Category: Made For Life

Tampons and Toxic Shock Syndrome: Understanding the Risks and Best Practices 

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Tampons and Toxic Shock Syndrome: Understanding the Risks and Best Practices 

Paz Etcheverry, MS, PhD

March 2024

What exactly is toxic shock syndrome, and why does the Food and Drug Administration (FDA) enforce a warning on tampon packaging? 

Toxic shock syndrome, or TSS, is an acute illness predominantly caused by the toxin-producing bacteria Staphylococcus aureus.[6]TSS is characterized by fever, chills, body rashes, vomiting, diarrhea, muscle aches, and low blood pressure. It is a very serious illness that can lead to multiple organ damage (including of the liver, kidneys, and heart) and death.[1] [3] 

TSS is primarily associated with the use of tampons, especially the super- and higher-absorbency types.[2] However, keeping a tampon inside the vagina for a long time can lead to TSS regardless of the tampon type. 

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The incidence of TSS related to menstruation, also known in the literature as menstrual TSS or mTSS, currently ranges between 1 to 3 per 100,000 in the US.[1] [6]This represents a considerable decline from the 1980s, when the incidence rate was between 2 to 16 cases per 100,000 menstruating women. This decline is mainly attributed to the implementation of consumer education and to the introduction of labeling requirements by the FDA.[7] [8] As per regulatory requirements, the FDA mandates that all tampon packages include the following warning: “Tampons are associated with Toxic Shock Syndrome (TSS). TSS is a rare but serious disease that may cause death. Read and save the enclosed information”.[9] 

For mTSS to occur, two essential factors are necessary: 

  1. the presence of S. aureus in the vagina
  2. the lack of antibodies to neutralize toxic shock syndrome toxin-1 (TSST-1) produced by the bacteria[10]

Among the women who use tampons, 1 to 5 percent have TSST-1-producing S. aureus in their vaginas and 10 to 20 percent have no protective antibodies against TSST-1.[1]In addition to the above two factors, scientists believe that tampons introduce oxygen, which creates a more aerobic environment in the vagina, which is favored by S. aureus.[10] The rapid removal of tampons may also cause small vaginal tears, which could lead to infections.[5] 

To reduce the risk of mTSS, women should avoid wearing the same tampon for more than 8 hours, refrain from wearing tampons overnight, change the tampon preferably every 4 hours, and unwrap the tampon from its packaging only when ready to use it. Additionally, women should use tampons with the lowest absorbency for their flow and switch from tampons to pads every other day, especially when the menstrual flow is the heaviest. Compared to regular- and light-absorbency tampons, super and higher-absorbency types are larger in size. This increased size could potentially lead to abrasion and irritation in the vagina, making it easier for TSST-1 to enter the body. Furthermore, it is important to opt for all-cotton tampons, as opposed to tampons with rayon/cotton blends, as they may be less irritating.[5] 

Treatment of mTSS usually involves intravenous fluids and antibiotics such as penicillinase-resistant penicillin, cephalosporin, or vancomycin along with either clindamycin or linezolid.[3] 

While mTSS has been associated with tampon use, wearing menstrual cups, cervical caps, diaphragms, pessaries, and natural sea-sponges increases the risk of the illness.[4] [6] TSS may also occur in non-menstrual settings such as in soft tissue infections, post-surgical infections, burns, nasal packing—gauze or sponge-like materials placed inside the nasal cavity—, and dialysis catheters.[6] 

If any signs of TSS arise, such as sudden high fever, rash, and low blood pressure, seeking prompt medical attention is of utmost importance. Overall, balancing menstrual practices with awareness and caution is key to minimizing potential risks associated with tampon use.

References 

[1] Billon, A., Gustin, M. P., Tristan, A., Bénet, T., Berthiller, J., Gustave, C. A., Vanhems, P., & Lina, G. (2020). Association of characteristics of tampon use with menstrual toxic shock syndrome in France. EClinicalMedicine, 21, 100308. https://doi.org/10.1016/j.eclinm.2020.100308

[2] Bobel, C., Winkler, I.T., Fahs, B., et al., editors (2020). The Palgrave Handbook of Critical Menstruation Studies [Internet]. Singapore: Palgrave Macmillan. https://www.ncbi.nlm.nih.gov/books/NBK565605

[3] Gottlieb, M., Long, B., & Koyfman, A. (2018). The Evaluation and Management of Toxic Shock Syndrome in the Emergency Department: A Review of the Literature. The Journal of Emergency Medicine, 54(6), 807–814. https://doi.org/10.1016/j.jemermed.2017.12.048 

[4] Hochwalt, A. E., Abbinante-Nissen, J. M., Bohman, L. C., Hattersley, A. M., Hu, P., Streicher-Scott, J. L., Teufel, A. G., & Woeller, K. E. (2023). The safety assessment of tampons: illustration of a comprehensive approach for four different products. Frontiers in Reproductive Health, 5, 1167868. https://doi.org/10.3389/frph.2023.1167868 

[5] Nicole, W. (2014). A question for women’s health: chemicals in feminine hygiene products and personal lubricants. Environmental Health Perspectives, 122(3), A70–A75. https://doi.org/10.1289/ehp.122-A70 

[6] Ross, A., & Shoff, H.W. Toxic Shock Syndrome. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459345/ 

[7] Roy, P., Sahni, A. K., & Kumar, A. (2015). A fatal case of staphylococcal toxic shock syndrome. Medical Journal, Armed Forces India, 71(Suppl 1), S107–S110. https://doi.org/10.1016/j.mjafi.2013.05.012 

[8] U.S. Food and Drug Administration (2005, July). Menstrual Tampons and Pads: Information for Premarket Notification Submissions (510(k)s) – Guidance for Industry and FDA Staff. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/menstrual-tampons and-pads-information-premarket-notification-submissions-510ks-guidance-industry#1 

[9] U.S. Food and Drug Administration (2023, October). CFR – Code of Federal Regulations Title 21. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=801.430 

[10] Vostral, S. (2017). Toxic shock syndrome, tampons and laboratory standard-setting. CMAJ: Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 189(20), E726–E728. https://doi.org/10.1503/cmaj.161479

Visits to the Gynecologist Among Teenagers and Young Women 

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Visits to the Gynecologist Among Teenagers and Young Women 

Isha Gupta

February 2024

Many teenagers and young women opt out of pap smears and mammograms, but are visits to the gynecologist still essential for teenagers and young women? Teenagers and young women are not usually medically advised to get regular mammograms like older women, since research has not found significant benefits regarding mammograms among this younger age group.[10] Moreover, some young women are not comfortable getting pap smears, even after they turn 21, because of personal and cultural beliefs, including bad experiences with previous gynecological tests and procedures, lack of social support, and facing discouragement from loved ones.[5] Although many teenagers and young women may not regularly get mammograms and pap smears, visiting the gynecologist can still help safeguard other aspects of their reproductive health and wellness. There is even a subspecialty within obstetrics and gynecology that is focused on the reproductive health of children and adolescents, known as pediatric and adolescent gynecology. By the same token, based on recommendations from the American College of Obstetrics and Gynecology (ACOG), the first pediatric gynecology exam should occur between 13 and 15 years of age, but it can happen earlier if gynecological health issues arise.[9] Furthermore, ACOG claims that there can be more than 21 reasons why teenagers should visit gynecologists.[1] A few of the most common reasons visits to the gynecologist are essential for teenagers and young women include concerns surrounding the menstrual cycle, preventing pregnancy, regulating hormones, and preventing, diagnosing, and treating sexually transmitted diseases. 

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Menstrual Cycle 

Teenagers and young women can have concerns about their menstrual cycles,[4]including amenorrhea (absence of menstrual periods), dysmenorrhea (menstrual pain), and menorrhagia (heavy menstrual bleeding). Gynecologists can help address these important issues which can significantly affect diverse aspects of their lives, such as by leading to reduced academic performance due to absenteeism, inability to participate in social activities, and infertility later on in life. 

Unplanned Pregnancy Prevention and Hormone Regulation 

According to the Centers for Disease Control and Prevention (CDC), there are several different types of birth control methods for adolescents, ranging from barrier methods like condoms to short-acting hormonal methods like daily pills, and long-acting reversible contraceptives like intrauterine devices.[2] Gynecologists can help prevent teen pregnancy and unplanned pregnancies among young women, by offering a safe and non-judgmental space where they can learn more about different birth control methods, and even evaluate with their medical provider which form of birth control is best suitable for them. Some forms of birth control, namely, the pill may not only prevent unwanted pregnancies but also help regulate hormone levels. This, in turn, can simultaneously help address menstrual cycle-related irregularities and complaints.[8] 

STD Prevention, Diagnosis, and Treatment 

According to the CDC, sexually transmitted diseases (STDs) are more common in adolescents and young people. STDs are a major cause for concern especially among this population, due to risky health behaviors and because they may not feel comfortable sharing personal information about reproductive health with medical professionals.[3] Preventing, diagnosing, and treating STDs early on is important to help prevent adverse health outcomes associated with these diseases, such as the development of cervical cancer and infertility,[7] which can have profound consequences for young people throughout their lives. Gynecologists can provide access to vaccines, testing, and treatment to help prevent, diagnose, and treat STDs in a timely fashion. These medical specialists can help promote health literacy about STDs, along with other reproductive health issues, among teenagers and young women. This, in turn, can also help combat disinformation about the transmission of such diseases and promote this population’s health. 

Although several gynecologic cancers and their associated risks of mortality are less common among teenagers and young women as compared to older women,[6] visits to the gynecologist are still significant among this age group. There are critical ways teenagers’ and young women’s gynecologic health can be affected. Some of the most common gynecological-related complaints teenagers and young women can have include concerns about their menstrual cycles, pregnancy prevention, hormone regulation, and STDs. Having access to a trusted medical professional specializing in gynecology where teenagers and young women can get accurate information about their health can empower them to make the best decisions for their reproductive health and well-being. Therefore, gynecologists can play significant roles in helping to promote teenagers’ and young women’s health and wellness. 

References

[1] “21 Reasons to See a Gynecologist Before You Turn 21.” American College of Obstetricians and Gynecologists, American College of Obstetricians and Gynecologists, 2024, www.acog.org/womens-health/infographics/21-reasons-to-see-a-gynecologist-before-you-turn-2 1. 

[2] “Birth Control.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 8 Jan. 2024, www.cdc.gov/healthyyouth/healthservices/infobriefs/birth_control_information.htm.

[3] “CDC Fact Sheet: Information for Teens and Young Adults: Staying Healthy and Preventing STDs.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 12 Apr. 2022, 

www.cdc.gov/std/life-stages-populations/stdfact-teens.htm#:~:text=How%20common%20are%2 0STDs%3F,ages%20of%2015%20and%2024. 

[4] Cummings, Holly W. “Should My Teen See an Ob-Gyn? Here’s What I Tell Parents.” American College of Obstetricians and Gynecologists, American College of Obstetricians and Gynecologists, Mar. 2022, www.acog.org/womens-health/experts-and-stories/the-latest/should-my-teen-see-an-ob-gyn-here s-what-i-tell-parents. 

[5] Hassani, L., PhD, Dehdari, T., PhD, Hajizadeh, E., PhD, Shojaeizadeh, D., PhD, Abedini, M., PhD, & Nedjat, S., PhD (2017). Barriers to Pap Smear Test for the Second Time in Women Referring to Health Care Centers in the South of Tehran: A Qualitative Approach. International journal of community based nursing and midwifery, 5(4), 376–385. 

[6] McGonigle, K. F., Lagasse, L. D., & Karlan, B. Y. (1993). Ovarian, uterine, and cervical cancer in the elderly woman. Clinics in geriatric medicine, 9(1), 115–130. 

[7] Monteiro, I. P., Azzi, C. F. G., Bilibio, J. P., Monteiro, P. S., Braga, G. C., & Nitz, N. (2023). Prevalence of sexually transmissible infections in adolescents treated in a family planning outpatient clinic for adolescents in the western Amazon. PloS one, 18(6), e0287633. https://doi.org/10.1371/journal.pone.0287633 

[8] Osborn, Corinne O’Keefe. “10 Benefits of Birth Control Beyond Preventing Pregnancy.” Healthline, Healthline Media, 26 July 2018, www.healthline.com/health/birth-control-benefits.

[9] “Pediatric Gynecology.” Cleveland Clinic, Cleveland Clinic, 5 Jan. 2023, my.clevelandclinic.org/health/articles/24574-pediatric-gynecology. 


[10] Qin, J., White, M. C., Sabatino, S. A., & Febo-Vázquez, I. (2018). Mammography use among women aged 18-39 years in the United States. Breast cancer research and treatment, 168(3), 687–693. https://doi.org/10.1007/s10549-017-4625-6

Understanding and Managing Intimate Pain 

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Understanding and Managing Intimate Pain 

Paz Etcheverry, MS, PhD

February 2024

When a woman experiences pain during intercourse, the condition is known as dyspareunia. In the United States, the prevalence of dyspareunia ranges between ten and twenty percent and varies by age.[3][10] Women with this condition often describe feeling sadness, anxiety, heightened sensitivity to pain, negative body image, and low self-esteem; hence, a timely intervention is crucial to address this disorder.[9] 

There are two types of dyspareunia that we need to be aware of– superficial and deep. When the woman experiences burning, stinging, or sharp pain at or near the entrance of the vagina on penetration, it is generally called superficial dyspareunia. Deep dyspareunia refers to pelvic pain experienced during deep vaginal penetration.[4] 

Superficial Dyspareunia 

Superficial dyspareunia has several causes. For example, it can be seen in patients with vaginismus—an involuntary response of the body causing spasms of the muscles in the vagina— or vulvodynia—a chronic pain condition of the vulva.[1][8][11] Other causes include congenital abnormalities such as vaginal agenesis—where a woman is born without a fully developed vagina—or imperforate hymen—where the hymen completely covers the vaginal opening.[4] 

Superficial dyspareunia can also result from insufficient lubrication due to a drop in estrogen levels after menopause, childbirth, or during breastfeeding. Certain medications like antidepressants, antihistamines, antihypertensives, certain oral contraceptives, and sedatives may decrease sexual arousal, which in turn causes decreased lubrication, thereby leading to painful intercourse.[4] 

Injury, trauma, or irritation to the vaginal region from accidents, pelvic surgery, procedures like female circumcision, and episiotomy—a surgical incision made between the vagina and anus— can also contribute to discomfort during sexual intercourse. Infections in the genital region, for example, candidiasis or herpes, or of the urinary tract can be another cause of pain. Women with conditions like eczema or dermatological issues such as psoriasis in the genital region may encounter discomfort during sexual intercourse.[4][6] 

Deep Dyspareunia

Deep dyspareunia can result from scarring from hysterectomy, radiation therapy, and chemotherapy for cancer treatment. Other conditions associated with deep dyspareunia include cystitis, endometriosis, hemorrhoids, irritable bowel syndrome, ovarian cysts, pelvic floor dysfunction, pelvic inflammatory disease, and uterine fibroids.[4] 

Treatments

During the treatment of dyspareunia, the goal is to treat both the physical and mental aspects associated with the condition. Here are some treatment approaches: 

Proper Vulvar Care 

It is important to stay away from irritants such as perfumed soaps, perfumed vaginal hygiene wipes, and perfumed paper sanitary napkins. Furthermore, prioritizing cotton underwear and avoiding snug clothing is essential. When cleansing, steer clear of hot water and apply a topical natural emollient or moisturizer. Olive oil and coconut oil are popular alternatives to off-the-shelf moisturizers. Always use a water-based lubricant without flavors, perfumes, or other irritants during intercourse.[6] 

Pelvic Floor Physical Therapy 

Under the guidance of a physical therapist, pelvic floor exercises can be quite helpful in the treatment of vulvodynia due to pelvic floor dysfunction.[2] 

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Psychotherapy 

Cognitive behavioral therapy has proven to be a helpful tool when treating dyspareunia as it teaches pain controlling techniques.[7] Couples counseling can also be a beneficial tool as it might help reduce or eliminate feelings of shame and poor body image as well as enhance communication.[6] 

Topical Treatments 

Topical five percent lidocaine prior to intercourse (thirty minutes before) has also proven to be useful. Be mindful that lidocaine gel or ointment can result in an initial sensation of burning upon application and that the partner may experience numbing of the penis at first; hence, the use of condoms is encouraged.[6] Topical estrogen cream is another treatment option for vulvodynia.[12] 

Oral Medications 

Oral medications may be used alone or in combination with topical treatments. These medications include gabapentin, pregabalin, tricyclic antidepressants such as amitriptyline, serotonin and norepinephrine reuptake inhibitors, and selective serotonin reuptake inhibitors. For dyspareunia caused by endometriosis, the first line of treatment includes nonsteroidal anti-inflammatory drugs, combination hormonal contraceptives, and progestin-only contraceptives. If the patient does not experience significant pain relief, then the second line of treatment includes gonadotropin-releasing hormone agonists, gonadotropin-releasing hormone antagonists, danazol, and aromatase inhibitors.[4] 

Surgical Intervention 

Vestibulectomy, a surgical intervention, may be an option for the type of vulvodynia that is unresponsive to all forms of treatment. This, however, needs to be evaluated by a provider.[5] 

When it comes to dyspareunia it is important to remember that addressing the condition is a journey. With the right support, there are treatments and coping strategies that can significantly improve comfort and well-being.

References 

[1] Corsini-Munt, S., Rancourt, K. M., Dubé, J. P., Rossi, M. A., & Rosen, N. O. (2017). Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions. Journal of Pain Research, 10, 2425–2436. https://doi.org/10.2147/JPR.S126259

[2] Ghaderi, F., Bastani, P., Hajebrahimi, S., Jafarabadi, M. A., & Berghmans, B. (2019). Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial. International Urogynecology Journal, 30(11), 1849–1855. https://doi.org/10.1007/s00192-019-04019-3

[3] Hill, D. A., & Taylor, C. A. (2021). Dyspareunia in women. American Family Physician, 103(10), 597–604. 

[4] Hrelic, D. A., Wax, E. M., & Saccomano, S. J. (2023). Dyspareunia: Etiology, presentation, and management. The Nurse Practitioner, 48(11), 27–34. https://doi.org/10.1097/01.NPR.0000000000000111

[5] Kliethermes, C. J., Shah, M., Hoffstetter, S., Gavard, J. A., & Steele, A. (2016). Effect of vestibulectomy for intractable vulvodynia. Journal of Minimally Invasive Gynecology, 23(7), 1152–1157. https://doi.org/10.1016/j.jmig.2016.08.822 

[6] Kumar, K., & Robertson, D. (2017). Superficial dyspareunia. CMAJ: Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 189(24), E836. https://doi.org/10.1503/cmaj.161337

[7] Masheb, R. M., Kerns, R. D., Lozano, C., Minkin, M. J., & Richman, S. (2009). A randomized clinical trial for women with vulvodynia: Cognitive-behavioral therapy vs. supportive psychotherapy. Pain, 141(1-2), 31–40. https://doi.org/10.1016/j.pain.2008.09.031 

[8] Pacik, P. T. (2014). Understanding and treating vaginismus: a multimodal approach. International Urogynecology Journal, 25(12), 1613–1620. https://doi.org/10.1007/s00192-014-2421-y

[9] Seehusen, D. A., Baird, D. C., & Bode, D. V. (2014). Dyspareunia in women. American Family Physician, 90(7), 465–470. 

[10] Sorensen, J., Bautista, K. E., Lamvu, G., & Feranec, J. (2018). Evaluation and treatment of female sexual pain: A clinical review. Cureus, 10(3), e2379. https://doi.org/10.7759/cureus.2379 

[11] Tayyeb, M. & Gupta, V. Dyspareunia. [Updated 2023 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562159/

[12] Ventolini, G. (2011). Measuring treatment outcomes in women with vulvodynia. Journal of Clinical Medicine Research, 3(2), 59–64. https://doi.org/10.4021/jocmr526w

Premenstrual Syndrome: Causes, Symptoms and Their Meanings 

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Premenstrual Syndrome: Causes, Symptoms and Their Meanings 

Rebecca Johnson

February 2024

Premenstrual syndrome, or PMS, is a term associated with the symptoms a woman experiences in the days leading up to her period. Usually, these symptoms arise about a week before menstruation begins. Common symptoms are breast tenderness, abdominal cramps, mood swings, food cravings, and irritability.[3] We are going to take a closer look at the biological bases of these symptoms, and why they affect us the way that they do! 

Tender Breasts

The reason our breasts get sore before our periods is because  Estrogen, a primary female sex hormone, enlarges the breast ducts. A simultaneous decrease in and the decrease of Progesterone, a steroid hormone, that causes swelling of the milk glands. This is because Estrogen increases during this time of the menstrual cycle. The usual role of Estrogen in breast ducts is to it stimulate milk production and expand the ducts into the mammary glands.[4] The growth is the result of Estrogen binding to the receptor Era at the start of puberty. But it’s important to monitor the symptoms you are having because some may be connected to more serious issues and may cause problems later in life.[1]

Abdominal Cramps

Abdominal cramps are caused by the contraction of the uterine lining of the uterine lining and may become thinner and thicker throughout your menstrual cycle. Regulated by prostaglandins, the muscles contract causing inflammation and pain. This hormone plays a part in primary dysmenorrhea, which is one type of period pain. In this case, excess prostaglandin release causes tightening and subsequent relaxation of uterine muscle, causing the sensation known as cramps. Causes are endometriosis and uterine fibroids, but normally, period cramps get better as you get older. To relieve the pain, you can try exercising, using a heating pad, or taking a hot pack.[5] 

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Mood Swings

Due to the fluctuation of estrogen and progesterone levels, you may feel more negative emotions before and during menstruation. Estrogen is connected to the hormone serotonin, which regulates happiness. However these two hormones aren’t always linear, and variations in them can cause mood changes. In fact, a study by Soyda Akyol E et al. showed that women who had PMS experienced more depression and nervousness.[2] 

Food Cravings

Before or during your period, fluctuations in estrogen and progesterone cause certain food cravings. Usually, you tend to crave carbohydrates and sugary foods during this time, especially starchy foods. This is to make up for the low serotonin levels produced in your body during pre-menstruation and menstruation. It will balance out your mood and provide the stability that is normally serotonin’s job. Also, this is the period where your body is best at metabolizing carbohydrates, so if there is any right time to consume it, it’s during your period! You become more sensitive to insulin, so the carbohydrates will be easier to convert to energy while the body has low insulin.[6]

References

[1] Arendt, L. M., & Kuperwasser, C. (2015). Form and Function: how Estrogen and Progesterone  Regulate the Mammary Epithelial Hierarchy. Journal of Mammary Gland Biology and  Neoplasia, 20(1-2), 9–25. https://doi.org/10.1007/s10911-015-9337-0 

[2] Genomind. (2023, May 4). How Hormones Affect Mood for Women – Genomind. Genomind.com.  https://genomind.com/patients/how-hormones-affect-mood-for 

women/#:~:text=While%20we%20know%20that%20estrogen 

[3] Mayo Clinic. (2022, February 25). Premenstrual syndrome (PMS) – symptoms and causes. Mayo  Clinic. https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms causes/syc-20376780 

[4] Normal Breast Development and Changes. (n.d.). Www.hopkinsmedicine.org.  https://www.hopkinsmedicine.org/health/conditions-and-diseases/normal-breast-development and-changes#:~:text=The%20hormone%20estrogen%20is%20produced 

[5] Period Pain. (2019). Medlineplus.gov; National Library of Medicine. https://medlineplus.gov/periodpain.html

[6] “There’s a Best Time in Your Cycle to Eat Carbs (and This Is It).” Eve Wellness, 22 June 2020,  evewellness.com/blogs/news/there-s-a-best-time-in-your-cycle-to-eat-carbs-and-this-is-it.  Accessed 12 Feb. 2024.

The Impact of Breast Cancer on Women

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Impact of Breast Cancer on Women

Makayla Anderson

February 2024

Finding the Cause 

Breast cancer is more than a medical condition; it’s an experience that affects millions of women around the globe. While the physical effects are often the focus, the emotional, psychological, and social effects are equally profound. Let’s delve into these multifaceted impacts of breast cancer on women, offering insight into the struggles and resilience that define their journey. 

Breast cancer treatment, often involving surgery, chemotherapy, and radiation, brings a host of physical challenges. Women may face postoperative pain, fatigue, nausea, and hair loss – visible markers of their battle. Long-term effects can include lymphedema, hormonal changes, and scars that serve as constant reminders of their sacrifices. The physical toll of breast cancer is not just about battling the disease but also coping with these life-changing side effects. 

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The diagnosis of breast cancer typically triggers a tumultuous emotional response. Women may oscillate between denial, fear, anger, and sadness. The psychological toll is immense, with many experiencing anxiety and depression. The loss of a breast or changes in physical appearance can significantly impact self-esteem and body image, often leading to a profound identity crisis. This emotional rollercoaster doesn’t end with treatment; the fear of recurrence can linger, impacting mental health long-term. 

Breast cancer also reverberates through the social and familial spheres. Relationships may be strained or strengthened in the face of illness. Partners, children, and relatives must navigate the uncertain terrain of caregiving, emotional support, and altered family dynamics. Professionally, women may face discrimination or struggle to reintegrate into the workforce. The social implications extend to a woman’s sense of community and belonging, often necessitating a reevaluation of her role and identity within these spaces. 

Despite these challenges, many women forge a path of resilience. Coping mechanisms vary widely, from seeking psychological counseling to finding solace in support groups. Some embrace advocacy, using their experience to champion breast cancer awareness and support. This journey of resilience is not just about surviving but about finding new meaning and purpose in the wake of the illness. 

Breast cancer, undeniably, leaves a lasting imprint on a woman’s life. It challenges her physically, emotionally, psychologically, and socially. Yet, within this crucible of adversity, many women discover a wellspring of strength and resilience. As we continue to advance in medical treatment, it’s imperative to equally prioritize and address the comprehensive well-being of those battling breast cancer. Their journey is a testament to the human spirit’s capacity to endure and evolve in the face of profound challenges.

How Does the Weather Affect Your Mood?

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How Does the Weather Affect Your Mood?

Rebecca Johnson

January 2024

Have you ever found yourself feeling happy on a sunny day, and gloomier on a cloudy day? Well, you are not the only one! This is because energy in your body is signaled to decrease by cold weather. Our circadian rhythms are our bodies’ natural sleep and wake cycle. Typically, light awakens your circadian clock, and darkness relaxes it. That is why you may feel more tired on days with less sunshine- your body may feel more relaxed! On the other hand, higher temperatures may increase your anxiety and irritability, because it can elevate cortisol levels (cortisol is your stress hormone), palpitations etc.[2] 

Humidity is the measurement of water vapor present in the air. A high amount of water vapor in the air means higher humidity. When the weather is humid, you may find yourself having a harder time to breathe and move. This is caused by an increase of the density of certain molecules present in the air, such as Hydrogen and Nitrogen. As a result, our lungs will have a harder time obtaining the oxygen from the air. This alters air quality, which in turn, can make us feel uneasy.[4] 

Ever heard of seasonal depression? It’s real!

Your body can also sense fluctuations in atmospheric pressure. The superior vestibular nucleus in your brain controls equilibrium, perception, and balance. Serotonin is a neurotransmitter in your body, which controls your mood and appetite. Atmospheric pressure may influence serotonin metabolism, and it could affect appetite, mood regulations, and even fever.[5] 

In instances when it is raining, atmospheric pressure drops. This drop will be sensed by your body, which in response, may cause changes to your joints. One type of joint is called the synovial joint. Our synovial joints contain cavities, which are filled with a viscous solution called synovial fluid.[7] Those who are affected with Arthritis may experience swelling in their soft tissues, which is caused by the expansion of the fluid in their joints, during rain. This contraction may cause pain to the nerves which surround the joint. Tendons and muscles may also expand during this time, also bringing about discomfort. But, one may relieve this pain by staying active, hydrated, and keeping warm.[6] 

References

[1] Swaim, E. (2022, August 12). How the weather might affect your mood and energy. Healthline. https://www.healthline.com/health/mental-health/weather-and-mood#the-effects 

[2] Anna.Docking. (2022, July 20). Summer and anxiety. Mental Health UK. https://mentalhealth-uk.org/blog/summer-and-anxiety/#:~:text=Increased%20temperatures%20cause%20higher%20cortisol

[3] Nast, C. (2022, October 17). The Scientific Reason Why Rain Can Really Dampen Your Mood. SELF. https://www.self.com/story/why-rain-affects-mood-mental-health#:~:text=A%20dose%20of%20morning%20light

[4] Humidity doesn’t just make you sweaty and uncomfortable—it can make you sick. (2017, July 26). HealthPartners Blog. https://www.healthpartners.com/blog/humidity-can-make-you-sick/

[5] Boker, S. M., Leibenluft, E., Deboeck, P. R., Virk, G., & Postolache, T. T. (2008). Mood Oscillations and Coupling Between Mood and Weather in Patients with Rapid Cycling Bipolar Disorder. International Journal of Child Health and Human Development : IJCHD, 1(2), 181–203. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2651091/#:~:text=There%20are%20several%20indirect%20reasons

[6] Orthobethesda. (2019, August 5). Why Your Body Aches When It Rains | OrthoBethesda. Ortho Bethesda. https://www.orthobethesda.com/blog/why-your-body-aches-when-it-rains/#:~:text=When%20there%27s%20a%20rainstorm%2C%20atmospheric

[7] Tamer, T. M. (2013). Hyaluronan and synovial joint: function, distribution and healing. Interdisciplinary Toxicology, 6(3), 111–125. https://doi.org/10.2478/intox-2013-0019

Postpartum Depression Through the Sociological Lens

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Postpartum Depression Through the Sociological Lens

Lula Dalupang

January 2024

Among the excitement and celebrations of childbirth, there are lesser known effects like distress and inner turmoil that fall under the disorder known as postpartum depression. In “Life in the Throes of Postpartum Depression,” the New York Times shares the stories of four mothers’ struggle with mental health after delivering their babies. These mothers suffered anxious thoughts and histrionic emotions. Other symptoms of postpartum depression include feelings of anger, withdrawing from loved ones, worrying about hurting the baby, and feelings of numbness and guilt.[1] The contextual struggles of these women include work-family balances, poor communication with pediatricians, and inaccessible therapy. Postpartum depression can be analyzed through the sociological viewpoint in terms of a female’s internalization of emotions, but from a contextualized perspective, the social stress process model plays a larger role in the role transition of becoming a mother. 

Although the Center for Disease Control reports that 1 in 8 women experience postpartum depression,[1] social stigma and underdiagnosis causes postpartum depression to be overlooked. The existing public stigma towards people with mental illness is amplified by the expectations of motherly responsibilities, which encourages the concealment of a disorder such as postpartum depression.[3] Concealment inhibits exposure to this disorder and even more importantly, the treatment of this disorder, which then allows the current stigma to persist. Mothers may also attempt to conceal their depression as a means of protecting their children. A mother from the New York Times directly acknowledged the stigma and worried that people would “…take her children away.”[5] This mother then goes onto therapy and medication, reporting that a main part of her recovery was being vulnerable. In relation, Emma McGinty,[3] PhD, in the Health Policy and Management Department of Johns Hopkins Bloomberg School of Public Health studied how exposure to successful treatment is an essential part of lowering stigma and promoting help seeking. 

Postpartum depression can be treated with the right support

Overlooking Postpartum Depression 

Additionally, postpartum depression is a type of intropunitive disorder. By internalizing symptoms, these types of disorders are more easily concealed. Women are found to be more commonly diagnosed with intropunitive disorders than men.[2] This makes it difficult for women to receive treatment unless a healthcare provider or an external source brings up the topic first. However, an OB-GYN physician admitted to the New York Times that they are not always able to mention mental health due to how busy they are. Additionally, one of the women suffering with postpartum depression reported that she had filled out the mental health form when seeing a pediatrician, yet nothing came out of it.[5] These specialists are focused and trained on obstetrics and pediatrics, often causing them to overlook mental health. Another woman felt undeserving of help due to the extensive amount of time required to get placed with a therapist. She felt that, “There are people out there who need it more than I do.”[5] Therefore, postpartum depression tends to be overlooked by both physicians and the mothers themselves. 

Sociodemographics and Risk Factors 

Some mothers are more likely to be affected by postpartum depression than others. Multiple studies found that the same factors predict postpartum depression: income, occupational prestige, marital status, education, age, and number of children.[1;6] These risk factors are known as socioeconomic status when examined through the lens of the social stress process model. Level of education influences the types of careers a person may obtain, which then influences their annual income. Lisa Sergre conducted sociodemographic interviews with new mothers and found that financial poverty is the single largest predictor of postpartum depression.[6] Financial poverty causes increased stress surrounding the series of monetary burdens throughout pregnancy and motherhood, such as hospital bills, feeding another mouth, and the cost of baby supplies. Costs for treatment of postpartum depression would be an additional strain, with prices around $350 per month. One of the mothers interviewed compared the fee to “like having another car payment”.[5]) The high cost of therapy thus prevents mothers from seeking treatment, reiterating the issue of concealing and internalizing the disorder. In addition, maternity leave is a cause for lower household income. This causes a role conflict in finding balance between working to provide for her family versus having time and energy to be a mother. 

Secondary Stressors 

In fact, there are many struggles with the role of being a new mother. A role transition takes place in becoming a mother and navigating new responsibilities. There is also role-blurring, the overlap of work and household roles, known to affect women more than men.[4] Women carry a larger mental load than men, and having a baby adds many more chores onto that to-do list.A spouse acts as a buffering effect, acting as both emotional support and instrumental support by helping out with household chores and being the primary source of income In contradiction, additional children may act as secondary stressors. Having a new child requires adjusting how much financial aid and quality the other children can receive, and since the newborn typically receives the most attention, the other children are likely to have negative responses. 

If a mother were to seek treatment, this would be another sacrifice of time that could be spent with her family. One of the mothers from the article struggled with committing to a treatment program because they took “full days, from 10 a.m. to 3 p.m.”[5] Likewise to how the cost of treatment acted like another car payment, the time for treatment acted like another job.  If the spouse is at work while the mother is seeking treatment or in the case of a single mother, a nanny would be required to look after the children. This would be an additional cost and would also play a stressor in the search for a compatible nanny. Although placing the responsibility of a child into someone else’s hands or even spending any time away from them would be a cause of anticipatory stress for the mother. Most of the mothers interviewed by the New York Times expressed a sense of panic whenever separated from their baby. These mothers often lost sleep due to fear that something would happen to their baby in the meantime.[5] Anticipatory stress is dangerous because there is no limit to which one can worry about the unknown. Like all other mental illnesses, accessibility to treatment and strong social support are crucial to helping mothers overcome postpartum depression. Another similarity is that attitudes towards these disorders can change over time and place as a result of being socially constructed. With the fluctuating environment of reproductive rights, further research must be done on how postpartum depression has been affected over time (i.e. pre- and post-Dobbs v. Jackson Women’s Health Organization) and over place (i.e. state by state). Although macro-processes like federal and state laws are factors, so are micro-processes like social support. Providing care and support can make a life-changing difference for new mothers. 

References 

[1] Depression among women. (2023, May 22,). Centers for Disease Control and Prevention. Retrieved 09/04/2023, from https://www.cdc.gov/reproductivehealth/depression/# 

[2] Loring, M., & Powell, B. (1988). Gender, race, and DSM-III: A study of the objectivity of psychiatric diagnostic behavior. Journal of Health and Social Behavior, 29(1), 1-22. https://10.2307/2137177 

[3] McGinty, E. E., Goldman, H. H., Pescosolido, B., & Barry, C. L. (2015). Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination. Social Science & Medicine (1982), 126, 73-85. https://10.1016/j.socscimed.2014.12.010 

[4] Pearlin, L. I., & Bierman, A. (2012). Current issues and future directions in research into the stress process. Springer Netherlands. https://10.1007/978-94-007-4276-5_16 

[5] Pearson, C. (2023, June 27,). Life in the throes of postpartum depression. The New York Times.

[6] Segre, L. S., O’Hara, M. W., Arndt, S., & Stuart, S. (2007). The prevalence of postpartum depression – the relative significance of three social status indices. Social Psychiatry and Psychiatric Epidemiology; Soc Psychiatry Psychiatr Epidemiol, 42(4), 316-321. https://10.1007/s00127-007-0168-1

Changing Tides: Prioritizing Mental Health for a Brighter Tomorrow

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Changing Tides: Prioritizing Mental Health for a Brighter Tomorrow

Roma Bhavsar

January 2024

What is Mental Health?  

It is no secret that we are in the midst of a mental health crisis. Over the last decade, there has been a large cultural shift that encourages healthy minds, sharing personal stories, and breaking down the stigma surrounding mental health[1-3]. This is good news; individuals should be open and vocal about mental health because this is integral to our overall well-being and state of mind. Mental health is a human right and it encompasses individual, psychological, environmental, and social well-being. These are vital components that affect our ability to act,  think, and feel and this can change over time depending on many factors.[2]

Who is Affected? 

The World Health Organization (WHO), among other organizations, have demanded a call to action for a collective and multisectoral approach to transform mental health globally, emphasizing human rights, empowerment, and a commitment to comprehensive mental health  resources and strategies to build supportive environments.[1] According to the Centers for Disease Control and Prevention (CDC), more than 20% of adults currently live with a mental illness, more than 20% of youth, ages 13-18, are experiencing mental illness now or had so in the past.[2] According to a recent 2024 Newsweek article, a whopping 33% of young adults aged 18-25 suffer from mental illness and are twice as likely to suffer from depression and anxiety  compared to teenagers. These statistics are alarming and warrants radical and immediate policy reform and advocacy to help prioritize and drive change to the health sector by enhancing  accessibility and affordability of mental health care.[3] 

Young adults are highly affected by mental health, and many go undiagnosed or without the help they need.

Why Mental Health is Important ​

Mental health is just as important as our physical health and symptoms can go unnoticed by both the individual and those around them. Individuals should be encouraged to acknowledge and address mental health challenges in order to reach their full potentials.[4]

The importance of self-awareness and transparent communication with healthcare providers,  family, or friends is underscored as the first step towards overall well-being. Undervaluing  our mental health can have a harmful impact on cognitive functioning, physical health, resilience, relationships, and overall well-being.[4] 

When we invest time and energy into our mental health, it comes with a lot of advantages. It can help us build confidence, self-esteem, and build resilience by learning how to manage our  feelings and not let our emotions get the best of us.[4] 

3 Quick Ways to Support One’s Mental Health[4,5] 

1. Take care of yourself first: prioritizing personal time and self-care through healthy  boundaries involve recognizing and respecting one’s values and limits without compromise. Disconnecting from social media, the constant buzz of the outside world, and reducing  stress through relaxation techniques such as meditation or mindfulness is key. In addition, regular exercise, maintaining a balanced diet, and getting adequate sleep are all examples  of actions one can incorporate into one’s routine to contribute to overall mental well-being. 

2. Support Groups: it provides individuals with a supportive, empathetic group of trusted confidants who share mutual interests and understand each other’s challenges. These groups offer a sense of connection, community, understanding, and a space to share coping strategies and encourage authentic conversations about their feelings. 

3. Psychotherapy: talking to a trained mental health professional who can offer personalized and effective intervention. Cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) are among various different therapeutic approaches one can take. 

Resources and Tips to Help Invest in YOU 

If you are not sure what mental health resources your insurance covers call your insurance  provider to see what is covered at no cost to you. Many plans now offer some therapy sessions  for free annually and some type of health coverage.  

Many workplaces now offer some easy measures for well-being such as mental health or  wellness days and flexible scheduling for therapy or treatment[3]. Be sure to not let these benefits  go to waste and take the time to understand your options. Below are links to a few resources to help get started:  

● Crisis Hotlines and Resources (apa.org) 

● Thrive Global: Well-Being & Behavior Change Platform 

● Support Groups | NAMI: National Alliance on Mental Illness 

● Substance Abuse and Mental Health Services Administration (SAMHSA) o National Helpline at 1-800-662-HELP (4357) 

● 988 Suicide & Crisis Lifeline – Call or text 988 or chat on 988lifeline.org  

Life is an emotional journey with lots of ups and downs! Our well-being is not dependent on external circumstances; we are in charge and we cannot let ourselves down. It’s vital to remain calm and take the time to prioritize mental health for a brighter tomorrow! 

References 

[1] World Health Organization. (2022, June 17). Mental health. World Health  Organization. https://www.who.int/news-room/fact-sheets/detail/mental-health strengthening-our-response 

[2] CDC. (2023, April 25). About Mental Health. Centers for Disease Control and  Prevention. https://www.cdc.gov/mentalhealth/learn/index.htm. 

[3] McGuire, K. (2024, January 8). Making Mental Health Our Number One Issue in 2024.  Newsweek. https://www.newsweek.com/making-mental-health-our-number-one-issue 2024-1858290.  

[4]  6 Reasons Mental Health Is SO Important. (2024, January 4). Cleveland Clinic.  https://health.clevelandclinic.org/why-mental-health-is-so-important.  

[5] Codd, E. (2020, September 21). Make Mental Health Your #1 Priority. Harvard  Business Review. https://hbr.org/2020/09/make-mental-health-your-1-priority. 

It’s More Than “Just a Pinch”

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It’s More Than “Just a Pinch”

Lisa Samy

January 2024

Hysteria. It’s a word that has stigmatized women throughout the ebb and flow of history, bunching a plethora of illnesses—and all women—into one category.[1] While this term lost its place as an official diagnosis, its connotation still negatively affects modern medical care. A recent study shows that doctors tend to undermine women’s pain compared to men and that women should primarily seek psychotherapy to alleviate their pain.[3] This originates from the subconscious, stereotypical belief that women are more “openly expressive” and “more emotional” when tolerating pain.[3] Therefore, there’s no need to take extra precautions, even for an extremely invasive procedure that myriad women dread having to endure: gynecological
exams.

Pain Isn’t Static

Lauren Capps, 28, accounts her past pap smears—a procedure where a medical provider scraps cells from a patient’s cervix to test them for cervical cancer—with, “I just remember the most terrible pain,” and, “I remember feeling violated.”[2] Additionally, Cooper Owens, 43, underwent a cervix dilation without anesthesia—she recalls, “I have never gone through that kind of physical agony in my 43 years of life.”[2] In the end, these women are shrugged off by medical providers because, well, childbirth hurts. Periods hurt. Women go through them all the time.

Therefore, women’s pain is routine.

The bottom line is this: levels of pain tolerance aren’t universal from person to person. When the line between necessary discomfort and pain blurs, so too does a medical provider’s judgment. That’s when it feels easy for a medical provider to laugh off a woman’s pain, or continue with the exam even though the patient doesn’t feel comfortable doing so.

It is important to communicate your comfort zones and limitations with your doctor.

For women who have experienced sexual assault, the barriers are even higher. Huma Farid, a practicing gynecologist and instructor at Harvard Medical School, says her patients who “experienced sexual assault confess that they have avoided or delayed seeking medical care due to their anxiety surrounding pelvic exams.”[4] Furthermore, these women have higher rates of post-traumatic stress disorder (PTSD), which instills the fear that they may relive their trauma during the exam.[4] This, of course, puts fearful and traumatized women at a higher risk of suffering from undiagnosed illnesses like cervical cancer or endometriosis.[1]

What Can Medical Providers Do?

Most medical providers wouldn’t intentionally harm their patients; however, biases, inattentiveness to a patient’s comfort, and a lack of pain management may cause them to inflict physical and/or psychological pain on their patients. The key to mitigating these issues is to reevaluate their mindsets toward women’s care; in particular, they can focus on a particular goal: individualized patient care.[2] 

This entails caring for a patient’s unique needs, fears, and ultimately, adjusting standardized procedures to their comfort. Medical providers can offer pain medication such as topical numbing cream before the procedure starts. Furthermore, they should remind the patient that they have full control and bodily autonomy, and encourage the patient to control the pace of the procedure. If the patient feels overwhelmed or is in excruciating pain, the medical professional must stop and ascertain their condition. If they’ve exhausted all their other options to continue the procedure, then there is only one option: schedule the appointment another time and prepare accordingly. Rescheduling should preferably be cost free to ensure the patient does not incur additional stress over finances and affordability. This in turn, helps the patient feel genuinely cared for and supported by their medical provider.

What Does Good Care Look Like?

For Kendra Perry, 47, her experience with an ideal medical provider is a paragon of good patient care. After several unsuccessful, and painful, attempts of undergoing an endometrial biopsy, even with prescribed medication, her medical provider opts to reschedule her appointment to conduct the procedure under general anesthesia for a pain-free experience.[2] Perry, pleased and relieved, says her gynecologist, “respected what [her] body could and couldn’t tolerate, or could and couldn’t do.”[2] To many people, this sounds like a pipe dream. And it’s about time this shifts into a shared reality for all women.

References

[1] Brooks, Laken. (2021). Painful Gynecological Visits Can Be Traumatic Instead of Healing. Forbes.

https://www.forbes.com/sites/lakenbrooks/2021/11/06/painful-gynecologist-visits-can-be-trauma tic-instead-of-healing/?sh=ffe63e847dbb​

[2] Nudson, Rae. (2022). Gynecology Has a Pain Problem Our discomfort is routine. What if it didn’t have to be? The Cut. https://www.thecut.com/2022/06/pain-in-gynecology-practice-exams.html 

​[3] Zhang, Lanlan. (2021). Gender Biases in Estimation of Other’s Pain. The Journal of Pain. https://www.jpain.org/article/S1526-5900(21)00035-3/fulltext ​

[4] Farid, Huma. (2019). When a pelvic exam is traumatic. Harvard Health Publishing. https://www.health.harvard.edu/blog/when-a-pelvic-exam-is-traumatic-201901291586

Breaking the Silence: Navigating Vaginismus with Understanding and Empowerment

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Breaking the Silence: Navigating Vaginismus with Understanding and Empowerment

Paz Etcheverry

January 2024

Is penetrative sex with your partner impossible because attempting it feels like “hitting a wall”? Have you never been able to insert a tampon? Do you skip your annual gynecological exam because the idea of having a speculum inserted into your vagina makes you extremely fidgety? If any of these scenarios resonate with you, you may have a condition known as vaginismus. Fortunately, there are treatment options.

Vaginismus is a psychological condition where the muscles of the vagina tighten up in a manner that makes the scenarios above very challenging or seemingly impossible to perform. It’s a completely involuntary response of the body triggered by fear and anxiety of penetration that affects up to six percent of women.[1] In those with this condition, vaginismus can lead to feelings of shame, hopelessness, and body insecurity,[4] which can result in relationship issues and mental health struggles.

Kegel exercises have been shown to improve symptoms of vaginismus

The term vaginismus was first coined in 1862 by James Marion Sims, a physician and pioneer in gynecology from South Carolina. He identified several contributing factors to this condition including emotional factors (anxiety of performance, sexual abuse, sexual issues with the partner, religious beliefs, and past trauma) and physical factors (cancer, childbirth, inadequate lubrication, and insufficient foreplay).[1]

Despite vaginismus being described over a century and a half ago, it continues to be a taboo subject, leading to significant stigma and underdiagnosis. It is rarely discussed in medical conferences, residency, or medical school. However, unlike other sexual disorders affecting women, vaginismus treatment has a high success rate.[6]

Treatment for vaginismus often involves a combination of physical therapy and psychotherapy. It’s essential to consult with a healthcare professional to determine the most appropriate treatment plan.

Some of the Treatment Options

Kegel Exercises

Kegel exercises consist of rapidly contracting and releasing the pelvic muscles, as though attempting to stop the flow of urine. As first described by Dr. Arnold Kegel in 1948, Kegel exercises can help with more than just alleviating vaginismus. These exercises have been shown to prevent urinary incontinence and genital organ prolapse, a condition where the uterus, bladder, or rectum descend into the vaginal canal due to weakened supporting tissues.[3] 

Vaginal Dilators

These dilators are graduated silicone or plastic tube-shaped devices that range in both size and thickness. Women insert a dilator into their vaginas and allow it to stretch the vaginal muscles for approximately twenty minutes. When they no longer experience discomfort, women can move on to the next size. This process is known as systematic desensitization.[5] Materna Medical has come up with an ingenious vaginal dilator by the name of Milli[TM] that gently enlarges within the vaginal area at a pace under the user’s control. In other words, Milli[TM] does not consist of multiple dilators, rather a single dilator that women can control with the simple press of a button.

Support Online Groups/Programs

Maze Women’s Sexual Health has a comprehensive supportive forum where women can discuss their symptoms, treatment, and progress in overcoming this condition. HelloGina[TM] offers an evidence-based digital therapy program through an app where women receive guidance from a skilled coach who supports them throughout their journey. The program, while pricey ($288), has a satisfaction rate of more than ninety-seven percent among users.

Primary Care Physician or Ob/Gyn

During the upcoming annual exam, ask your ob/gyn healthcare provider to consider using a smaller speculum. It’s also advisable to request the speculum to be warmed for added comfort. If you’ve been using dilators, you may choose to self-insert the speculum. Make sure to talk to your doctor so that the gynecological exam can proceed at a pace that is most comfortable for you.

Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, is a form of psychotherapy that aims to identify and modify negative thought patterns and behaviors. It focuses on the interplay between thoughts, feelings, and behaviors, helping individuals develop healthier coping mechanisms. There is evidence that CBT may help women with vaginismus. For example, after receiving CBT for three months, eighteen percent of women were able to successfully have intercourse with their partners compared to none in the control group.[8] 

Hypnosis

In the course of hypnosis, the underlying issues contributing to vaginismus can be examined, and efforts may be made to address, and potentially reverse, the fears and anxiety associated with the condition. Hypnosis can delve into some of the psychological causes of vaginismus, suggesting that some women have the capability of overcoming vaginal muscle spasms.[5]

Botox

Botulinum toxin, when injected in the perineum or area between the anus and the genitals, may be an effective treatment for vaginismus based on a few studies.[2] 

While overcoming vaginismus may initially appear quite daunting, it’s important to remember that there are available treatment options to address and manage this condition. Experiencing vaginismus can lead to feelings of shame and body insecurity, but it’s crucial to remember that you are not alone. Embracing the journey to overcome vaginismus brings the promise of empowerment, healing, and the possibility of rediscovering a fulfilling relationship with one’s own body.

References

[1] Anğın, A. D., Gün, İ., Sakin, Ö., Çıkman, M. S., Eserdağ, S., & Anğın, P. (2020). Effects of predisposing factors on the success and treatment period in vaginismus. JBRA Assisted Reproduction, 24(2), 180–188. https://doi.org/10.5935/1518-0557.20200018 

[2] Helmi, Z. R. (2022). Comparative Study of 150 vs. 200 Units of Botulinum Toxin as Treatment for Vaginismus. Estudo comparativo de 150 vs. 200 unidades de toxina botulínica como tratamento para vaginismo. Revista Brasileira de Ginecologia e Obstetricia : Revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 44(9), 854–865. https://doi.org/10.1055/s-0042-1751287 

[3] Huang, Y.C. & Chang, K.V. Kegel Exercises. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555898/ 

[4] McEvoy, M., McElvaney, R., & Glover, R. (2021) Understanding vaginismus: a biopsychosocial perspective. Sexual and Relationship Therapy. 

[5] Melnik, T., Hawton, K., & McGuire, H. (2012). Interventions for vaginismus. The Cochrane Database of Systematic Reviews, 12(12), CD001760. 

[6] Pacik, P. T. (2014). Understanding and treating vaginismus: a multimodal approach. International Urogynecology Journal, 25(12), 1613–1620. 

[7] Pithavadian, R., Chalmers, J., & Dune, T. (2023). The experiences of women seeking help for vaginismus and its impact on their sense of self: An integrative review. Women’s Health (London, England), 19, 17455057231199383. https://doi.org/10.1177/17455057231199383 

[8] ter Kuile, M. M., van Lankveld, J. J., de Groot, E., Melles, R., Neffs, J., & Zandbergen, M. (2007). Cognitive-behavioral therapy for women with lifelong vaginismus: process and prognostic factors. Behaviour Research and Therapy, 45(2), 359–373. https://doi.org/10.1016/j.brat.2006.03.013