GynoFiles

Painful sex is a seldom talked about, but frequent problem in women. Generally speaking painful sex, also called dysparunia ,  as women age is due to VVA , the most prominent symptom of what is now more accurately called genitourinary syndrome (GUS) of menopause. It is due to lower levels of estrogen, and decreasing male hormones, even those of the adrenal gland. Making use of the fact that adrenal hormones themselves can affect the vaginal tissue, and the fact that some of the male hormones are converted to estrogen there is now a new treatment, DHEA that has been shown to be effective according to a new study published in Menopause . The pH of the vagina and the lining of the vagina are the first things to change, and in fact there can be secondary frequent infections that can be causing the actual quick onset of significant pain with sex. To some extent the routine treatments for infection will offer some help won't work as well unless the underlying hormonal problem of VV...

We may be one step closer to our dream of eliminating cervical cancer . The HPV vaccination has gotten an upgrade! On December 10th the US Food and Drug Administration (FDA) today approved Gardasil 9 , a human papillomavirus (HPV) vaccine from Merck that prevents cancers and other lesions caused by nine HPV types, five more than the original Gardasil protected against. The Gardasil vaccine is still available now, and the newest version will be available in Feb 2015 for those who want to schedule appointments or consultations . There is virtually 100% protection of the HPV type you get in a vaccine if you have not yet been exposed to that vaccine. The first vaccine protected against  HPV types 6, 11, 16, and 18. Gardasil 9 covers these as well as types 31, 33, 45, 52, and 58. These latter five are currently responsible for roughly one in five cases of cervical cancer. In the earlier vaccine there was some cross protection of other viruses, and since there ar...

Clitoral Scaring, Also Known As A Hood, In this Case From Lichen Sclerosus Vulvar health is one aspect of women's health care that has replaced incontinence as the least talked about conditions with Low estrogen levels, chronic vaginal infections, warts and skin conditions like lichen sclerosus have to be treated promptly in order to preserve sexuality as you get older. Skin conditions can become debilitating for women with these. Over time the vagina can narrow, and shorten with lack of estrogen, but external skin conditions can produce sexual difficulties as well. Both Lichen Sclerosis and Lichen Planus can cause itching, irritation, difficulty with intercourse and disfiguring of the normal anatomy of a woman's vulva. This condition, but also low estrogen levels, chronic untreated infections, and some cases of warts can produce sexuality problems. In fact it can be a reason that women do not have orgasms if they get the thick bridges over the clitoris. These bridges ...

MRSA of the Mons Cancer signs may truly be revealed if listening to your body, so here are some signs to listen to, which is the gyno's way of promoting #RealWorldEvidence 1. Abnormal Bleeding 2. Pelvic Pain 3. Bleeding After Sex 4. Bleeding After Menopause 5. Abdominal Swelling 6. Unexplained Weight Loss 7. Pain With Sex 8. Abnormal Feeling of Fullness 9. Vulvar Sore that Will Not Heal 10. Hard Lump In the Abdomen MRSA of the Vulva

Most women assume that vaginal itching and irritation is an infection. Women can get external itching and redness just from allergic reactions. It is in fact very commonly the cause of the symptoms that some women confuse with yeast infections. Most often it's due to pad use, soaps, fragrances, antibiotics, or detergents. It's also commonly seen in women who have some urine leakage. Urine is very irritating to such sensitive tissues. Odd cases of these allergic or simple dermatologic reactions are due to dry weather, the cold, biking or too much sex and irritation form the semen. So don't necessarily self treat if you think an allergy could be the problem, check in with the gyno. 

Lichen Sclerosus Lichen sclerosus is a chronic condition that will cause itching, burning, skin changes and eventually changes to your vulvar anatomy. It may make you more susceptible to yeast or bacterial infections, but discharge is not usually a common symptom from this condition alone. Women of any age can get this, cases as young as girls prior to puberty have been reported, it's not thought to be caused by infection. Looking at the conditions of the external tissues a physician cannot always make an accurate diagnosis, but the tissue has characteristic thin white paper look that has been called "cigarette paper" look. So the most accurate way to diagnoses is a biopsy Severe Lichen Sclerosus with Ulceration without a biopsy. If there is a condition that presents itself and then clears up with treatment, that may be a situation that wouldn't need a biopsy. But conditions that do not clear up with treatment especially are good cases for a biopsy. One sign...

Vulvodynia is  the syndrome of unexplained vulvar pain and many women also have sexual dysfunction at the same time. The signs of vulvodynia are rawness, sting, irritation and or burning of the vaginal opening and surrounding tissues. It can be a source of psychological distress as well as even tampon insertion can be uncomfortable. Other women describe being unable to wear tight pants. There are apparently subtypes of vulvodynia, and one is vulvar vestibulitis.  Women who have pain at attempted intercourse when there is no infection may be suffering from vulvar vestibulitis. This is a confusing disorder of local vulvar pain, a sensation of irritation probably causes the feeling of rawness, and a chronic condition of vulvar tissues that are so paper thin they are prone to tearing. Women may complain of stinging, burning, and a hypersensitivity to touch, but about 15% of women describe the pain as knifelike . There is no known cause but we think that chronic infections, par...

Pain seems like something your gyno should be able to fix, and more often than not, we can. But there are aches and pains that just seem to defy solutions and remain a puzzle. Scientists are trying to figure out why. Start with the concept that pain is the feeling we get when a particular type of nerve fiber sends the brain a signal. A nerve is not just a nerve by any name. While this discussion is of course a gross over simplification, a few important facts have started to emerge. We have Type A-beta fibers, the mediate touch and sensation and we have C fibers, those mediate our perception of noxious stimuli. What triggers the chronic pain, irritation and discomfort of women with vulvodynia seems to be these C fibers getting out of whack. They release cytokines and neurokines to perform their signaling. And with chronic inflammation, product use, treatments, the responses can become inappropriate. So simple touch can give off a pain signal. Makes some sort of sense. In fact it's t...

Dr. Charles Penrose of the Gynecean Hospital published his Textbook of Disease of Women in 1900 and eloquently described effective treatments for vulvar itching or other discomforting diseases of the external genitalia that included mercury, bitter almonds, lead or just a solution of pure cocaine used locally. Often copious powders, opium or morphene, all used topically, were employed as well. Exciting reading in those old texts!

Sometimes it begins as a small spot, you may have thought it was a rash. But it's actually a skin condition called vitaligo. Its simply depigmentation. Not harmful, in some the skin color differences are certainly not dramatic. The darker natural skin color as in this patient does make it more visible. If the area is symptomatic in any way, or progressing a biopsy can be done, but usually the diagnosis is made by looking. Most women, can ignore it for the most part, and if it doesn't change and the look isn't bothersome to you, particularly in the vulvar area, it's not thought to be harmful and so you can ignore! Pigment treatments, steroids, various creams like calcineurin inhibitors,vitamin D, pseudocatalase creams,or  hydroquinone. If that hasn't worked light therapy has worked in some cases. An excellent organization devoted to helping women with this condition and providing answers is on line at National Vitaligo Foundation