Diagnostic Evaluation will Drive Effective Therapy

Is Sex Causing You Pain?

It could be Endometriosis Pain

Endometriosis pain is difficult to cure early as most women suffer for years between the start of symptoms and the diagnosis. Endometriosis is a common condition that causes pain and the control of endo pain is difficult. Some women have scaring around the Fallopian tubes, the ovaries or the bowel of the pelvis and it is thought this is part of the pain. Sometimes the implants themselves cause pain. It is possible that the implants are behind the uterus or over the rectum or vagina in a way that there is pain with intercourse. Shrinking or removing the implants with direct effect, reducing overall inflammation, and directly suppressing the substances that can affect nerves and trigger nerve pain response is the best cure. There are two strategies to pain management. First use of pain pills, second use of hormonal therapies that can resolve the condition or control the condition. Many of these women try to manage their pain with OTC pain medications from the NSAID group including ibuprofen and naproxen. However, in a new publication on the National Library of Medicine site they point out that o trials done well have answered the question as to whether NSAIDs are helpful for pain in women with endometriosis. 

Maybe you do have a Hernia

Women experience undiagnosed pelvic pains have now been found to have another condition that is curable by a relatively simple laparoscopic surgery. This condition is of internal inguinal hernia that is so subtle that it often is not appreciated. In an article about hidden agonies for women by the Personal Health Editor Jane E. Brody in today’s NY Times. In the GynoGab post regarding Post Endometrial Ablation Syndrome women who write will occasionally write that their gynecologist has not discovered this condition but is at a loss to say why there is no solution to their pelvic pains. It doesn’t seem possible that the procedure would predispose women to these hernias, but prior surgery some time can contribute to hernias in other locations, even C-sections can cause both hernias and pains after that surgery, so it’s something that can be worked up by MRI, and worth having a gab with your gyno about.

Painful Sex can be due to many causes

For some women getting back into sex shape after birth is easy to fix, but just not addressed. Childbirth can cause many pelvic floor changes, most will heal. Sometimes need attention to make sure the healing is proper and doesn’t cause problems with your sexuality. Between a quarter and a third of women report painful sex after having a child. Unfortunately, this is one area of gynecologic care that has not been well studied or much attention given to how to avoid these problems. Basically, your gyno gives you the green light to begin to have sex, and not much more information. Some of the main reasons for painful sex after childbirth are: tears, breastfeeding, and episiotomy. Circulatory problems may cause painful sex after childbirth as well. If the trauma of compression, or the location of tears. This can lead to difficulty with dryness, arousal, or painful sex. This condition is more typically caused by conditions other than childbirth. It is termed clitoral and vaginal vascular insufficiency syndromes. Due to poor blood flow from some very complex network of blood vessels deep in the pelvis. Painful sex can also be due to stress and depression, even in the absence of physical problems. It is important to bring up the topic with your gyno as all of these conditions are treatable. For some women the pain with sex after childbirth may mean exercises, for some toning, for some women medication, for some surgery, for some MonaLisa Touch or ThermiVa

If your use of Ibuprofen doesn’t work Genetic Variation Can Explain Poor Pain Control From Pain Medicines and new research has now linked poor pain control with poor metabolism of the very medications physicians have been prescribing strictly for pain control.

When we take pain medications some women with endometriosis, because of fibroids, bladder spasms, or menstrual cramps, it should work! But not all women get excellent relief, and others either get no relief or very partial relief. This can be true for all of the pain medications. But in particular it is the Cytochrome P450 2C9 variant enzyme (CPY2C9 for short) that will determine whether typical medications such as ibuprofen or naproxen will work for you as this enzyme controls how these NSAIDs are metabolized. You can get tested for these genes to see if these medications will work for you. For information on how in the Women’s Health Practice Clinical Research Division we furthered the science of individual care, read about some of the results from the RADAR study. 

Uterine Fibroid Pain

Uterine fibroids are very common and we have not specifically developed cures. It is possible to keep fibroids of the uterus controlled in size and the amount of bleeding they cause. It is also possible to prevent miscarriages and infertility, although sometimes this means surgical therapies. When uterine fibroids cause heavy bleeding, they can cause painful menstrual cramps. Controlling the menstrual periods can reduce the pain of uterine fibroids. Often women have tried NSAIDs such as ibuprofen, which can help to some degree. It may also be beneficial to you to try antispasmodics including hyoscine, butylbroimide/buscopan are sometimes as effective as pain medication. The best new treatments are with the modern medications Oriahann and Myfembree If you would like to know more about fibroids, or to be in a Clinical research study, contact us.