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The agony of vaginal atrophy.

The Agony of Vaginal Atrophy

Q: I'm over sixty and remarrying. My problem is vaginal atrophy. Can you suggest a "drugless" preparation method?

A: Yours is a common problem, since many postmenopausal women experience vaginal atrophy as a result of insufficient estrogen, leading to loss of elasticity and narrowing of the vagina. Usually, an estrogen cream is prescribed, but because of your concern for the possible side effects, other remedies must be sought. Please understand that women who undergo a prolonged period of sexual inactivity often have severe problems in resuming intercourse. Therefore, like beginning exercise after a period of inactivity, intercourse should be resumed gradually and gently. A lubricant, such as K-Y Jelly, should be used.

Q: I work with teenagers. What would you suggest for effective counseling?

A: Probably the most needed counseling is in the area of influencing sexual behavior and ethics. Several studies have shown that providing contraceptive devices or contraceptive prescriptions only results in a high degree of noncompliance, increased teenage sexual encounters, and pregnancies. Education showing the negative effects of teenage pregnancies, abortion, and sexually transmitted diseases, and how these can be avoided, should be emphasized. A close ongoing relationship with the counselor probably will improve chances for teenage compliance.

Q: I am a 38-year-old woman who has been having problems with urinary frequency for the past 19 years. I've been to urologists and gynecologists and have had numerous cystoscopies, intravenous pyelograms and urethroscopies, which show inflammation in my urethra and bladder, and I have also had numerous urethral dilations. I used oral contraceptives for several years. The frequency of urination has gotten so bad that I have difficulty getting enough sleep to stay awake at my job. Any suggestions?

A: Sexually active women are more prone to infections of the posterior urethra and bladder. Cure is not always possible, but control can be achieved with proper treatment. Persistence, cooperation, and understanding between patient and physician are needed. There are several new drugs, together with urethral dilation, that are effective in most cases over an extended period of time.

Q: Is there any truth to the theory that cervical cancer may be linked to early sexual activity?

A: Early sexual activity is the most significant etiologic factor in the causation of cervical cancer. In fact, cervical cancer, which is not regarded as a sexually related disease, does not occur in the absence of sexual congress. There are three etioligic factors in determining relative risk of developing cervical cancer. They are:

1: Age at first sexual activity. The younger a woman is when first commencing sexual activity, the greater the risk.

2: Sexual activity. The greater the frequency of intercourse, the greater the risk.

3: Number of sexual partners. The more sexual partners a woman has, the greater the risk.

It is believed exposure to a suspected carcinogenic agent, human papilloma virus types 16 and 18, which is discharged by the male, is the cause.
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Article Details
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Title Annotation:includes related questions on gynecology; The Doctor's Casebook
Author:Flatto, Edwin
Publication:Nutrition Health Review
Article Type:column
Date:Mar 22, 1990
Words:490
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