Tag Archives: Pain With Intercourse

Lets talk about sex 1

Let’s Talk About Sex- How often, what’s normal & how to boost that libido

Posted on by

Sex is something that nearly every human on this planet gets to experience, and for each person, the experience of sex can be different. Many people have different perceptions on this important topic, so lets talk about sex, how often, what’s normal and how to boost that libido in those having issues.

As a healthcare practitioner who is a Master in Women’s Health Medicine and a Master of Reproductive medicine, I have to talk about the topic of sex on a daily basis. A lot of people come into my clinic (both men and women) with varying expectations and thoughts on what is normal, when concerning sex. Unfortunately a lot of people are way off the mark when it comes to a healthy sex life and what a healthy libido should be.

Libido is influenced by our health

If you do not have a healthy libido, there could be something wrong with your health. Yes, what you eat, think, do etc, all plays a part in your sexual appetite. But, we can all have differing libido’s and it is important to understand this and seek help if you are having issues. A healthy libido is a sign of a health body and healthy mind.

What defines a healthy sex life

The average healthy human being in a healthy relationship should be having sex at least 1-3 times per week, depending on age etc. I know a lot of you are lucky to be having sex 3 times per month.

What’s concerning about this is, some of these people are trying to have a baby and can’t understand why they aren’t falling pregnant. The answer is obvious, but, I’ll say it anyway, you have to have sex regularly to fall pregnant and it has to be at the right time. You need to be trying every day, or every second day of your cycle as we now know ovulation just doesn’t take place mid-cycle only.

Clinical research shows that more than 70% of people are ovulating before day 10 and after day 17 of their cycle. So if you are just trying it that small window of day 10-16, this could be the reason you aren’t falling. Btw, don’t stop having sex just because you are doing IVF. Sex (climax in particular) helps with implantation so stopping having sex is only hindering your chances of conception. I have talked about this is a previous post (click here to read)

We also now know that sperm also play a part in a health menstrual cycle as they help to trigger certain hormones to trigger ovulation and thus help with regulation of the menstrual cycle. It may explain why women using barrier methods of contraception have more issues with irregular cycles and menstrual issues. Not that we are promoting unsafe sex mind you. This is for couples in a healthy relationship. I have spoken about this is a previous post too (click here to read)

Why is climax/orgasm so important

Climax also stimulates blood flow into the uterus; helps trigger certain hormones and also helps with implantation. Climax also helps ones libido and it can even help in the treatment of depression.

We also hear the jokes about men and their ever-constant desire to have sex, but most of the time this is greatly exaggerated. In practice I am actually seeing that women are now the ones with the higher libidos and it is the men that are having all the problems. Stress is a big factor these days. We are also seeing many men with testosterone deficiency. Being overweight and unhealthy physically and mentally can be a factor also.

It has also been shown that regular sex, even if scheduled, actually helps with the libido and helps with the desire around wanting more sex.

Understanding differing libido’s

Men and women are different when it comes to libido and the desire around sex. Men need to understand that it can often take all day for a woman to arouse her desire around wanting sex. Men need to know that women need to be wooed, given playful thoughts, mind play and a place to feel safe to get her into the mood for sex. Guys, apparently helping out around the house also helps (hint, hint)

Intimacy is more than just sex

Remember sex is a healthy part of a relationship and a healthy libido shows good health. Sex is also a way of connecting with your partner and couples should find way to prioritise each other so that this connection happens regularly. It is also about intimacy and that sacred intimacy, which is on a whole other level to the physical act of just having sexual intercourse.

What affects a libido?

Many people do talk about having differing libido’s, or having trouble with libido, and it is important to understand what may be affecting ones sex drive.

So, what are some of the main things that effect libido?

  • The Pill – First and foremost, the pill for women. Anything that decreases fertility can decrease your sexual desire. The pill also turns off certain receptors responsible for conception, which can then turn off the libido.
  • Stress – Constant low grade, or high grade stress, is a big problem when it comes to loss of libido. It can cause impotence & erectile dysfunction in men and loss of libido and menopausal symptoms in women.
  • Medications – Drugs such as anti-depressants, the pill, anti-inflammatories, and lots of other medications can ruin your sex life. They can also delay or stop orgasm. There are some that can improve it too. Not many!
  • Alcohol and recreational drugs– This one is pretty self explanatory. We’ve all heard the saying ‘Fosters flop’ from drinking too much beer. Drugs such as marijuana, speed, and other illicit drugs can all impair libido
  • Sexual Abuse– A history of sexual abuse can definitely affect the sex life. This needs to be dealt with by speaking to a counsellor, psychologist or sex therapist.
  • Health Problems– Health problems such as Low Thyroid, Diabetes, being overweight, depression, eating disorders, can interfere with your libido and sex life.
  • STD’s– Some STD’s are often undetected and cause pain and discomfort during sex, which leads to not wanting to have sex. Many of these can be cleared up with medication so that your sex life can return to normal. Some STD’s are there for life but can be controlled. STD’s such as herpes and HIV don’t have to stop your sex life.
  • Gynaecological issues – Some gynaecological disease states such as Endometriosis and Adenomyosis can make sex painful and cause a lack of desire. Have a read of my article about painful sex. Women with PCOS can have low libido as a result of hormonal fluctuations and insulin resistance.
  • Diet– This is a big one. If you eat the wrong foods the body will respond accordingly. Your sex life can be ruined by what you put in your mouth to sustain your body.
  • Exercise– Over-exercising can stop you getting a period and cause fertility issues in both men and women. Reduce the exercise and the libido will respond accordingly. Exercise can also increase libido. It is about moderation.

Final Word

If you are having trouble with your libido there are many medical and natural products that have been shown to assist with low libido and help with a healthy sex life for both men and women. It is important that you talk to a qualified healthcare practitioner about issues to do with sex and libido. You need to see an expert who is trained to know issues that may be causing your particular issues. The can also give you dietary and lifestyle advice to help in this area too.

If you do need help with issues around sex and libido, please give my friendly staff and call and find out how I can assist you. I also have a great network of sex therapists, psychologists and medical specialists I work in with as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-The Women’s Health Experts

 

 

pelvic floor hypertonus 1

What The Hell is Pelvic Floor Hypertonus?

Posted on by

Pelvic floor hypertonus is a condition that not many people hear about, or even know about. Often when we talk about pelvic floor dysfunction many people will automatically think of weak pelvic floor muscles often created from having children, or part of the aging process. This is where the pelvic floor muscles are too relaxing and need tightening and strengthening.

However more and more we are now seeing women, especially young women, with pelvic floor muscles that are too tight and non-relaxed and this is leading to chronic pelvic pain and other pelvic health and sexual health issues. This is called Pelvic Floor Hypertonus. For this article I will be talking about how Pelvic Floor Hypertonus affects women, even though men can have this as well.

What is Pelvic Floor Hypertonus?

Pelvic floor hypertonus occurs when the muscles in the pelvic floor become too tight and are unable to relax. Many women with an overly tight and non-relaxing pelvic floor experience pelvic health issues such as constipation, painful sex, urinary urgency, bladder issues and pelvic pain. Women with pelvic floor hypertonus may also have musculoskeletal issues that cause tightness and tension in surrounding hip, sacrum and pelvic muscles.

Pelvic floor hypertonus is not widely recognized and can often go on undiagnosed. It is certainly on the missed and dismissed list. Unlike in pelvic floor disorders caused by muscles too relaxed and are easily identified (such as pelvic organ prolapse or urinary incontinence etc), women affected by pelvic floor hypertonus may present with a broad range of nonspecific symptoms mentioned previously and below. All these related symptoms require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. Many of these symptoms can really affect the quality of woman’s life.

The signs and symptoms of pelvic floor hypertonus

The main and typical symptom of pelvic floor hypertonus is pelvic pain, or pelvic muscular pain. There can be a wide range of other symptoms including the following:

  • Urinary issues such as urge frequency, frequent urination or painful urination
  • Incontinence
  • Slow flow, hesitancy, or delayed start of urination
  • Constipation and straining when emptying the bowels.
  • incomplete emptying of the bowels
  • pressure feeling in the pelvis and rectum
  • pain in the pelvis, genitals or rectum
  • chronic pelvic pain
  • muscles spasms in the pelvis, or pelvic floor
  • low back pain
  • hip pain
  • coccyx pain
  • painful sex
  • vaginismus

If left untreated pelvic floor hypertonus can lead to long term health issues, colon and bladder damage and can also cause infection.

What causes pelvic floor hypertonus?

There is no one defining cause of pelvic floor hypertonus. Many things can cause non-relaxing pelvic floor muscles ranging from sitting too much, exercising too much, obesity, stress and also chronic inflammatory disease states. Here are some of the causes of pelvic floor hypertonus:

  • Endometriosis
  • Adenomyosis
  • Interstitial cystitis
  • Irritable Bowel Syndrome
  • Pudendal Neuralgia
  • Vulvodynia
  • History of holding onto the bowels, or bladder too long
  • Over exercising and over exercising the core muscles
  • Being sedentary, or over-sitting too long
  • High levels of stress, fear and anxiety
  • Obesity or being overweight
  • Child Birth, or Birth Trauma
  • Injury to the pelvic floor
  • Sexual and emotional abuse
  • Surgery
  • Nerve Damage

It is very important to identify the cause of pelvic floor hypertonus individually and why it is so important to see a healthcare expert, or pelvic floor specialist that specialises in this area. As with many other inflammatory conditions, a multimodality treatments approach is needed and may involved several modalities, or practitioners working together to help the individual. A pelvic floor physiotherapist may also be needed to help with exercises to relax the pelvic floor along with other modalities such as acupuncture to help with pain, relaxation and stress relief.

What are some of the things that can benefit pelvic floor hypertonus?

As mentioned before, it is important to see a healthcare expert who can identify what the cause of the pelvic floor hypertonus is and recommend a management and treatment plan moving forward. This will usually require a multimodality treatment approach, which could involve the following:

  • Pelvic floor muscle relaxation techniques
  • Mindfulness and meditation techniques
  • Breathing techniques
  • Pilates and yoga to help with stretching
  • Advice on better bladder and bowel habits
  • Pelvic floor and core muscle releasing abdominal massage
  • Specific stretches for the pelvis, hips and sacrum
  • The use of vaginal dilators, and/or vaginal eggs to help with relaxing and stretching the pelvic floor muscles
  • Acupuncture to help with pain, stress and relaxation, alongside medical interventions.
  • Massage to help with internal scar tissue (done by a pelvic floor physiotherapist)
  • Warm baths and self care
  • Use of TENS and electro-neuro stimulators to help with pain
  • Biofeedback therapy
  • Pain medications and muscles relaxants
  • Complementary medicines (prescribed by a qualified healthcare professional)
  • Surgery

Outlook and importance of seeing an expert

The main goal of treating and managing pelvic floor hypertonus is to relax the muscles of the pelvic floor to relieve pain and other associated symptoms.

Although living with pelvic floor hypertonus embarrassing or sometimes painful, non relaxing pelvic floor dysfunction is a highly treatable condition. It is important that you talk to a healthcare expert in this area, or a pelvic floor specialist. It’s important not to self-diagnose your symptoms, or try to Dr Google your symptoms, because left untreated pelvic floor hypertonus can lead to long term pain and health issues and also irreparable damage.

There are many conservative management approaches that can be used before resorting to hard-core pain medications, muscle relaxants and surgery. Your healthcare expert will be able to discuss all these options and ongoing healthcare management and treatments with you. The main thing is booking a consultation with a proper healthcare expert to get a proper diagnosis.

If you need help and assistance with pelvic floor hypertonus, or pelvic pain, please give my friendly staff a call and find out how I can assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

 

 

The OVA

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

Posted on by

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.

 

Adenomyosis 2

Let’s Talk About Adenomyosis

Posted on by

As a healthcare practitioner with a special interest in women’s health, more and more I am seeing women presenting with all the symptoms of Adenomyosis. This is why this post is called “Let’s Talk About Adenomyosis”.

Just like endometriosis, many women have had this condition missed and dismissed and then have to suffer the consequences and think that they just have to put up with it month after month.

Some women are completely unaware that they have adenomyosis. Those that have already been diagnosed with endometriosis often believe that all their symptoms are just related to this disease only, when it fact, they could have two diseases creating all their issues.

Many of the symptoms are the same as endometriosis, except that women will usually have heavier menstrual bleeding, or irregular bleeding issues.

Women can have both endometriosis and adenomyosis at the same time and now research is showing that they are basically one in the same disease, but just in different locations.

What is Adenomyosis?

Adenomyosis is defined as the presence of endometrial glandular tissue occurring deep in the endometrial lining (myometrium). The exact cause of adenomyosis is unknown, but current research is showing that it is a similar process to how endometriosis is caused.

Histologically both endometriosis and adenomyosis are one in the same disease state, but just occurring in different locations. We know that both diseases are driven by estrogen and that they have all the same signs and symptoms. Adenomyosis and endometriosis are not caused by estrogen dominance either. Even small amounts of estrogen will drive both diseases.

The only difference between the two disease states is that adenomyosis typically causes more heavy bleeding symptoms. The abnormal bleeding occurs when the ectopic endometrial tissue induces hyperplasia and hypertrophy of the surrounding myometrium. This causes uterine enlargement and subsequent changes in vascularisation (the new vessels may also be more fragile than usual) in addition to an increase in the surface area of the endometrium.

One of the key diagnostics for adenomyosis is the presence of an enlarged uterus on ultrasound, or via MRI. The enlarged uterus can also impact the surrounding structures and often impacts the bladder, leading to urinary frequency and other bladder issues.

Adenomyosis can also have the same bleeding symptoms as fibroids but correct diagnosis and investigations, will differentiate the two and ensure correct management moving forward.

What Are the Symptoms of Adenomyosis?

As mentioned previously, adenomyosis has all the same symptoms as endometriosis. Just like endometriosis, some women often have no symptoms (are asymptomatic), and are only diagnosed when they are having issues trying to conceive.

The main symptoms of Adenomyosis are:

  • Heavy, prolonged menstrual bleeding
  • Severe pain and menstrual cramps
  • Abdominal pressure and bloating
  • Bladder issues (frequency, urge frequency, incontinence)
  • Anaemia

Other associated symptoms such are:

  • Irregular bleeding
  • Pain with bowel movement
  • Irritable Bowel like symptoms
  • Urinary Tract Infection (UTI) like symptoms
  • Fatigue
  • Mental and emotional disturbances (depression, premenstrual dysphoric disorder)
  • Pain with intercourse
  • Infertility
  • Musculoskeletal pain
  • Lack of quality of life

Diagnosis of Adenomyosis.

Ultrasound is the most common (and indeed most useful) first-line imaging tool used to diagnose adenomyosis in a women presenting with any abnormal uterine bleeding. While ultrasound cannot definitively diagnose adenomyosis, it can help to differentiate and rule out other conditions with similar symptoms.

Sometimes saline solution is injected in the uterus at the same time as ultrasound is performed to give better imaging and to help evaluate the symptoms associated with adenomyosis. This is called sono-hysterography.

While trans-vaginal ultrasound (TVU) can be used, it can also miss the disease, especially if the user doesn’t have an expert eye, or extra training, or specialises in the diagnosis of adenomyosis.

MRI is considered a much better tool for the finding of adenomyosis, but it is a more expensive option. Even though ultrasound is a cheaper option, it can be inaccurate.

Blood tests cannot diagnose adenomyosis, or endometriosis.

The only proper way to definitely diagnose adenomyosis is via surgical intervention and a biopsy, but this is rarely done prior to a hysterectomy due to risk factors of damage to the uterine lining. Unlike endometriosis, the disease cannot be excised and the only cure for adenomyosis is hysterectomy.

Treatment and Management Options For Adenomyosis

The treatment and management of adenomyosis will depend in part on your presenting symptoms, their severity, and whether you have completed childbearing.

The medical management options for adenomyosis are usually in the form of hormonal therapy (the Oral Contraceptive Pill, Mirena IUS or other types of progestogen therapy) or surgical.

The surgical options are endometrial ablation, uterine artery embolism and hysterectomy. When considering surgical therapy it must be acknowledged that endometrial ablation and uterine artery embolism is less effective compared with the more definitive but more invasive option of hysterectomy.

Research does show that a significant portion of women, who choose to do endometrial ablation, or uterine artery embolism, will end up needing a hysterectomy. Hysterectomy is not the major procedure it was years ago and many are done laparoscopically and done intravaginally. This also helps with the recovery time. It all gets back to quality of life for many women with endometriosis. This is why hysterectomy is now a better option than other surgical interventions.

While hysterectomy is not something to be taken lightly, we do need to be real about quality of life and the ongoing pain, other associated symptoms, long term bleeding and the dangers of long term anaemia that adenomyosis can cause to a woman. Many women often quote getting their life back and wished that they had the hysterectomy sooner, rather than putting up with the lack of quality of life. Hysterectomy is a cure for adenomyosis, but it is not a cure for endometriosis.

Other Management Options For Women With Adenomyosis

  • Medical treatments(pain medications, iron infusions)
  • Complementary medicines (Acupuncture, Chinese herbal medicine, vitamins and nutrient support),
  • Nutrition and diet
  • Counselling & Psychology
  • Meditation and Mindfulness
  • Pain management clinics
  • Physiotherapy
  • Exercise therapy(weight baring exercise, resistance training)
  • Core strengthening(pilates, yoga)
  • Pelvic floor management(Pilates, Kegels Exercises/Kegels balls, Vaginal stone eggs),
  • Urodynamics

For women who do not want to consider surgical options, adenomyosis requires a multimodality/team approach for ongoing management, treatment and support. In most cases it will need a combination of the therapies above, or all of them, in conjunction with medical interventions and medicines.

In nearly all cases, treatment and management is the same as endometriosis, except there needs to be more focus on the heavy bleeding symptoms. I always apply a multi-modality approach to assist all my patients who have adenomyosis, or endometriosis, or both combined.

Mild symptoms may be treated with over-the-counter pain medications, complementary medicines and supplements and the use of heating pads to ease pain and cramps. It is important to talk to your healthcare practitioner about treatment options to suit your individual needs and individual symptoms.

Outlook For Women With Adenomyosis

Adenomyosis is not a life-threatening condition, although if some symptoms, such as anaemia and emotional disturbances, aren’t managed properly, or early on, it could potential be life threatening. Many of the symptoms such as heavy bleeding, pelvic pain, pain with intercourse, anaemia and bladder and bowel issues can, and do negatively impact a woman’s life.

Women with adenomyosis are often anaemic and long-term anaemia can have serious health consequences. See my post of serious consequences of iron deficiency. Click here

Many women with adenomyosis, if not all, will need an iron infusion if their iron levels are low. See my post “Could you need an Iron Infusion?”

While surgical options such as hysterectomy can cure adenomyosis, there are both medical and complementary medicines available that may help alleviate the symptoms of adenomyosis.

Adenomyosis and associated symptoms can resolve on their own after menopause. If women have endometriosis as well, they will often require ongoing treatment and management after hysterectomy, as hysterectomy does not cure endometriosis. As mentioned previously, hysterectomy will cure adenomyosis.

Anyone with symptoms of adenomyosis should consult a medical specialist, a healthcare practitioner that specialises in adenomyosis and endometriosis.

Final Word

If you do need help and assistance with the management of adenomyosis, the please call my friendly staff to find out how I may be able to assist you. My motto is ‘no stone left unturned’ and I apply this to every person I see and help. I also have a network of other healthcare professionals I work with as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine and Master of Reproductive Medicine

-The Endometriosis Experts (incorporating adenomyosis as well)