From the desk of Ms B

HEALTH


Note from Ms B : I'm including this study as many dancers are affected by one or more of these conditions. Many of us think its largely due to the fact that we're always in tight, sweaty clothes for the most part of the day which could aggravate or trigger conditions such as those listed below.

Help For Intimate Pain

Chronic pelvic pain (CPP) affects 1 in 7 women and is notoriously difficult to heal. New treatments are bringing hope and genuine relief. What doctors now know is that CPP is rarely due to just one problem. Most women have three or more conditions, each of which adds to their overall discomfort. If you treat just one cause, the patient won't get much better. To find relief, you'll need to be your own educator and advocate. It's essential that you understand some of the more common components of CPP, the subtle differences between them that even doctors miss, and how the various conditions interact with one another and exacerbate your symptoms. Familiarize yourself with the test you'll need, as well as the menu of conventional & natural therapies available to you.

Five common conditions for which your doctor will test are :

1. Endometriosis (5 million women have it)

Cells similar to the tissue lining the uterus migrate elsewhere and break down each month in sync with your period.

* Telltale signs : severe cramps, often coinciding with your menstrual cycle, that radiate to the lower back and leg.

* How it's diagnosed : laparoscopy (a minimally invasive surgical procedure) to perform biopsies (removal of tissue samples for examination under the microscope).

* Treatments : frontline remedies include nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen sodium, along with birth control pills and other hormones to shrink endometrial tissue. your doctor may recommend minimally invasive surgery to remove or destroy endometrial growths or, in severe cases, a hysterectomy.

2. Interstitial Cystitis (900,000 women have it)

This involves recurring discomfort in the bladder, which may be caused by a breakdown of mucin, cells on the surface of the bladder that protect it from acidity.

* Telltale signs : women say interstitial cystitis (IC) is like the worst urinary tract infection they ever had, with burning or stabbing pains when their bladders are full and when they urinate, which some do as often as 60 times a day and night.

* How it's diagnosed : by ruling out other conditions that could cause the same symptoms. Your doctor with test your urine for bacteria to eliminate a urinary tract infection and use a thin, lighted instrument called a cystoscope to examine your bladder; a bladder wall biopsy may be needed to cross of cancer as a possibility.

* Treatments : Elmiron, the first oral drug developed for IC, coats the bladder surface and may take 6-9 months to be totally effective. Doctors have also had some success with antihistamines, a variety of tricyclic antidepressants (used for their anti-pain properties), anti-seizure medications (increasingly prescribed for hard to treat pain) and other medications instilled directly into the bladder.

3. Pelvic Floor Tension Myalgia (common, frequency unknown)

Many issues, both physical (such as difficult childbirth) and emotional, can lead to chronic tension in the pelvic floor muscles, which support your pelvic organs.

* Telltale signs : a heaviness of achiness in the pelvis; burning, itching and pain in the vagina or urethra (the tube that drains urine from the bladder).

* How's its diagnosed : physical examination by an experienced pelvic pain practitioner.

* Treatments : the most effective treatments involve pelvic floor physical therapy. You'll learn how to align our pelvis and do a core strengthening and stretching routine that helps prevent pelvic floor muscles from going into spasm. Botox injections may prevent spasms by temporarily relaxing the muscles. Trigger point injections of the anesthetic lidocaine relieve pain for some women.

4. Pelvic Congestion Syndrome (7 million women have it)

Varicose veins in the pelvis cause pain. Like varicose veins in the leg, the valves in veins become weak and don't close properly, so blood pools, causing painful pressure.

* Telltale signs : women complain of a dull, aching, throbbing pain in the pelvis, often describing a 'heavy' feeling. The pain is absent or mild in the morning and gets progressively worse throughout the day. It improves when you lie down or apply heat.

* How it's diagnosed : A special test called a transcervical venogram enables your physician to measure the size of the abnormal vein and its rate of blood flow.

* Treatments : doctors often first try a progestin hormone, which has been shown in studies to decrease pain and shrink the veins. If drugs fail to provide relief, embolization, a procedure that closes off problem veins, helps as many as 70% of patients. If a woman is finished with childbearing, a hysterectomy, in which the tubes and ovaries are removed along with the affected vein, has been shown to the the most effective therapy.

5. Vulvodynia (6 million women have it)

Vulvodynia means 'chronic vulvar pain', most often described as a burning or searing sensation. Although the causes of vulvodynia are unknown, experts speculate that previous yeast infections may make some women more susceptible to developing vulvodynia. Another possible cause is nerve damage caused by anything from horseback riding to childbirth. 75% or women with vulvodynia suffer from vulvar vestibulitis - pain at the entry to the vagina.

* Telltale signs : a persistent or intermittent burning or stinging in the vulva that may spread to the buttocks and upper thighs. Inserting a tampon, sitting or wearing jeans can bring it on. About 80% of women with this disorder have pain during intercourse.

* How it's diagnosed : the 'cotton swab' test, in which doctors touch parts of the vulva to detect pain, helps identify vestibulitis. There is no test for vulvodynia; docs rely on an extensive exam, your health history and test to exclude other causes.

* Treatments : frontline remedies include anti-seizure drugs, anti-depressants and the topical anesthetic lidocaine. Some specialist have had success by compounding all of these drugs into a topical formula that's applied directly to affected tissues. Surgery to remove nerve endings at the entrance to the vagina (the vestibule) helps up to 90% of women with vulvar vestibulitis but is a last resort.

Natural Remedies That Work

Relaxation exercises have been shown to ease pelvic pain. Other natural options aside from good hygiene are :

- nearly three-quarters of patients who have tried new biofeedback-guided Kegel exercises have found relief for pelvic floor tension myalgia.

- an organic diet with no red meat or dairy containing hormones helps some women with endometriosis.

- a low-acidic diet that excludes bladder-irritating foods such as coffee, tea, citrus fruit, hot peppers and chocolate may ease symptoms in women with interstitial cystitis.