Friday, July 31, 2009

Sex and Urinary Incontinence

Does this happen to you?

Many women experience the embarrassing sensation of leaking some urine during sex- some with penetration and some with orgasm.

It can be very distressing and lead to sex avoidance and impact negatively in qualtiy of life.

See my article recently published in The Female Patient. Download it. It's free.

Monday, July 27, 2009

Competitive Cycling May Reduce Genital Sensation in Women

Researchers in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine and The Albert Einstein //College of Medicine report that women who are into regular bicycling experienced reduced genital sensation and were more likely to complain of pain in the genitals. The researchers undertook a comparative study between 48 women competitive cyclists and 22 women runners.

With the help of non-invasive techniques, they studied the possible implication of bicycling on genital sensation and sexual health. Participants in the study were women bicyclists who consistently rode an average of at least 10 miles per week, four weeks per month. Women who ran at least one mile daily or five miles weekly were chosen as a control group because they represent an active group of women who were not exposed to direct pressure in the perineal region. “We found that competitive women cyclists have a decrease in genital sensation. However, there were no negative effects on sexual function and quality of life in our young, healthy pre-menopausal study participants,” said lead author Marsha K. Guess, M.D., assistant professor of obstetrics and gynecology at Yale.

About 13 million American women bicycle regularly, according to statistics cited in the article. While health benefits of bicycling are many, the activity has also been linked to injuries and fatalities due to motor vehicle collisions, neck and back pain, and chafing, folliculitis, and other ailments that affect both sexes. Past studies, including one authored by National Institute for Occupational Safety and Health co-investigator Steve Schrader, have found an association between bicycling and erectile dysfunction and genital numbness in men. “This is the first study to evaluate the effects of prolonged or frequent bicycling on neurological and sexual function in women,” said Guess. “While seated on a bicycle, the external genital nerve and artery are directly compressed. It is possible that chronic compression of the female genital area may lead to compromised blood flow and nerve injury due to disruption of the blood-nerve barrier.”

Tuesday, July 14, 2009

Free Seminar on Mesh Complications After Pelvic Floor Repair

I will be giving a Grand Rounds presentation at Banner Desert Medical Center, in Mesa, AZ on July 23, 2009, in the Rosati Education Center, Ocotillo Amphitheatre.

It will be on Mesh Complications of Pelvic Floor Repair. It is for physicians and nurses, but for anyone who is interested as well.

Registration and Lunch are at 12pm, and the program begins at 12:30pm

To register, call Wendy Tee at 480-512-3852

Friday, July 10, 2009

Vibrator Use Common and Linked to Sexual Health

A recent nationwide sampling of women conducted by Indiana University revealed that 53% of women have used vibrators during sex. Despite longstanding assumptions, this was the first large survey on such matters. It affirms what many therapists and doctors have known for years.

The study was conducted on over 2,000 women between the ages of 18-60 years. There were some other interesting findings with the study:

52.5% of women have used a vibrator, with about 25% having used it in the past month.

Vibrator use was more likely if the woman had a gynecological exam within the past year, or had done a genital self-exam within the last month, reflecting an awareness and interest in maintaining sexual health.

71.5% reported have no side effects from the vibrator. Most side effects reported were rare and short in duration.

Wednesday, July 1, 2009

Pelvic Floor Muscle Retraining Can Reduce Urinary Incontinence in Late Pregnancy and Post Partum Women in the first 12 months

Urinary Incontinence (UI) is a common female pelvic health problem and physical therapy is the most commonly recommended first line therapy for it. About 1/3 of women have UI. It is usually recommended for Mixed UI (Stress and Urge) and less commonly for Urge Incontinence alone. Pelvic Floor Muscle (PFM) retraining is usually done over 5 -12 sessions in order to adequately localize the correct muscles to train and reinforce therapy and adherence.

There are no adverse effects of doing PFM retraining. Overall, it is most beneficial when individually taught to the individual woman who is immediate post-natal but at high risk for incontinence (urinary or fecal), such as after instrument delivery, vaginal delivery after a large baby, or a third degree perineal tear.

If women perform PFM training during pregnancy or just after birth what are the findings:

In women without UI who have never given birth yet, or those with only one birth, PFM reduce UI in late pregnancy (34 weeks or more pregnant), immediate post partum (up to 12 weeks), and even up to 3-6 months after birth.

In women with UI at baseline, PFM retraining did lower UI in late pregnancy but did not show lasting effects into the post partum period.

So for all you soon-to-be new moms or those with only one child who do NOT have UI, start doing those Kegels about 2 months before the baby is due to help cut down on UI after birth.