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Vaginismus
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Vaginismus
ABOUT
DESCRIPTION
IN THIS ARTICLE
When a woman has vaginismus, her vagina's muscles squeeze or
spasm when something is entering it, like a tampon or a penis.
It can be mildly uncomfortable, or it can be painful.
There are exercises a woman can do that can help, sometimes
within weeks.
Symptoms
Painful sex is often a woman's first sign
that she has vaginismus. The pain happens only with penetration. It usually
goes away after withdrawal, but not always.
Women have described the pain as a tearing sensation or a
feeling like the man is "hitting a wall."
Many women who have vaginismus also feel discomfort when
inserting a tampon or during a doctor's internal pelvic exam.
Causes
Doctors don't know exactly why vaginismus happens. It's
usually linked to anxietyand fear of having sex. But it's unclear which came first, the
vaginismus or the anxiety.
Some women have vaginismus in all situations and with any
object. Others have it only in certain circumstances, like with one partner but
not others, or only with sexual intercourse but not with tampons or during
medical exams.
Other medical problems like infections can also cause
painful intercourse. So it's important to see a doctor to determine the
underlying cause of painduring sex.
CONTINUE
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Women with vaginismus can do exercises, in the privacy of
their own home, to learn to control and relax the muscles around the vagina.
The approach is called progressive desensitization, and the
idea is to get comfortable with insertion.
First, do Kegel exercises by squeezing the same
muscles you use to stop the flow of urine when urinating:
- Squeeze the muscles.
- Hold for 2 to 10 seconds.
- Relax the muscles.
Do about 20 Kegels at a time. You can do them as many times
a day as you want to.
After a few days, insert one finger, up to about the first
knuckle joint, inside the vagina while
doing the exercises. It's a good idea to clip your fingernails first and use a lubricating
jelly. Or do the exercises in a bathtub, where water is a natural lubricant.
Start with one finger and work your way up to three. You'll
feel the vagina's muscles contracting around your finger, and you can always
take your finger out if you're not comfortable.
For women whose vaginismus is related to fear or anxiety,
therapy helps.
WebMD Medical Reference Reviewed by Nivin Todd,
MD on August 05, 2018
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© 2018 WebMD, LLC. All
rights reserved
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What
Is Adenomyosis?
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What Is Adenomyosis?
ABOUT
DESCRIPTION
IN THIS ARTICLE
Adenomyosis is a condition in which the
inner lining of the uterus (the endometrium) breaks through the muscle wall of
the uterus (the myometrium). Adenomyosis can cause menstrual cramps, lower abdominal pressure, and bloatingbefore menstrual periods and can
result in heavy periods. The condition can be located
throughout the entire uterus or localized in one spot.
Though adenomyosis is considered a benign (not
life-threatening) condition, the frequent pain and heavy bleeding associated
with it can have a negative impact on a woman's quality of life.
What
Are the Symptoms of Adenomyosis?
While some women diagnosed with adenomyosis have no
symptoms, the disease can cause:
- Heavy, prolonged menstrual bleeding
- Severe menstrual cramps
- Abdominal pressure and bloating
Who
Gets Adenomyosis?
Adenomyosis is a common condition. It is most often
diagnosed in middle-aged women and women who have had children. Some studies
also suggest that women who have had prior uterine surgery may be at risk for
adenomyosis.
CONTINUE READING BELOW
Though the cause of adenomyosis isn't known, studies have
suggested that various hormones -- including estrogen, progesterone, prolactin, and follicle stimulating hormone -- may
trigger the condition.
Diagnosing
Adenomyosis
Until recently, the only definitive way to diagnose
adenomyosis was to perform a hysterectomy and
examine the uterine tissue under a microscope. However, imaging technology has
made it possible for doctors to recognize adenomyosis without surgery. Using
MRI or transvaginal ultrasound, doctors can see
characteristics of the disease in the uterus.
If a doctor suspects adenomyosis, the first step is a physical exam. A pelvic exam may reveal an
enlarged and tender uterus. An ultrasound can allow a doctor to see the
uterus, its lining, and its muscular wall. Though ultrasound cannot
definitively diagnose adenomyosis, it can help to rule out other conditions
with similar symptoms.
Another technique sometimes used to help evaluate the
symptoms associated with adenomyosis is sonohysterography. In
sonohysterography, saline solution is injected through a tiny tube into the
uterus as an ultrasound is given.
MRI -- magnetic resonance imaging -- can be used
to confirm a diagnosis of adenomyosis in women with abnormal uterine bleeding.
Because the symptoms are so similar, adenomyosis is often
misdiagnosed as uterine fibroids. However, the two conditions
are not the same. While fibroids are benign tumors growing in or on the uterine
wall, adenomyosis is less of a defined mass of cells within the uterine wall.
An accurate diagnosis is key in choosing the right treatment.
How Is
Adenomyosis Treated?
Treatment for adenomyosis depends in part on your symptoms,
their severity, and whether you have completed childbearing. Mild symptoms may
be treated with over-the-counter pain medications and
the use of a heating pad to ease cramps.
Anti-inflammatory medications. Your doctor may prescribe nonsteroidal
anti-inflammatory drugs (NSAIDs) to relieve mild pain associated with
adenomyosis. NSAIDs are usually started one to two days before the beginning of
your period and continued through the first few of days of your period.
Hormone therapy. Symptoms
such as heavy or painful periods can be controlled with hormonal therapies such
as a levonorgestrel-releasing IUD (which is
inserted into the uterus), aromatase inhibitors, and GnRH analogs.
Uterine artery embolization. In this minimally invasive procedure, which is
commonly used to help shrink fibroids, tiny particles are used to block
the blood vessels that provide blood flow to the adenomyosis. The
particles are guided through a tiny tube inserted into the vagina through the cervix. With blood supply cut off, the
adenomyosis shrinks.
Endometrial ablation. This minimally invasive procedure destroys the lining
of the uterus. Endometrial ablation has been found to be effective in relieving
symptoms in some patients when adenomyosis hasn't penetrated deeply into the
muscle wall of the uterus.
Does
Adenomyosis Cause Infertility?
Because many women who have adenomyosis also have endometriosis, it is difficult to tell
precisely what role adenomyosis may play in fertilityproblems. However, some studies have
shown that adenomyosis may contribute to infertility.
Can
Adenomyosis Be Cured?
The only definitive cure for adenomyosis is a hysterectomy,
or the removal of the uterus. This is often the treatment of choice for women
with significant symptoms.
WebMD Medical Reference Reviewed by Traci
C. Johnson, MD on February 03, 2017
Enlarged
Uterus
IN THIS ARTICLE
From conception to
delivery, a woman's uterus can grow from the size of a pear to the size of a
watermelon. But pregnancy isn't
the only potential reason for an enlarged uterus. An
enlarged uterus is common and can be a symptom of a variety of medical
conditions, some of which require treatment.
Two of the most common causes of an
enlarged uterus are uterine fibroidsand adenomyosis.
Uterine fibroids. Uterine fibroids are common noncancerous tumors of the
muscular wall of the uterus, affecting as many as eight in 10 women by the age
of 50. Fibroids more commonly affect women over age 30. They are also more
common in African-Americans than Caucasians. Overweight and obese women
also have a greater risk of developing fibroids. Hormonal and genetic factors
contribute to their growth.
While some fibroids are very small, others
grow to weigh several pounds. A woman may have a single fibroid or multiple
fibroids. In addition to an enlarged uterus, symptoms of uterine fibroids may
include:
CONTINUE READING BELOW
- Feeling of fullness or pressure in the lower abdomen
- Heavy, painful, and/or long-lasting periods,
sometimes with the passage of blood clots
- Bleeding between periods
- Constipation
- Frequent urination
- Pain during intercourse
- Pregnancy or delivery complications
If symptoms are severe, treatment may
involve a procedure called uterine artery embolization
to cut off the blood supply to
the fibroids so that they shrink and eventually die, or surgery to remove the
fibroids (myomectomy) or the
entire uterus (hysterectomy). Other
treatments include endometrial ablation.
This procedure is performed for small submucusal fibroids (when the inside lining
of the uterus is removed, burned or frozen) and laparoscopic myolysis (when
freezing or an electric current is used to destroy the fibroids). Medications to help control painful
periods or for pain may also be used. Other treatment options include
focused ultrasoundsurgery
and an intrauterine device (IUD)
to decrease bleeding.
The cause of fibroids is not known, but
the tumors seem to rely on estrogento grow.
After menopause, they
often shrink naturally and cause no symptoms.
Adenomyosis. Adenomyosis is a diffuse thickening of the uterus
that occurs when the tissue that normally lines the uterus (endometrium) moves
into its muscular outer wall and behaves like the endometrium. When this
happens in a small area, or is localized, it is called an adenomyoma.
While the cause of adenomyosis is unknown,
the condition usually occurs in women older than age 30 who have had children.
It is more common in women who have had uterine surgery, including a cesarean section.
In addition to uterine enlargement,
symptoms may include:
- Long periods or heavy bleeding
- Painful periods, which get continually worse
- Pain during intercourse
Most women have some adenomyosis at the
end of their childbearing years. Most don't require treatment, but some need
medication to relieve pain. Birth control pills and
an intrauterine device (IUD) containing progesteronemay help
decrease heavy bleeding. Women with severe symptoms may need a hysterectomy to
relieve symptoms.
Other Causes of an Enlarged Uterus
In some cases, an enlarged uterus can be a
symptom of uterine cancers, including endometrial cancer (affecting
the lining of the uterus) and cervical cancer (affecting
the lower portion of the uterus where it joins the vagina). Treatment
depends on the location, the extent of the cancer, and other factors.
Symptoms of an Enlarged Uterus
If you have an enlarged uterus, you won't
necessarily notice it yourself. Your doctor may discover it during a physical exam or
on imaging tests. Many conditions that cause an enlarged uterus are benign and
don't require treatment unless symptoms are severe.
If you experience problems such as
irregular bleeding; painful, heavy periods; pain
during intercourse; or feelings of fullness or pressure in the lower abdomen,
see your doctor, who can help determine the cause and best treatment.
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2017 WebMD, LLC. All rights reserved.
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