OurGYN

Vulvar vestibulitis syndrome (also know as vestibulodynia or vestibular adenitis)  is a subset of vulvodynia that is characterized by severe pain during attempted vaginal entry (intercourse or tampons insertion), tenderness to pressure localized to the vulvar vestibule and redness of the vulvar vestibule (click for photos of vestibulitis).   Increased awareness of vestibulitis has led to exciting new research and it has become apparent that vestubilitis is not just one disease but is in fact just a symptom of several different disease or conditions.

On ABC TV's 20/20 on August 7, 2009, Dr. Timothy Johnson, ABC News’ chief medical editor, discussed the diagnosis and treatment of sexual pain disorders with Dr. Andrew Goldstein, Director of the Center for Vulvovaginal Disorders and author and educator, and Amy Stein, MPT, a physical therapist who specializes in the treatment of chronic pelvic and urogynecological pain. Dr. Goldstein is the medical director of ourgyn.com. To view the segment click here . Click here to discuss these issues on our Bulletin Board.

Oprah, celebrities, and others all claim to communicate the truth about bioidentical hormones, but what do medical experts say? As a medical journal for ObGyns, we (The Female Patient journal) have the facts in our patient magazine for women titled “The Buzz on Bioidenticals,” and available free online at http://www.femalepatient.com/pdf/BuzzPatientEdition.pdf. This magazine is an educational service developed by The Female Patient®, the Red Hot Mamas®, and Elizabeth Lee Vliet, MD, and supported by an educational grant from Ascend Therapeutics, Inc.

This is an excerpt from 100 Questions & Answers About Women's Sexual Wellness and Vitality: A Practical Guide for the Woman Seeking Sexual Fulfillment by Dr. Michael L. Krychman and published by Jones and Bartlett Publishers. His brief bio follows at end of this fascinating and valuable excerpt.

1. What is sexual medicine?
Sexual medicine means different things to different people. To some it conjures up images of intense therapy sessions delving into your sexual past and upbringing, whereas to other individuals it represents a complete medicalized approach to sexuality. Others still take the approach of a comprehensive yet dynamic definition.

Odyne was the "Greek goddess of pain." Therefore, the term vulvodynia literally means "vulvar pain." Vulvodynia is currently defined as "vulvar discomfort, most often described as burning pain, occurring in the absence of relevant visible findings or a specific, clinically identifiable disease" This classification acknowledges that vulvar pain may be attributable to diagnosable and treatable disorders such as infections (yeast, trichomonas), dermatologic disorders (lichen sclerosus, lichen planus, plasma cell vulvitis), hormonal (atrophic vulvovaginitis) and neurologic disorders (pudendal neuralgia, pudendal nerve entrapment, and post-herpetic neuralgia.) However, these definable causes of vulvar pain are not defined as vulvodynia.   Therefore, while many women are referred to the Centers for Vulvovaginal Disorders with the diagnosis of "vulvodynia," the physicians at the CVVD only rarely give this diagnosis because they are very skilled in the diagnosis of the specific diseases that cause vulvar pain.

There’s a lot of confusion about estrogen. Take it? Stop it? How much? How long? What kind? What about bioidenticals? They’re safe, right? According to Suzanne Sommers, bioidenticals are better and safer.

Maybe. Read on.

Interstitial Cystitis (IC), also called Painful Bladder Syndrome (PBS), is linked to dyspareunia (pain with intercourse) and is thought of as contributing to long term female sexual dysfunction. Interstitial cystitis is the most therapeutically frustrating condition of the urinary tract.

New research published in the Journal of the American Medical Association (JAMA) found that taking menopause hormones increases breast density, making it more difficult for doctors to detect cancer using mammograms. The study says the changes disappear when women stop taking the hormones. The study looked at more than 5000 postmenopausal women aged 40 to 96 who were enrolled in a large health maintenance organization. Participants had two mammograms between 1996 and 1998. The study looked at breast density, comparing women who didn't use hormones to those who did.

Over the past few years, we have been bombarded with information regarding the trials and tribulations of various hormone therapies. If you're wondering why, there is a multi-million dollar, 15-year project being conducted that is sponsored by the National Institutes of Health (NIH) and the National Heart, Lung, and Blood Institute (NHLBI). In case you haven't been in the hormone therapy loop, the Women's Health Initiative (WHI) is a clinical trial and long-term observational study that focuses on women between the ages of 50 and 79.