The OVA

Let’s Talk About The Health Of The Vagina, The Pelvic Floor & Stone Eggs

As a Women’s Health Expert I hear about all manner of things and what people are trying, or using for their various health issues. Today I am going to talk about the sensitive topic of the health of the vagina and the pelvic floor and how stone eggs (yoni eggs, jade eggs etc) may be of assistance.

Stone eggs have been used by women for thousands of years. The practice of using them is believed to have started in Japan.

Many modern day women are now using these stone eggs (Yoni eggs, Jade eggs, Ba wen balls, Fertility Ball etc) and many are using them under the advice of celebrities, influencers and people who are not healthcare professionals. So I thought it was an important topic to talk about and look at the pros and cons of what these eggs may, or may not be used for.

I also talk about the outlandish claims that some celebrities have made around these stone eggs and I also talks about the things that these eggs many be useful for. I also talks about the importance of quality and hygiene and where to get good quality stone eggs if you are going to try them. As mentioned in the video, before using stone eggs, always consult with your healthcare practitioner, or pelvic floor specialist first.

If you do want to purchase good quality stone eggs, “The Women’s Health Experts” have their own high quality ones called “The O-VA”.  They come in a set of 3 eggs (choice of rose quartz or dark amethyst) and they are also in a discreet box that can be stored away and keep them hygienically clean at the same time, ready for their next use. They also come with instructions on how to use them, clean them, look after them and what they may assist with.

Please be careful of being inferior ones off the internet and from people who are not healthcare professionals. To find out more please contact my staff on 07 38328369, or email info@drandreworr.com.au.

 

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The Importance of Following Through With Advice, Treatments & Change

I see so many people who have been ‘missed’ and ‘dismissed’ and who have suffered in silence with their disease state.

But the biggest shame is when those that are offered real help, then do nothing with that advice and continue on the vicious, merry-go-round cycle of their disease.

My motto is “No Stone Left Unturned” and I apply that to every patient that I see. My initial consults are usually 1-2 hours in length and I also do lots of preliminary work prior to see a patient as well. I make sure all my patients are now only sent health appraisal questionnaires, but are also evaluated with mood and stress questionnaires for their mental health too.

I really want to delve into every fine detail of a persons life to see what may be driving their disease state and symptoms. It is to also help with diagnosing those that have not been properly diagnosed either. I then write up a comprehensive report for all my patients, with everything they need to do, the changes they need to make, the medicines they need to take, the investigations and testing they need to have and all their step by step health management moving forward. It really is a matter of ‘No Stone Is Left Unturned’ as I mentioned before.

As I mention in this video blog is that the greatest shame is those that come to get the advice and help and then do nothing with it. Just remember that if you do not change anything, or do the work needed, then nothing changes. The key to real change is actually within you.

If you so need help with a particular health issue, or you just aren’t getting the right answers and care, then please book in a time to see me and let me be your guide to better health and getting your life back to normal.

Cancer Pregnancy Endometriosis

Why am I getting bleeding between my periods?

Vaginal bleeding between periods can be common and is not generally a cause for concern. Most of the time women will get just very light pink coloured watery flow, or just some spotting.

There can be many reasons why a woman would be getting bleeding between periods, which includes hormonal changes, injury, or an underlying gynaecological, or health condition.

While bleeding between your periods may not be cause for concern, on one level, the ideal situation is to not have any form of bleeding at all and if you do get bleeding between your cycle, it is a good idea to have this investigated, just to be on the safe side.

What a proper menstrual cycle should be like

I have done quite a few posts on what a proper menstrual cycle should be like, but I will go over this again just briefly

A proper menstrual cycle should be between 26-32 days in length and really only have about 3-5 days flow. Any longer than this can be too long and put a woman at risk of being low in iron, especially if this happens all the time.

The blood flow should be a nice red consistency, no clots, with no stopping and starting, and women shouldn’t have too many digestive disruptions, and really, a woman should not be getting pain with her cycle.

A little bit of distention and knowing the period is coming is fine, but there should not be pain at all. If you have to reach for the pain killers and the heat pack, or are doubled up in pain, this is not normal and you need to get this checked out.

What are the causes of bleeding between periods?

As mentioned before, there can be a variety of reasons for breakthrough bleeding, some of which are no cause for concern at all. Some however do need to be investigated.

Below are some of reasons for bleeding between periods:

Ovulation

When an egg is released from the ovary, it does create a tiny wound, through which the egg will then travel through the tubes and prepare to make its way to be fertilised, or then shed with the menstrual flow. At ovulation, this tiny wound can also create a tiny amount of bleeding, which can be seen as spotting during the ovulatory phase of a woman’s cycle.

Implantation bleeding

When an embryo implants into the uterine lining and begins to grow, many women experience spotting around this time. This is called implantation bleeding. They may also experience some slight cramping at the same time and all of this is quite normal. Some women may then experience some lighter bleeding as the embryo grows further. They usually get some light spotting, which can be a light pink, or a brown colour. Sometimes it can be more like fresh blood. While this is normal, it is a good idea to get this checked out just to be on the safe side and to also put the pregnant mothers mind as ease too.

Miscarriage

Bleeding between menstrual periods can be an early sign of a miscarriage. Many women may not even know they are pregnant and may be completely unaware they are having a miscarriage.  While it is generally thought that once a woman reaches twelve weeks gestation everything is generally going to be ok, miscarriages can occur at any time during pregnancy.

Termination

After having a termination women can bleed for some time after the procedure, or taking the medication to start the abortion process. If bleeding continues and is very heavy, women need to seek medical advice.

Polyps 

Polyps are small growths that can develop in the uterus or on the cervix. They are often a cause for unexplained bleeding between the cycles. Polyps do need to be removed as they can prevent implantation happening and they can also turn cancerous if left behind. Polyps are a very common cause of bleeding between periods.

Fibroids

Fibroids, or myomas (also known as leiomyomas, or fibromyomas) are growths, or benign (non-cancerous) tumours that form in the muscle of the uterus. Up to 40% of women over the age of 40 years have fibroids and as many as 3 out of 4 women develop fibroids in their lifetime.

Fibroids can cause heavy bleeding, extended bleed and painful periods. They can also cause infertility, miscarriage and premature labour. In many women, they will not cause any problems at all. Fibroids are a very common cause of bleeding between the cycles.

Polycystic Ovarian syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a very common condition that can cause irregular periods, absent periods, and can also cause bleeding between periods. PCOS can also cause other issues such as acne, weight gain, infertility and hormonal and emotional disturbances.

Endometriosis or Adenomyosis

One in ten women are diagnosed with endometriosis and many more do not even know that they have it. Endometriosis and Adenomyosis are very closely related, with endometriosis usually being more superficial disease and not confined to the uterus,  and adenomyosis being deep within the uterine tissue. Chronic conditions such as endometriosis and adenomyosis, can cause bleeding or spotting between periods.  These conditions may also cause heavy or painful menstrual periods and cramps between periods. Adenomyosis will usually cause more bleeding symptoms along with pain etc.

Sexually transmitted infections (STIs)

Some sexually transmitted infections (STIs) can cause pain, vaginal bleeding and spotting. If you do suspect you may have a STI, you need to see your doctor for investigation and treatment.

Injury to the vaginal wall

During sexual intercourse the tissue of the vagina can be damaged and this can then cause bleeding. If the vagina is too dry, lack of arousal, and not lubricated enough this is more likely to happen. It can also happen if there is atrophy in the vaginal tissue as well. This is called atrophic vaginitis.  This is more likely to be seen when a woman is going into menopause, or undergoing cancer treatments, or has diabetes.

Menopause or perimenopause

The menopausal stage of life and especially the perimenopause stage, can be a cause of irregular menses and irregular bleeding. It can also cause spotting, or heavy bleeding too. Perimenopause is the period leading up to menopause. This stage of a woman’s life can last for up to 10 years as hormone levels in the body change and can be unstable.

Hormonal contraceptives

Hormonal contraceptives are a common cause of bleeding between periods. They can also cause irregular bleeding and this can be quite usual in the first 3 months of using the contraceptive. If a woman misses takin her oral contraceptive, it can also cause irregular bleeding, or a withdrawal bleed.  Intrauterine Devices (IUD’s) like the Mirena, will often cause irregular periods and irregular bleeding in the first 3 months after it have been inserted. If bleeding lasts for longer than 3 months on any contraceptive, it is a good idea to seek medical advice and get investigated and managed properly.

Emergency contraception

The morning after pill, or emergency contraceptives, may also cause bleeding. If bleeding persists, you should seek medical advice.

Certain cancers

Vaginal bleeding between periods can also be a sign of gynaecological cancers in women. Most bleeding that women get is not serious, but it still needs to be checked.  Cervical cancer can affect women of any age. Bleeding between the cycle, or after intercourse, and pain after intercourse, or unpleasant smelling discharge can be symptoms of cervical cancer and these all need to be checked by your doctor, or gynaecologist.

Uterine cancer tends to occur in women over 50 year of age. One of the early symptoms of uterine cancer can be vaginal bleeding. Uterine cancer mostly affects women are in the menopause and no longer have periods, so this is why any bleeding after menopause needs to be investigate and seen as not being normal.

Stress

Yes, stress can cause abnormal bleeding and also interfere with a woman’s cycle. Increased levels of stress can interfere with hormones and this can lead to bleeding, irregular cycles, or pain with cycles too.

When to see a doctor

If vaginal bleeding between periods is heavy, persistent, or unusual then a woman should go and see a specialist, or a gynaecologist, who is a specialist in this area of medicine. As mentioned previously, while some causes of bleeding are not serious, some are and need to be properly investigated and properly managed medically.

Treatment and prevention

All women should keep a record of their menstrual cycle and when the period starts and how long it lasts for. Any abnormal bleeding should be recorded so that you can show your healthcare specialist if need be. Any abnormal bleeding should be investigated and the treatment will depend on what the underlying cause is.

Women should try and see their healthcare specialist for regular pap smears and regular check-ups for gynaecological health.

If women are getting small tears and bleeding caused from dryness in the vagina, then there are water based lubricants that can be used to help with lubrication and to moisturise the surrounding tissue.

There is no cure for gynaecological and reproductive issues such Endometriosis, but these disease states can be treated and managed to give women a normal life.

Proper treatment of these issues needs a “Team”, or multimodality approach using medical options, surgical interventions, pelvic floor specialists, complementary therapies, hormone therapies, and diet and lifestyle changes. It is about using what works for the individual and not a blanket one treatment fits all approach.

Last but not least, all women should know that period pain is not normal and that irregular bleeding really isn’t normal either. While most causes of bleeding are not life threatening, they still need to be investigated and checked out properly. Never ever put off seeing a medical specialist if you have abnormal bleeding.

If you would like to book in a consultation with me and find out how I can assist you with women’s health conditions, please give my friendly staff a call and they will be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

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Menopause

The average Australian woman reaches menopause at 51 years of age- with a normal range from 40-55. Contrary to the popular concept, the female body does not become depleted of eggs at this time, but the remaining follicles become less and less responsive to hormonal stimulation.

Premature menopause is defined as cessation of ovarian function prior to 40 years of age. About 1% of women will experience menopause before 40.

The approach of menopause is signalled by rising LH and FSH levels as the pituitary attempts to prompt a response by the ovaries.

The menopause signals the permanent end of most ovarian function and hence the menstrual cycle in a woman’s life. Sex hormones don’t only influence reproductive tissues but also have a multitude of other functions including effects on bone and mineral metabolism, cardiovascular function, memory and cognition, effects on the breast and genitourinary system as well as nutrient absorption.

There are a variety of symptoms which are believed to be due to reduced oestrogen levels and approximately 85% of women will experience some of these symptoms to a greater or lesser degree. These symptoms can be summarised as:

Vasomotor symptoms– (these tend to be early onset):-Hot flushes ( or “flashes” as they are called in USA literature), Night sweats, Formication ( a particularly unpleasant sensation likened to ants crawling under the skin – “formica” is latin for ant)

Urogenital Symptoms– (tend to occur about 3-4 years after menopause):-Dry Vagina, Change in vaginal pH, Atrophic vaginitis/altered vaginal discharge, Dyspareunia, Urinary frequency/dysuria/aggravation of stress incontinence

Associated physical changes-these are partly the result of the normal ageing process, but may be accelerated by declining oestrogen levels. These may include decreased fitness and flexibility, changes in distribution of body fat, changes in sleep patterns

Loss of elasticity of skin and support tissues (may result in):- Worsening of uterine prolapsed, Loss of glandular breast tissue ( breast size and texture changes), Skin changes and wrinkling, Less nipple sensitivity and erectile potential, Joint and muscle pain, Skin dryness

Emotional and psychological changes– it is sometimes difficult to separate the hormonal from the personality-driven and situational as the cause for these symptoms, but women at the menopause may complain of such symptoms as:- Anxiety and/or depression, Insomnia, Lack of concentration and poor memory

Effects on Bone– (these effects may not become apparent until some years after menopause) :- Osteopenia/osteoporosis, Fracture and bone pain

There are other symptoms which have been ascribed to declining androgen levels, though the evidence is less clear-cut. These may include such symptoms as:
Change of body shape – increasing fat deposition around abdomen, less at buttocks and thighs
Loss of libido :- Many libido issues are caused by emotional issues and changes to lifestyle rather than being a hormonal issue
Change in body hair distribution– Pubic hair thins, hair on the head may thin or if woman carries the gene for male-pattern baldness may recede at temples and crown. Facial hair may increase.

Treating symptoms of Menopause

The main cause of people seeking treatment for the menopause is for relief from vasomotor symptoms, the main one being hot flushes or night sweats.

There is a lot of misinformation about the peri-menopause and menopause stage of a woman’s life. Some of the peri-menopause (meaning before the menopause) symptoms can start up to 8 years before a woman actually goes into menopause (meaning the menses stop). Then some of the actual menopausal symptoms can last many years after the menses has stopped and this is something that is not discussed enough and often poorly understood by many, including many healthcare practitioners.

Some women with menopausal symptoms do not choose to pursue any medical treatment when they experience it. However, some women have severe symptoms that affect their quality of life, and may need to have medical treatment in the form of hormone replacement.

One of the biggest fears around hormone replacement therapy is the increased risk of breast cancer. You can talk to your specialist, or doctor about these risks before you start any form of treatment. There are now compounded bio-identical hormones to assist menopausal symptoms and these may not have the breast cancer risk factors of conventional hormone replacement medications.

Examples of some medical treatments available for menopause include:

  • Hormone replacement therapy, such as taking estrogen therapy at the lowest, most effective dose.
  • Vaginal estrogen, which is applied directly to the vaginal tissues to aid with elasticity and assisting with vaginal atrophy
  • Antidepressants (SSRI’s), have been shown to reduce the incidence of hot flashes in some postmenopausal women.

Traditional medical HRT can also help with bone strength and reduce the risk factors for heart disease.

Bioidentical Hormones

The Women’s Health Initiative of 2002, issued a warning against the long-term use of traditional hormone therapy (HT) because of the increased risk of breast cancer, but this study was poorly explained and created lots of panic for both practitioner and patient alike. Since then alternative methods, such as bioidentical hormone therapy, have been developed.

Bioidentical hormones  are chemically the same as those that the body produces naturally. As a result, the body should is not able to tell the difference between the hormones it produces and the bioidentical ones. Bioidentical hormones can be made from a variety of sources that span plant and animal products and are said to have less side effects than traditional hormone replacement medications. Many women get great relief from Bio-identical Hormones, but it is important to speak to your healthcare provider about these and if they are suited for you.

Complementary Medicines

Women may also consider trying herbal medicines or other dietary supplements as a means to reduce the incidence of menopause symptoms. There are now many menopausal formulations on the market and anyone wishing to use complementary medicines should speak to a qualified complementary medicine practitioner about what is suitable for them. Never self prescribe natural medicines with consultation from a qualified healthcare practitioner.

Chinese Medicine and Acupuncture

Chinese medicine has been treating and assisting symptoms of menopause for thousands of years very effectively. Chinese medicine and Acupuncture may assist menopausal symptoms, along side medical interventions. (1,2,3)

The key to Chinese medicine treatment is that a practitioner will assess and treat each person individually, not with the one treatment fix all plan. We aren’t all the same so why should we all be given the same treatment.

It must be noted that up until recent times the Chinese did not have a word for Menopause and that very few women experienced any of the symptoms of menopause. The only ones that did seem to were the rich and those of noble heritage, who ate very rich and luxurious diets. This does show that diet and lifestyle factors do affect menopausal symptoms.

Many used to believe that the Chinese women didn’t get menopausal symptoms because of their higher consumption of phytoestrogens such as soy. This has now been proven not the case, as soy products “do not” have any benefit to menopausal symptoms, but adherence to proper diet and lifestyle improvements does.

There is also some really good evidence to show that acupuncture may assist with hot flushes and also assist with other symptoms of menopause. (1)

Things to do at home

In addition to medical and complementary medicine treatments, there are many at-home treatments that a woman can do to reduce menopausal symptoms. These include:

  • Avoiding triggers that are know to make hot flushes worse. Examples can eating spicy foods, drinking hot beverages, acidic foods,  being in hot weather, or being in hot rooms.
  • Using water-based vaginal lubricants during sexual activity to reduce discomfort due to dryness and thinning tissues. Vaginal estrogen creams may be needed as well.
  • Reduce Stress & Practicing stress-relieving techniques. Examples can include mindfulness, Tai Chi, Qi Gong, meditation, yoga,  journaling, massage, counselling and other forms of relaxation therapy
  • Do not smoke. Smoking can increase the risk of hot flushes and contributes to many other health issues such as certain cancers.
  • Do Weight Baring Exercise. Weight baring exercise is needed to keep strong and health bones and it also has other health benefits. You can also look into doing yoga and pilates to help with core strength and to help with pelvic floor strength and tone. Exercising can also help to relieve stress.
  • Pelvic Floor Exercises. Kegels exercises or use of Vaginal eggs (ask about The O-VA), or Ba Wen Balls, can help with pelvic floor muscles and increase blood flow into the vagina and pelvic floor area and also help with bladder control. (4)

Summary

It must be noted that menopause is a normal part of a woman’s life and menopause is not a medical condition. The main reason that women seek help in menopause for is the menopausal symptoms such as hot flushes, dryness and loss of libido etc.

At my clinic I use a multi-modality and individualized approach to assisting the symptoms of menopause, while working alongside medical interventions and treatments.

Regards
Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Experts

-The Women’s Health Experts

References

  1. https://bmjopen.bmj.com/content/9/1/e023637
  2. Yao SA. Review on the research and development of Chinese medicine in menopausal syndrome (in Chinese). J Tradit Chin Med 1994; 35: 112-114.
  3. Li CJ. Menopausal symptoms. In: Dai DY, editor. Current application and research of Chinese medicine and pharmacology: gynecology. Shanghai: Shanghai University of Traditional Chinese Medicine Publishing House, 1995; 174-182
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462060/
Atrophic Vaginitis

What causes a burning sensation in the vagina and around the vulva?

A burning sensation in and around the vaginal, vulva area is a relatively common complaint that many women experience and something that is seen by healthcare practitioners very often.

There are so many different causes of vaginal and vulva burning, including irritants, sexually transmitted diseases, atrophic vaginitis, thrush, lichen sclerosis, climates changes and is very common in peri-menopause and the menopause period. Each of the causes has its own set of symptoms and the treatments can all vary, depending what the cause it.

In this article we will look at the common causes of having a burning sensation in the vagina and around the vulva area. We will also look at treatments and management of these as well.

Before we start, it is important that women know that often people use the wrong term for the vagina and the surrounding area and often refer to a woman’s genitals as just being the vagina. It is important that we use the correct terms for a woman’s anatomy so that we can correctly identify were problems are.

The vagina is more the internal part of the female genitals and the vulva is the external part. Th Vulva is an umbrella term for the various parts of the external female genitals. These parts include:

  • Mons pubis – the fatty ‘pad’ that’s covered in pubic hair
  • Labia majora – outer lips
  • Labia minora – inner lips
  • Clitoris – small organ that’s packed with nerve endings
  • Urethral opening – which allows the passage of urine
  • Vestibule – area around the opening of the vagina
  • Perineum – area between the vagina and anus

Now that we understand the proper terms for the anatomy, lets have a look at what some of the common causes of burning sensation are.

Common causes of vaginal and vulva burning sensation

1.Skin Irritation

There are many things that can irritate the skin of the vulva and vagina when they come into direct contact with it. This is known as contact dermatitis.

Irritants that can cause contact dermatitis, inflammation and burning symptoms include non pH neutral soaps, certain fabrics, perfumes, vaginal hygiene sprays, some lubricants and allergens. As well as burning sensations, women may experience the following:

  • severe itching
  • redness and rawness and sometimes bleeding
  • stinging feelings and sensations of heat
  • pain and sometimes

The main way to treat irritation is to avoid whatever has caused the irritation in the first place. Avoiding the irritant and allowing the inflamed area and the skin to heal is one of the best things to do. Sometimes, a woman may require medications to settle the inflammation, or dermatitis down.

2. Candidiasis (Thrush, Yeast infections)

An overgrowth of bad bacteria in the vagina can lead to a burning, stinging sensation and one of the common causes of issues for women. Candidiasis, or thrush is very common in women and is causes through changes in the gut and vaginal flora and this then leads to overgrowth of bacteria, which causes many of the following symptoms

  • itching
  • soreness
  • pain during sex
  • pain or discomfort when urinating
  • discharge from the vagina (either white, or coloured)

Women are more likely to be prone to getting thrush if they are taking antibiotics, using certain form of hormones and contraceptives, have a weakened immune system, live in humid climates, have diabetes, are pregnant, or not cleaning themselves properly. High stress can also lead to changes in the gut and vagina flora and this can also lead to thrush.

Thrush is usually an antifungal medicine called azoles. Azoles can either be used internally into the vagina, or taken orally as a capsule, or both at the same time. Pre and Probiotics should be taken to help build up the good bacteria and women should take care with personal hygiene. Partners may also need to be treated to prevent further reintroduction of thrush via sexual intercourse.

3. UTI- Urinary tract infection

When a woman has a urinary tract infection (UTI), she will be likely to feel burning in and around the vagina when urinating. There may be other presenting symptoms such as:

  • needing to urinate more frequently, or have urgency to urinate
  • pain with urination
  • smelly, or cloudy urine
  • blood in urine
  • pain in lower stomach and radiating pain into the back and kidney area
  • feeling tired or unwell

When a woman has a urinary tract infection antibiotics will be needed and the antibiotics needed will depend on what the cause of the infection is. Usually an infection will clear up in around 5 days after starting a course of antibiotics.Repeat medication may be required if an infection returns.

4. Bacterial Vaginosis (BV)

Bacterial Vaginosis (BV) is the most common vaginal infection in women aged 15 to 44. Bacterial Vaginosis (BV) is a condition that occurs when there is too much of certain kinds of bad bacteria in the vagina, affecting the balance of good bacteria and flora. One of the main symptoms of BV is a burning sensation in the vagina, which can also occur when urinating.

BV does not always cause symptoms but when it does cause symptoms, besides a burning sensation, it can cause the following:

  • white or gray vaginal discharge
  • pain and irritation
  • itching and redness
  • strong fish-like odor, especially after sex (one of the key symptoms)

Having BV can increase a woman’s risk of STI’s and it can also increase her risk of miscarriage, once she is pregnant. If you think that you may have the symptoms of BV, you need to have it check by your doctor as soon as possible. BV is usually treated with antibiotics and you can use complementary medicines to assist in the treatment as well. It is a good idea to restore the good bacteria into the gut and vagina as well. This can be done through the use of prebiotic and probiotic bacteria combined.

5. Trichomoniasis

Trichomoniasis is a common STI and is caused by a parasite that is passed from one person to another during sexual intercourse. Many people may not know that have Trichomoniasis, but symptoms can present with a burning sensation and may  also present with  the following:

  • itching, redness, or soreness
  • discomfort when urinating
  • women can have vaginal discharge that can be clear, white, yellow, or green and with a fishy smell

Trichomoniasis can increase a woman’s risk of miscarriage, so it need to be treated asap. Trichomoniasis is treated by using certain forms of medicines called azoles.

6. Gonorrhea

Gonorrhea is an sexually transmitted infection where bacteria called Neisseria gonorrheae infect mucous membranes, such as the cervix, uterus, and fallopian tubes. If a woman is infected with gonorrhoea she can experience vaginal burning when urinating, as well as the following symptoms:

  • pain when urinating
  • vaginal discharge
  • vaginal bleeding between periods

Gonorrhea can be cured with the right medical treatment and it needs to be treated with specific medications. Often dual forms of medication are used for effective treatment.

7. Chlamydia

Chlamydia is a common STI caused by the bacteria Chlamydia trachomatis and is  transmitted through sexual intercourse with someone who has the infection.

If a woman comes in contact with chlamydia through intercourse, many times she may be asymptomatic (meaning no symptoms) and this is why it is often known as a silent infection. When symptoms do occur it can cause a burning sensation in the vagina and surrounding area. There can be other symptoms which include:

  • increased vaginal discharge
  • pain with urination and pain during sex
  • bleeding during sex and between periods

Chlamydia can cause damage to a woman’s reproductive organs and can affect her fertility, so it is important to have this treated as soon as possible.  Chlamydia is treated using specific high dose antibiotics. Treatment may also require IV antibiotics and for someone to be admitted to hospital while these are being administered.

8. Genital herpes

Genital herpes is a common sexually transmitted disease caused by skin-to-skin contact with a person with the herpes virus. Once a person has the virus, it stays with them for life. Sometimes the virus can remain dormant and then at certain stages of life (during stress, illness etc), it can become active and start producing symptoms.

If the virus becomes active, they might experience a burning sensation in the vagina, along with some of the following symptoms:

  • an itching or tingling sensation
  • flu-like symptoms
  • swollen glands
  • pain in the vaginal area, particularly when urinating
  • change in vaginal discharge

Painful sores, blisters, or ulcers may also develop after a few days. The symptoms of genital herpes can be treated with antiviral medication but once you have herpes, it cannot be cured. You just need to manage it and its symptoms.

9. Lichen sclerosus

Lichen sclerosus is a skin condition that affects the vulva area in women. Lichen sclerosus can cause burning sensation around the vulva area. It can also cause the following symptoms:

  • itching and tenderness.
  • Pain
  • Scarring
  • Wrinkling and white patches

Postmenopausal women are most susceptible to have lichen sclerosus. The cause is thought to be an autoimmune response of some kind, since the condition is associated with autoimmune disorders such as Graves’ disease and vitiligo. Treatment includes topical steroid creams, other medications, silica cream, zinc cream and regular medical monitoring. Lichen sclerosus is linked to an increased risk of vulvar cancer.

10. Menopause

Vaginal and vulva burning can be as a result of the perimenopause, or menopause stages of life. The shifting levels of hormones in a woman’s body before she enters menopause can affect the vagina and surrounding area. Burning sensations, in the vagina and around the vulva area is one possible result of these changes, especially during sex.

Some of the common symptoms of the perimenopause/menopause period are:

  • hot flushes & night sweats
  • difficulty sleeping
  • reduced sex drive
  • vaginal dryness
  • headaches
  • mood changes
  • Pain with sex
  • Atrophic vaginitis.

Not all women entering menopause have treatment to relieve symptoms, but there are often options available that a doctor, or healthcare practitioner, can outline, including hormone therapy. There are also many natural therapies that can help during peri-menopause and menopause stages of life.

What you can do to help yourself

Many causes of vaginal burning require medical treatment. If you are concerned, the best you can do is to see your healthcare practitioner. There are things you can do before seeing your doctor. Sometimes a ice pack or cold compress to the affected area can help reduce the burning sensation. You can also try some over the counter soothing creams, or antifungals.

Make sure you are practicing proper hygiene and cleaning the outer area of the vulva properly. Women should avoid using douches, which can affect the good bacteria and internal flora of the vagina.  Wearing cotton underwear and avoiding tight-fitting clothes can help reduce irritation in the vaginal area. It is also important to avoid products that could irritate the area further, such as perfumed soap, scented toilet paper, and sanitary products with deodorant, or a plastic coating.

Possible complications

Some causes of vaginal burning, such as urinary tract infections, BV, STI’s, lichen sclerosis can have some serious complications if left untreated. Cancer also needs to be ruled out so this is why it is important to have any symptoms of burning checked out by your doctor.

STI’s can affect future fertility and are also harmful to women who are pregnant, as they can affect their baby, or pregnancy. Many STI’s can cause preterm delivery and also increase the risk of miscarriage.

While some causes of vaginal and vulva burning may go away on their own over time, it is still important to go and get your doctor’s advice just to be safe. If your symptoms aren’t going away, are becoming worse, or are of a concern, then the woman should go and see a doctor as soon as possible. The longer you leave something, the worse it can get and the more issues it can cause, if left untreated. Many of the cases of burning sensation in the vagina and around the vulva will be relieved once the underlying cause is treated properly and with the appropriate medicines.

While medical options will be needed for some conditions, there are complementary medicines and complementary medicine modalities that may be able to assist your particular issue, or alongside medical treatments. Please always see a qualified healthcare practitioner and not use Dr Google, or take advice from friends or family for any medical advice.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

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Stop Telling Women That Period Pain is Normal

After seeing my 10th case of misdiagnosed Endometriosis this week, and goodness knows what else, I can say that I am well and truly over it and about to scream.

I am about to scream if I hear that one more woman, young or old, is told by their healthcare professional, GP, specialist, best friend, mother, facebook buddy etc, that period pain is normal.

Period pain IS NOT normal. It is far from normal and we all need to stop telling our daughters, sisters and women of this world that it is.

I think that anyone that says that need to come and work with me for a day and see the ramifications of women believing that period pain is normal, just because their doctor, healthcare professional, friend, or mother told them that it is.

I think I should post up some rather gruesome pics of women’s reproductive organs stuck together, their insides bleeding, and their pelvis completely obliterated. Yes, obliterated. That was the words that one of the surgeons used today to explain the insides of a woman that had been told that there is nothing wrong, just suck it up, scans haven’t found anything and just go on the pill and btw, period pain is normal.

No it bloody well isn’t (sorry for swearing but time for diplomacy is over). Women need a voice and need to be heard. Some of these poor women may not be able to have children, or have a healthy sex life, or be able to feel the pleasure of wonderful sex without pain, or ever hold their own baby, because they have been told to suck it up and be told that period pain is normal.

Period pain IS NOT normal and the sooner we get everyone to know this important fact the better. Sure, a little bit of discomfort can be normal. By that I mean just a tiny bit of pressure and basically knowing your period is about to come. But pain…. That is not normal. If you, your friend, your daughter, your sister, your wife, or any other woman you know, has to have days off work, days of school, is laying on the floor in pain, taking pain killers to get through the day, or beginning of their period, then that IS NOT normal.

Please get them to get a referral and see a good specialist who will listen to them and not dismiss them and may miss a gynaecological issue that could affect them for the rest of their lives. No… scans and blood test etc, do not always find the cause of period pain. Have a read on my other posts about this.

If you cant find someone that will listen and help, then book in a consult with me and I will assist you in getting you properly investigated and properly managed moving forward

My motto is “No Stone Left Unturned”and my other motto is “Period pain IS NOT normal”. If you are in pain with your menses, or even any any other time during your cycle, or having pain with sex, or pain with ovulation, pain with bowel movements, pain for no known reason at all, then you need to get something done about it.

I think if I hear one more poor woman get told that Period Pain is normal, I am going to start sending those people gruesome pics of all the insides of women who have been told that period pain is normal, only to find out that it isn’t and all the reasons why.

Sorry for the rant, but our daughters, our sisters, our wives, our female partners and women all over this world deserve better.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

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Asking the Right Questions about Period Pain & Gynaecological Issues.

All to often women have gynaecological disease states “missed” and “dismissed” because their healthcare practitioner was not asking the right questions about period pain and gynaecological issues.

I didn’t know how I was going to start this post, or begin to talk about what I am about to talk about, other than I got some inspiration after a text message, and a phone call later on,  from my eldest daughter some time ago.

I will talk about that soon. But let’s talk about some of the phone calls and messages I get from people every day and how some of these messages gives me a heads up into what may be going on for these people and then getting them in for a proper consult and the right help.

Every day I get phone calls, emails, Facebook messages etc, from women (young and older) who are experiencing period pain, menstrual issues, and other related symptoms and nearly all of them have the same story.

“I have been to the GP and I have had blood tests and scans and they say that there is nothing wrong”. This is what I hear all so often.

It happens so often and it is like there is a script written for these poor women who just want to get out of pain and get some sort of normal life back. I get so annoyed when I hear this repetitious line. Not at the people telling me, but knowing that these poor women really haven’t been investigated properly at all and probably won’t be unless they come and see me.

I remember I got a text that I really wasn’t expecting, as it was from my eldest daughter.

It read “Hey Dad, is endometriosis hereditary?”

To which I replied “Yes it can be, why?”

I anxiously awaited the next reply and thankfully she was asking on behalf of a friend. But this poor friend had been experiencing really bad period pain and had basically had blood tests and scans and been told that everything was normal.

Apparently one of the scans showed some fluid in the Pouch of Douglas (POD), which can actually be a sign of endometriosis and inflammation. Worse still, this poor girl’s mother actually has endometriosis and nobody is putting two and two together and asking the question “I wonder if the daughter may have it too?”

Well, there is more than a good chance that she does have it and thank goodness my daughter actually knows the signs and knows that scans and bloods tests cannot diagnose many gynaecological issues, especially endometriosis.

Lucky my daughter also knows that you need to see an advanced trained laparoscopic surgeon who specialises in the excision of endometriosis and has done years of extra surgical training to specialise in these disease states. The good thing is that she knows that you cannot just see a regular gynaecologist to get this done.

But, not everyone is as fortunate as my daughter to know this and help her friend to come and see me to help her see my surgeon and then I can help her with management of the disease, if found (which is highly likely) after the surgery.

The other good thing is that my daughter knows there is no cure for endometriosis and that surgery isn’t going to fix the problem either. She knows it will help, and is needed, but after the surgery, the management post surgery is the most important, for disease states like endometriosis.

Unfortunately not many people know this and don’t have the disease managed properly post surgery. Women with endometriosis and some other inflammatory gynaecological issues will need a team approach, or a multimodality approach  post surgery, because even with the best medical intervention, it really isn’t enough and why so many women have the disease and symptoms return, or may still be in pain and have other recurring symptoms.

There is never a one treatment, one pill, fix all approach to disease states such and endometriosis. This is where so many go wrong.

One of the main issues for women can be that they really have not seen the right healthcare professions, especially the right surgeon and unfortunately this is many of the women that have had surgical intervention. This one is so important.

Whenever I get messages from women in pain, or I consult with women who have period pain and all the other associated symptoms, there are some standard questions I ask, to know if they have been given the right information, been diagnosed properly, or seen the right surgeon.

  1. I always ask “what tests have you had done?” – I know that if they have only had blood tests and some scans, then these women have not been investigated, or diagnosed properly.
  2. Then I usually ask “Have you just seen your GP, or have you seen a specialist?”– Most of the time many women have not been referred onto a specialist and have only just been seen to by a GP. This is one of the biggest issues women face when it comes to gynaecological conditions. GP’s are just general practitioners. They are not gynaecologists and definitely not advanced trained laparoscopic surgeons. The best thing any woman can do is ask for a referral to a specialist and a good GP should know to do this anyway. This is one of the biggest reasons that women from all over the world take up to a decade to be diagnosed with disease states such as endometriosis. On a daily basis women are missed and dismissed and told there is nothing wrong, go on the pill, or that they have some inflammatory bowel condition, when in fact they have endometriosis, or adenomyosis, or some inflammatory gynaecological issue. Btw, this isn’t to put GP’s down, unfortunately this is what happens to so many women and why it often takes up to a decade for women to be diagnosed with diseases such as endometriosis. This is an unfortunate fact and it needs to change.
  3. Then I ask “Have you had a laparoscopy?”– One of the most common responses is “What is a laparoscopy?” and that way I know they haven’t had one done. A laparoscopy is the gold standard investigation of the pelvis and the only way to properly diagnose disease states and causes of period pain, such as endometriosis.
  4. If the woman has had surgery I then ask “was the surgery done publically, or privately?” – This will tell me a few things. It will let me know if it was just done be a public surgeon, who probably isn’t an advanced trained laparoscopic surgeon. The issue is that there really aren’t that many advanced trained laparoscopic surgeons that do public work, and even if you strike the jackpot and do happen to get one, there is a good chance they are only in a teaching role to instruct a trainee surgeon to do the surgery anyway. But mostly women do not get an advanced trained laparoscopic surgeon in the public system. It is sad, but true unfortunately. Many times the first surgery in the public sector is purely investigative too and no excision (disease removal) is performed. This means that the woman has to come back for further surgery, or surgeries.
  5. If they the woman has had surgery done previously by a private specialist then I usually ask “Who was the surgeon that did your investigation and surgical procedure?” – Sometimes I can ask if the surgeon was an advanced trained laparoscopic surgeon and the patient usually will respond to not knowing, or even know what I was talking about. That usually gives me a clue that it most probably wasn’t, but then I can go and check the specialists qualifications online and see if they are, or most probably aren’t, an advanced trained laparoscopic surgeon who has done years of extra specialised surgical training.

All those 5 questions can tell me much about what some of these poor women have had done, or haven’t had done, and then I can formulate an appropriate treatment plan and management for these women moving forward.

It is always hard explaining to the ones that have had surgery before that they haven’t seen the right surgeon and that they are going to need further surgery. The hardest thing for me is seeing women on support pages about to have their first surgery and I always worry that they aren’t seeing the right surgeon and if they don’t, there is a good chance that they are still going to be going through the same issues, over and over again, until they find the right person to help them.

If only I could see all these women before they did anything, so that they can be given the right information and the facts and be managed properly.

The good thing is that when I do get to see women who chose to see me, I can explain to them the facts and the right information and then why and how with a proper surgeon, that it can make a huge difference to how they are feeling and their recovery and management post surgery.

I can also explain how surgery really is necessary, but is only a small part of their overall treatment and management of their disease moving forward. I can also explain the facts around their disease moving forward too and make sure that women under my care are given the right information, the right investigations and right management going forward.

This is why my initial consultations take about an hour and a half and we go over everything from their health history, medical history, hereditary issues, diet, lifestyle, surgical intervention, medications, natural medicines, blood tests, scans, investigations, sleep, sexual health, libido and everything that a woman needs to know about her particular issues.

It is also about listening to a woman’s concerns and complaints and really hearing what she has to say and is experiencing.

Then I formulate a treatment plan and management and 20 page report of findings for them for what we are going to be doing to help them moving forward.

I also give them a step by step treatment plan of treatments and medicines etc they will need too. That is why my motto is “No Stone Left Unturned”, because there is no stone left unturned and I also make sure they see the right people (surgeons and anyone else that they may need to see).

If there are things that I can’t do (surgery etc), I make sure that my patients only see the best people, in my trusted network,  and then I can help manage their disease state alongside other specialists and medical interventions.

I wish I could see every woman before they went for any investigation, or surgery, so I can point them in the right direction and help them manage their gynaecological condition properly.

This is why I am so passionate about doing my posts on social media, or giving time for charity events to talk about women’s health issues and gynaecological issues such as endometriosis, adenomyosis and PCOS.

It is why I do healthcare practitioner education and seminars to help educate them better too, so that they can help their patients better and not miss and dismiss them.

I just hope that I can help those who have not been heard and that have been missed and dismissed. I also hope we can get people to listen to the things I have presented above and also help women get a voice, be heard and get government listening and get more education to younger women too.

Lastly, I cannot say it often enough….. Period Pain “IS NOT” normal and if you, or your daughter, or your sister, or your mother, or cousin, your best friend, or anyone you know has period pain, especially bad period pain and other symptoms, please, please, do not tell them that this is normal.

Period Pain is not normal and women who are experiencing period pain need to see someone who specialises in women’s health and gynaecological conditions, so that they can be investigated properly and have their issues managed properly too.

If you do need assistance with a women’s health issue, you can make a booking to have a consultation with me. Please call my friendly staff to find out more.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Care Advocate

-The Endometriosis Experts

-The Women’s Health Experts

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Atrophic Vaginitis

Atrophic vaginitis is a vaginal disorder that usually happens after menopause, but it can happen long before this time as well. When estrogen levels fall, the vaginal walls can become thin, dry, and inflamed. This then causes the surrounding tissue to lose its elasticity and become atrophied.

This can be uncomfortable and it can make sex uncomfortable, or extremely painful. Gynaecological conditions such as endometriosis, adenomyosis and fibroids can make someone more prone to atrophic vaginitis as well.Many women that have atrophic vaginitis may not even know that they have it.

As many as 40% of postmenopausal women experience symptoms of atrophic vaginitis after menopause, but only 20 to 25 percent will seek medical help.

Many women will not seek treatment because they feel embarrassed due to the sensitive nature of the condition. Some women just put up with it believing it is normal.

Untreated, it can affect a woman’s quality of life and even lead to increased risk of prolapse and other gynaecological and urological conditions. Many of the treatments are non-invasive and are very effective in a short amount of time.

Symptoms of Atrophic Vaginitis

  • vaginal dryness
  • pain during sexual intercourse, or dyspareunia
  • thin, watery, yellow or gray discharge
  • paleness and thinning of the labia and vagina
  • irritation when wearing certain clothes, such as tight jeans, or when on a bike seat
  • more frequent urinary tract infections (UTIs), or urinary tract like infections(which is from inflammation, with no infection present)
  • Vaginal Prolapse

Symptoms can also present in issues with the bladder and urination

  • painful urination
  • blood in the urine
  • increased frequency of urination
  • incontinence
  • increased likelihood and occurrence of infections, or irritation to the bladder that may feel like an infection

There may also be a reduction in pubic hair, and the vagina may become narrower and less elastic, which may cause a condition called vaginismus.

Causes

During perimenopause, menopause and post-menopause, a woman can have decreased levels of estrogen. When the ovaries stop making estrogen after menopause, the walls of the vagina become thin, and vaginal secretions are reduced. Similar changes can happen to women after childbirth, but these changes are temporary and less severe.

These same changes can happen for women with endometriosis and adenomyosis and often why there can be changes to the wall of the vagina. Some of the medications used to help these conditions can also cause thinning of the vaginal wall and surrounding area. Many women with endometriosis, adenomyosis, fibroids etc, will have increased risk of atrophic vaginitis during the perimenopause, menopause and post-menopausal period.

Medications, or hormones, can be used as part of the treatment for breast cancer, endometriosis, adenomyosis, fibroids, or infertility to reduce estrogen levels. This decrease in estrogen can lead to atrophic vaginitis.

Other causes of atrophic vaginitis include:

  • severe stress
  • depression
  • Surgery, or treatment to the pelvic area
  • uncontrolled diabetes
  • rigorous exercise
  • chemotherapy

Other substances that can cause further irritation to the vagina are:

  • smoking
  • soaps
  • laundry detergents
  • lotions
  • perfumes
  • douches
  • tampons
  • yeast infections
  • condoms (due to latex allergy)

Diagnosis

The best person to see for this condition is a pelvic floor/urodynamic specialist, or a women’s health specialist. While you GP can help with diagnosis of this condition, it is preferable to see a specialist who has more training in this condition and can help manage this moving forward. A specialist will carry out proper examinations, be able to diagnose this correctly and ask about medical history. They may ask about the use of agents that can irritate the area and cause or aggravate symptoms, such as soaps or perfumes.

Your specialist will also do tests to rule out STI’s and other possible causes of infections such candidiasis, bacterial vaginosis etc. Atrophic vaginitis can make the area more susceptible to becoming infected. It can occur alongside an infection. A diabetes test may be performed to rule out diabetes. A biopsy may be taken to rule out cancer.

Treatment

The first line treatment is usually conservative treatments with topical estrogen creams inserted into the vagina and focuses treatment on the affected area. A low-dose estrogen cream can be used to stimulate rapid reproduction and repair of the vaginal wall, tissue and cells. Women should be shown how to insert the creams with an applicator and then use their finger to help disperse the cream properly to get good coverage of the vaginal wall.

Creams are much better than pessaries, because pessaries often do not disperse well and may only give coverage to a small area. These creams are also safe to use for those at risk of certain cancers, or who have had hormone dependent tumors.

Some women may also need to take Hormone Replacement Therapy (HRT), in the form of a tablet, gel, patch, or implant to supply estrogen to the whole body. These estrogens are effective, but there may be side effects. Patients should discuss the risks of long-term HRT (especially breast cancer risk) with their healthcare practitioner.

Some women may also need to use a water-soluble vaginal lubricant may help to provide relief during intercourse, for mild cases.

Regular exercise is important, as it keeps blood flow and genital circulation high. Pilates and yoga may be beneficial for the pelvic floor and core stability and should be part of a woman’s overall lifestyle management. Women in the perimenopause and menopausal periods of their life should be doing some form of weight baring and strengthening exercise regularly.

There are also natural medicines that may assist in the treatment of  atrophic vaginitis. Acupuncture and Chinese herbal medicine may help and assist with the symptoms of atrophic vaginitis (such as pain), alongside medical treatments.

Prevention

Regular sexual activity and stimulation of circulation to the vagina can help prevent atrophic vaginitis. It is more around climax helping, rather than just sexual activity, or intercourse. Some women have pain during intercourse, or experience dryness, so foreplay and being well lubricated can help this. Using a water-soluble vaginal lubricant can soothe mild cases during sexual intercourse. Masturbation and stimulation without intercourse to produce climax may help those women who have pain with intercourse, or who may not have a partner.

Regular climax and sexual activity can also show benefits for both the elasticity and flexibility of the region. Women who have regular climax and are sexually active report fewer symptoms of atrophic vaginitis when compared to women who do not regularly climax, or have regular sexual intercourse.

Regular exercise, such as Pilates and Yoga may assist in helping with the pelvic floor, vaginal tone, bladder and reproductive organs. Kegels exercises, and vaginal eggs/stones may also assist with atrophic vaginitis, alongside medical interventions.

There are natural medicine which may assist with the prevention of atrophic vaginitis and assist with circulation and hormone regulation. To find out more, please consult your healthcare provider.

Fast facts on atrophic vaginitis

  • Atrophic vaginitis refers to dryness of the vagina.
  • Symptoms include painful intercourse and an increase in urinary tract infections (UTIs), or urinary tract like infections (due to inflammation of the bladder, not from infection).
  • It is caused by a reduction in estrogen, normally following menopause or treatment with anti-estrogen drugs. It can also be caused from gynaecological conditions such as endometriosis, adenomyosis and fibroids.
  • Topical treatments and hormone replacement therapy (HRT) may help relieve symptoms
  • Around 40 percent of postmenopausal women experience symptoms of atrophic vaginitis, but many do not seek treatment.

If you do need help with suspected atrophic vaginitis,please see your healthcare provider, or see a specialist in this area.

Take care

Regards

Andrew Orr

– Women’s and Men’s Health Advocate

-“No Stone Left Unturned”

-The Women’s Health Experts