Bringing a new life into the world is truly a miracle. Yet in the aftermath of the birth and all the excitement surrounding bringing the baby home, many women find themselves noticing something not so miraculous — their body is not the same.
The uterus, vagina, pelvic muscles and nerves undergo tremendous change during pregnancy, delivery and postpartum.
The uterus shrinks back to approximately its pre-pregnancy size within six weeks. Bleeding can persist throughout this time, but resumption of an actual period is variable and often significantly delayed if a woman decides to breast-feed. [read rest of column]
Our Bodies, Our Lives is a column focusing on issues surrounding women’s sexual, gynecological and emotional health, currently published in the Galveston County Daily News. Drs. Tristi Muir and Catherine Hansen are gynecologists at UTMB. See more of their writing on the Working Wonders blog.
Dr. Catherine Hansen, an obstetrician/gynecologist with the Pelvic Health and Continence Center, was interviewed recently about sexually transmitted diseases for an article published in the July-August 2012 issue of Women's Health.
Dr. Joseph Sonstein recently wrote in the Galveston County Daily News: "In the United States, urinary incontinence affects an estimated 17 million men and women and costs an estimated $30 billion to manage. Despite the uncomfortable nature of the problem, an open discussion with your doctor about it is important for two reasons: One, the problem may be treatable, and, two, the leakage might actually be a result of a more dangerous problem. Underlying diseases or conditions that might lead to urinary leakage include infection, damage to the nervous system, diabetes, heart disease, constipation, side effects from medications, obstruction from the prostate in men or prolapse (hernia) of the female organs in women and even cancer. Often, if these underlying conditions can be treated, the incontinence will improve or disappear completely." Read more...
Dr. Catherine Hansen, an obstetrician/gynecologist with the Pelvic Health and Continence Center, was interviewed recently about premenstrual dysphoric disorder (PMDD). The article in Lifescript – Healthy Living for Women – describes how premenstrual syndrome (PMS) means something different to every woman – irritability, bloating, food cravings. And for a small percentage with PMDD, it means falling into a mid-cycle depression so deep they can hardly perform daily activities. A woman may have PMDD if at least one of her five symptoms includes a severe emotional symptom, such as feelings of hopelessness, major depression or anxiety, an overwhelming feeling of sadness or severe anger. Premenstrual dysphoric disorder (PMDD) can be debilitating if undiagnosed. Read more...
Recently, the Institute of Medicine (IOM) released a report suggesting that contraceptives, sterilization and reproductive education should be covered by health insurance plans under the health care reform law -- at no cost to patients. UTMB Health's Dr. Tristi Muir was interviewed as part of a report on the proposed changes, on the Self.com health blog written by Amy Paturel. Read the post online...
Dr. Muir also was interviewed by Paturel on the pros and cons of blood tests that reveal a baby's gender as early as seven weeks into pregnancy. Read more...
Also, Dr. Catherine Hansen was quoted in a story on a dangerous new trend, "Mommy-rexia," as it's cleverly coined. The syndrome describes women who strive for barely-there bumps and are obsessed with getting their pre-baby body back quickly. While eating too much when pregnant isn't always a good idea, neither is eating too little, Dr. Hansen said. "Low weight gain or weight loss during pregnancy increases the potential for irreversible neurologic effects for the baby." Read the post online...
Dr. Tristi Muir, UTMB’s director of urogynecology, offers tips on how to avoid urinary tract infections during the summer. Promptly changing out of a wet swimsuit, drying off thoroughly, and drinking lots of water can all help, she says. Enhanced or more frequent intimacy can also increase the chance of a UTI. She was quoted as part of a Cosmo Health Report feature in the August 2011 issue of Cosmopolitan.
Dr. Tristi Muir was interviewed on Dr. Joe Galati’s “Your Health First” radio show on Sunday, Feb. 13. Dr. Muir, an associate professor of obstetrics and gynecology and the director of urogynecology at UTMB Health, discussed pelvic health and incontinence issues, new treatments, and services offered at the Pelvic Health and Continence Center at Victory Lakes. She is passionate about broadening the scope of options available to treat urinary and fecal incontinence and pelvic organ prolapse, and equally excited about educating women about their gynecologic health and providing them with options. The radio show, which is broadcast from 7 to 8 p.m., airs on KTRH 740 AM.
You can hear a webcast of Dr. Muir's interview online; her section begins at the 21:30 minute mark.
Dr. Jeff Temple, an assistant professor in the department of obstetrics and gynecology and a member of the Pelvic Health and Continence Center team, will study the impact of teen dating violence on mental health with the help of a research grant from the Hogg Foundation for Mental Health. His proposal was selected from a pool of 47 applicants from 19 universities across Texas. The foundation awarded 10 grants totaling nearly $150,000. Temple will expand an ongoing study of the effects of teen dating violence on mental health and dropout rates among low-income and ethnically diverse youth. According to his proposal, an estimated 25 percent of teens are physically or sexually abused by dating partners each year. Many more are victims of severe emotional and verbal abuse. Read more…
Weakened Pelvic Muscles May Result In Incontinence, Discomfort, Activity Limitation
Nearly 24 percent of U.S. women are affected with one or more pelvic floor disorders, report researchers funded by the National Institutes of Health. Their analysis is the first to document in a nationally representative sample the extent of pelvic floor disorders, a cluster of health problems that causes physical discomfort and limits activity.
The study also revealed that the frequency of pelvic floor disorders increases with age, affecting more than 40 percent of women from 60 to 79 years of age, and about 50 percent of women 80 and older.
Pelvic floor disorders result when the muscles and connective tissue within the pelvic cavity weaken or are injured. These muscles and ligaments form a sling across the opening of a woman’s pelvis, holding the bladder, uterus, bowel, and rectum in place. The three main pelvic floor disorders are urinary incontinence, fecal incontinence, and pelvic organ prolapse. Pelvic organ prolapse results when pelvic organs such as the uterus, bladder and bowel, collapse onto the vagina. The resulting pressure may cause a bulge or protrusion through the vaginal canal. This protrusion may be uncomfortable, may make physical activity difficult, and may interfere with sexual functioning.
The study results appear in the September 17, 2008 Journal of the American Medical Association.
“The study results underscore the need to identify the causes of pelvic floor disorders and the means to prevent and treat them.” said Duane Alexander, M.D., director of the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “The NIH Pelvic Floor Disorders Network is conducting studies to provide much needed answers.”
Funding was provided by the NICHD, the National Institute of Diabetes and Digestive and Kidney Diseases and the Office of Research on Women’s Health (ORWH), all at the NIH, and by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention.
The study’s first author was Ingrid Nygaard, M.D., M.S., of the University of Utah School of Medicine, Salt Lake City. The study was conducted by researchers in NIH’s Pelvic Floor Disorders Network, which seeks to improve diagnosis, treatment, and prevention of pelvic floor disorders in women.
To conduct the study, the researchers submitted questions on pelvic floor disorders for inclusion in the 2005-2006 National Health and Nutrition Examination Survey (NHANES), a periodic survey of the U.S. population conducted by the NCHS
“Before our study, there were no comprehensive national prevalence estimates for pelvic floor disorders,” said Susan Meikle, M.D., M.S.P.H, Project Scientist for the NIH Pelvic Floor Disorders Network.
The 1961 women who participated in the survey answered questions about symptoms of pelvic floor disorders. The women were age 20 and older and were not pregnant. Overall, 23.7 percent of the women had symptoms of at least one pelvic floor disorder: 15.7 percent had urinary incontinence, 9.0 percent had fecal incontinence, and 2.9 had symptoms of pelvic organ prolapse.
The proportion of women who reported at least one pelvic floor disorder increased with age: 9.7 percent of women aged 20 to 39 years, 26.5 percent of women aged 40 to 59 years, 36.8 percent of women aged 60 to 79 years, and 49.7 percent of women 80 or older.
Underweight and normal weight women were less likely to have a pelvic floor disorder (15.1 percent) than were overweight women (26.3 percent) and obese women (30.4 percent).
The prevalence of pelvic floor disorders also varied with the number of times a woman had given birth: 12.8 percent for women who had never given birth, 18.4 percent of women who had one child, 24.6 percent of women who had two children, and 32.4 percent for women who had three or more children.
The researchers did not find any differences in pelvic floor disorders based on race, ethnicity, or level of education achieved.
The researchers noted that their study focused on moderate to severe forms of pelvic floor disorders, and so did not include women with mild symptoms.
Treatment for pelvic floor disorders varies with the severity of symptoms. Treatment may involve behavioral therapies, exercises to strengthen muscles, vaginal devices to hold up the bladder or other pelvic organs, medications, or surgery.
In 2006, researchers in the Pelvic Floor Disorders Network published study results describing a successful surgery to reduce the urinary incontinence caused by pelvic organ prolapse: http://www.nichd.nih.gov/news/releases/surgery_reduces_incontinence.cfm
Additional information on pelvic floor disorders is available at http://www.nichd.nih.gov/health/topics/Pelvic_Floor_Disorders.cfm.
Friday, January 22, 2010
We’ve come a long way since women’s pelvic conditions were dismissed with a blush as “female troubles.” Or have we? A recent study in the Journal of the American Medical Association (JAMA) found that pelvic problems plague nearly one in four women older than age 20. But all too often women put off calling their doctors for these conditions, often out of embarrassment.
The women in the JAMA study complained of incontinence—leaking urine, and, less commonly, feces—and pelvic organ prolapse. Prolapse is the falling of pelvic organs into the vagina. Women may also suffer pelvic pain. Treatments exist for all of these problems, and the team at UTMB’s Pelvic Health and Continence Center can help end the suffering and discomfort.
Dr. Catherine Hansen writes a column, "Woman to Woman" in every other issue of Life is Good Magazine.
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