[rootytooty]

I am a 57 year old woman. About 3 years ago I started having pain with intercourse. A year or two previous to that there had been some discomfort occasionally, but it would go away. I thought it was tension and just figured if I relaxed I would be okay and the pain would go away. About the same time, my interest in sex was diminishing. My doctor prescribed physical therapy for me. I went to PT and got some relief. My doctor thought that it was tight pelvic muscles. PT did help some but still did not allow me to have pain-free intercourse. For almost 3 years I did PT off and on with some limited success, but still had the pain. I learned to become more aware of my body’s patterns and learned ways to relax and release the tension.

Finally after one recent PT session a few months ago, I had excruciating pain that lasted for 5 days. This was the first time it impacted my life in that way. The only good thing about it was that it made me take my problem much more seriously. I continued with PT and everything was fine until 2 months later when I started having awful pain again. My doctor did the q tip test and diagnosed me with Pudendal Nerve Entrapment. He said I needed to get a diagnostic pudendal nerve block. I really did not feel comfortable with the diagnosis. After more misery and uncertainty, I went to another doctor specializing in pelvic pain disorders and she diagnosed me with PNE too. I still felt like something was missing. There was no doubt that my pelvic muscle tone was very tight and that would affect my nerves, but how did they know it was PNE?

I learned about Dr. Irwin Goldstein and called him. After my description, he suggested that it could very likely be provoked vulvodynia and it may be due to hormone deficiencies and imbalances. That was the first time I had heard that my problem could be due to hormones. I made my appointment to see Dr. Goldstein and also got a complete blood test to check my hormone levels. During my appointment we reviewed the blood test results. Clearly there were deficiencies. Dr. Goldstein showed me a slide that how lack of hormone production affects the genitals. The slide showed the genitals of a girl in prepuberty, a woman before menopause, and a woman post-menopausal with hormone deficiencies. The slide of prepuberty and post-menopausal females were the same in terms of genitals. That was a revelation for me. I found out that the labia becomes resorbed, the g spot disappears, the rugae disappear, the vaginal wall skin thins out, the vagina atrophies, and the glands stop producing lubrication. During my physical examination, Dr. Goldstein tested my pudendal nerve by testing my reaction to heat and cold, and my reaction to vibrations. My pudendal nerve was working perfectly. That was a sigh of relief. My diagnosis was clearly Provoked vulvodynia. I am about to start the hormone therapy. It is a bit daunting but the alternative is much worse. I need to take testosterone, 3 forms of estrogen and a progesterone pill. I have chosen the testosterone cream behind my calf. It’s not clear yet whether my tight pelvic muscles are a result of the pain associated with PVD. Or if it is a separate condition.

I have been taking the hormone therapy for almost a week now. I made a chart to keep track of all the different medications and the timing. I tend to be very sensitive to any changes in my body. I noticed I was feeling agitated energy. It was not exactly pleasant. Dr. Goldstein was surprised that I would feel the effects of the testosterone so quickly, and suggested that I reduce the medication to 1/14 of a tube instead of 1/10 of a tube. I feel a little bit of a whirly, dizzy feeling too at times but hope that will go away as my body adjusts. I am using the emu oil. The first day it was fine but the second day I experienced a lot of stinging, so I stopped it and will try using much less, or a different oil. I did have a sexual dream a few nights ago-the first in a long time, and that is apparently the testosterone. I do not have much pain now. I think knowing my diagnosis reduces my anxiety about my condition which helps me relax. I am also becoming aware that the pain that I feel is more localized to the areas that are affected. I am exercising again more and realize that any muscle tenderness is normal and it is something to work through. I will continue and see what happens.

[linda]

Your story sounds a lot like mine. I started seeing Dr. G last October and also had a diagnosis of Vulvodynia. Unfortunately, I also have PGÅD( persistent genital arousal). However, I wanted to reassure you that the hormone therapy has worked beautifully for me. I am 60 but feel like a newly wed. Toward the end of 2 months, waiting to have sex was excruciating, but my husband and I were glad we did. We brought in the new year with great celebration!

My hormone level was recently checked, and there are still some imbalances. For example,my testosterone level is back to below 0; so I have an appointment next week for another pellet implant. I sure can tell the difference in my level of desire! We are also working to regulate my thyroid dose. It seems that I am right between two dosage levels.Nothing is ever easy for me!

Bringing sex back into our lives has rejuvenated our marriage. Hang in there because the payoff is worth it. I feel so fortunate to have found Dr. Goldstein and his magic medicines.