Vaginal Atrophy

Vaginal Atrophy

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I returned recently from an event hosted by the International Society for the Study of Women’s Sexual Health (ISSWSH) in Scottsdale, AZ. This conference was held in conjunction with the Society for Sex Therapy and Research (SSTAR) where physicians, gynecologists, pelvic floor therapists, sex therapists, urologists, and more professionals came together to present a smorgasbord of clinical information regarding women’s sexual health.

Among the many award winning presentations, Dr. Irwin Goldstein, Editor in Chief of the Journal of Sexual Medicine, gave a lecture about the common practices that lead to vaginal atrophy. Dr. Goldstein is now President of The Institute for Sexual Medicine, Inc., and a 2009 winner of the Gold Medal awarded by the World Association for Sexual Health in recognition of his lifetime contributions to the field. I will be summarizing my interpretation of Dr. Goldstein’s presentation regarding the hormonal consequences of birth control pills and how it effects women’s sexual health.

During the ISSWSH conference Dr. Goldstein shared an informative presentation regarding the effects of birth control pills. First, there are actually 3 types of categories that create the Yoni: vulva (exterior portion), vagina (interior portion or canal), and the vestibule, the delicate and pink tissue that connects the vulva and vagina. “Taking birth control pills over time contributes to a woman’s vestibule atrophy” stated Dr. Goldstein. The vestibule of a woman involves her clitoris, labia, and the glands that make vaginal mucus. Estrogen, although a dominant player is not the only major hormonal moderator of women’s sexual health.

According to Dr. Goldstein, testosterone continues to be inadequately appreciated as a female ally compared to estrogen. Here is why: birth control pills cause a process resulting in (1) significantly lower testosterone in vestibular tissue, (2) atrophy of vestibular muscle, (3) diminished blood flow to the vagina, (4) atrophy of the nerves that cause women to feel genital pleasure, and (5) lower sexual desire. For these reasons, the degree of loss of sexual desire correlates strongly with diminished testosterone levels in women. Doctors must tell women that birth control pills “ throw them into a low testosterone state 100% of the time.”

In order to further understand women’s sexual health, Dr. Goldstein measured women’s sex hormone-binding globulin (responsible for binding androgens and estrogen) in those women who were using birth control pills and those who were not. What he found was those who were taking birth control pills had significant size decrease in their clitoris, g-spot (or prostate gland) and labia! Dr. Goldstein later stated that by “simply looking at the size of the clitoris,” or measuring it to the head of a q-tip, “I could determine if a woman was using birth control pills or not,” even in women as young as 16! He also added that the use of birth control pills contributes to bone disease, depression, and less sexual interest.

Therefore, Dr. Goldstein urges eliminating the use of birth control pills as the sole solution to avoiding pregnancy. However, if women desire to stop the effects of an atrophied vagina he suggests seeking a testosterone treatment, such as AndroGel from a medical professional. Dr. Goldstein also stated that those women who have undergone the testosterone treatment in his office had a 50-60% success rate, and over the course of 2-3 months this group of women regained their vaginal tissue.

Similarly to birth control pills, another over looked behavior that contributes to vaginal atrophy is cycling. As Dr. Goldstein stated in his ISSWSH presentation, cycling while pressing the clitoris against the head of the bike’s seat and pressing our body’s weight firmly against it causes the nerve endings in our clitoris to be ruptured. Again, with damaged nerve ending either through atrophy or excessive pressure on the vaginal tissue can radically impact a woman’s sensation to pleasure and decrease blood circulation, impacting her desire for sexual pleasure.

After returning from the International Society for the Study of Women’s Sexual Health (ISSWSH) I am fully convinced that a woman’s health relies on her sexual satisfaction and fulfillment. Most women consider being fully sexual or embracing their sexual pleasure as deviant, when in fact it contributes to their longevity. Among the many pioneers in sexual medicine, Dr. Goldstein, a urologist from McGill University and Editor in Chief of the Journal of Sexual Medicine discussed how the effects of birth control pills and cycling negatively impact a woman’s sexual health.

I am super grateful to have been able to personally listen to all the presenters during this 3 days conference and all of their remarkable information. Women’s sexual health and pleasure is my life’s passion, and I plan on continuing to work towards helping women fully embrace their orgasmic power with honor and enthusiasm

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