Middlesex MD Blog

[Heather34]

Hi ladies. There is an excellent blog written by Dr. Barb DePree, MD:

http://blog.middlesexmd.com/

She writes:

“I am Dr. Barb DePree, M.D., a women’s health provider for more than 20 years, and a menopause care specialist for the past four. In my practice, I see women of my own generation, women who are more independent, educated, and assertive about their health than any generation before. But you know what? Most of us are still reluctant to talk with our doctors about our sexual experiences. And, as a doctor, I know that few medical practitioners receive the training they would need to help women — particularly those in menopause — with their sexuality. But our generation is going through a big change. Sexual desire and function decrease with age in both sexes, and more markedly for women. Natural aging and hormonal changes slow down our sexual response, leaving some of us feeling we’ve lost of a vital part of lives and relationships. Misinformation about these normal changes, along with a lot of mystery about what is ‘expected’ sexual behavior at our age, can interfere with a couple’s ability to maintain a fulfilling sexual relationship. So we have a puzzle. We want our sexual well-being, but we don’t know how, when, or who to ask for help. And the advice we go looking for often leads us into places we find uncomfortable, or may misguide us entirely. I’m launching MiddlesexMD, essentially to share practice-tested, clinically sound information with women my age.”

The blog discusses everything from low libido that may occur during menopause to specifically referencing menopausal vaginismus in the May 2011 section.

I would encourage you to follow it and welcome your comments and feedback here.

[Heather34]

Hi gals. This MiddlesexMD Blog is excellent and I encourage you to follow. So great is the fact that they continuously reference and discuss vaginismus. In one particular discussion, they write:

“Q: Why am I too tight for sex?

What you describe could well be vaginismus, which is the involuntary spasm of pelvic floor muscles of the outer (lower) third of the vagina. The resulting interference with intercourse is experienced as “too tight,” “he can’t get in,” or “it’s like he’s hitting a wall.”

Because the spasm is involuntary, the cause is sometimes difficult to understand. Pain in the area of the pelvis can be a contributing factor, so the hip pain you describe is likely involved. Beyond interfering with intercourse, vaginismus–those pelvic floor muscles in spasm–can also be experienced as pain in the pelvis, low back, low abdomen, and upper thighs.

It’s important to have an exam to better understand what’s happening for you, and I’d advise that you have the exam sooner than later. If you have surgery in your future, physical therapy that starts before-hand (and continues after) could help in your recovery, too. Vaginal dilators are often a part of therapy for vaginismus, and that, too, can start now and deliver benefits for your recovery.

Good luck in working through this! With patience and good information, you can do it.”

[Heather34]

Hi all. If you haven’t already, I would encourage you to subscribe to this excellent Blog. As written above, they discuss vaginismus and sexual pain but this is just one of the many interesting topics discussed.

I wanted to share one article concerning Assessing Sexual Pain

http://blog.middlesexmd.com/2012/02/16/assessing-sexual-pain/

Excerpts from the article include:

“Secondary and primary dyspareunia may be associated with a myriad of causative factors, including lack of estrogen in the vulvar tissues, vulvar dermatoses, scarring, fissures or adhesions, and psychogenic issues like past or current sexual abuse. One of the most common causes of pain is vulvar vestibulitis syndrome (VVS), also referred to as provoked vestibulodynia (PVD). This is characterized by localized redness, generalized rawness, itching, discomfort at the vaginal opening, and discomfort associated with a gentle cotton swab touch, upon exam, to the glands at the vaginal opening.
Healthcare for the woman with VVS/PVD begins with competent and early diagnosis. Up to half of women are misdiagnosed. Most women are told that their symptoms are psychological, and that they need to “relax” or that they have an ongoing yeast infection. A simple physical examination can usually provide the correct diagnosis. In the “touch test,” vulvar structures like the glands of the vulva are tested with a cotton swab; the woman with sexual pain will often find these touches painful. Touch testing should be performed as part of a thorough pelvic and vaginal examination, including cultures for species identification for yeast (and bacteria, if necessary).
Managing dyspareunia often begins with anti-irritant hygiene regimens: avoiding scents, allergans, and irritants from soaps and other products. Other treatments a healthcare provider may prescribe include topical hormone creams, antifungal therapy, pelvic muscle physical therapy, biofeedback, and/or surgery.
Alternative approaches include use of topical creams like Neogyn vulvar soothing cream, compounded creams containing capsaicin, amitriptyline, cromolyn, atropine, and other therapies such as acupuncture.
Women should be aware that symptoms are not “in their heads,” and that it may take months for pain to diminish. Patience is paramount. Maintaining a physical relationship (other than intercourse) with a partner is important, because “complete intimacy avoidance” can be common among women with sexual pain and can be detrimental to the couple’s relationship.
A relationship therapist can help women—and their partners—coping with sexual problems. Both patients and clinicians can learn more about the condition by visiting the National Vulvodynia Association website at http://www.nva.org”

[Heather34]

Hi all. There is an awesome blog that I wanted to share titled: Clinical Pearls for Sexual Health and Happiness

Excerpts include:

“Here are Susan’s top clinical pearls for our sexual health and happiness:
Add moisture daily. If we use a water-based, bio-adhesive lubricant several times a week, regardless of sexual frequency, we can get a lot more comfort and satisfaction with sex and just make it easier to have an orgasm whenever we want to.
Nourish yourself. A Mediterranean diet has been shown to promote sexual function, (and, we just learned, perhaps lower breast cancer risk). And regular exercise improves mood and overall health, both of which contribute to better sex.
Talk it out. When we use “I” language to talk with our partners about sex honestly and in a non-accusatory way, we increase the chances of sexual success. Your NAMS doctor or therapist can help provide the vocabulary and communication tips.
Prioritize pleasure. Don’t wait for intimate time to just happen. Even a 20-minute block of time, scheduled weekly, for touching and intimate conversation can clear the way to better sex. Putting it on your checklist may seem like a cold thing to do, but trust us, it gets hotter with practice.
Mindfulness matters. Reading or watching even the softest erotica, being mindful of erotic thoughts as they occur, and focusing on sensation rather than distractions during arousal are all important. All mindfulness training can contribute to your ability to stay in the moment during your most intimate moments.
Intensity, baby. After menopause, many women need more intense stimulation to reach orgasm. Consider introducing vibrators into sex play. The term, “Doctor’s orders!” can be very useful here. You have our permission to use it.
Do try. Just opening up and talking about sex problems, and finding what can still be sexual successes, shows that a woman is committed to her partner, and taking action shows her level of care and concern for the relationship. Mutual affection, honest attempts at exploring what is possible, comfortable, what still feels good, does amazing things for a relationship.”

I encourage you to read and welcome your comments and feedback here.