the anus can become affected when the levels of estrogen decline as women get older. With post-menopausal vaginal symptoms women may experience vaginal dryness, vaginal discharge, burning with urination, itching of the vaginal area, and itching of the area of tissue between the vagina and the rectum known as the perineum. In severe cases women will report bleeding after sex, bleeding after exercising or spot bleeding unexpectedly. Some just report a sticky green or brown discharge that is very bothersome. If you have a pelvic exam you may be told by your gyno that you have vaginal atrophy which is a thinning and dryness of the vaginal walls. Lack of estrogen and the post-menopausal vaginal syndrome may also loosen the muscle tone of the vagina. Post-menopausal estrogen syndrome typically will not occur in perimenopause, but occurs a few years after your ovaries quit making estrogen. If a woman gets treated with estrogen to cure the post-menopausal vaginal syndrome you probably know that the treatment is working if your symptoms improve. After estrogen treatment the vaginal pH will decrease back to your premenopausal levels, and a pap test can show that the cells of the lining of the vagina are reverting to their normal state. There are many treatments, including those that are non-hormonal as well as hormonal. So women will have a choice of medications, and no longer necessarily have to use estrogen as their only treatment.And for women who do not want hormonal treatments, consider MonaLisa Touch Therapy.

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Thank you for your comments and questions. This blog is not intended to replace medical care, but is informational only. We hope you will become a follower or visit Womens Health Practice. We offer a variety of unique services including MonaLisa Touch, Coolsculpting, Labiaplasty, and Gynecoloigic Clinical Research Trials. For more information on menopause see http://www.amazon.com/Menopause-Make-Peace-Change

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