Vulvar Varicosities

What Are Vulvar Varicosities?

Vulvar Varicosities are a form of varicose veins occurring in the inner thighs and vaginal region in approximately 4% of women. They can be extremely painful, and are a natural source of embarrassment given the region in which they occur. This can lead to many women refraining from even discussing the matter with their respective OBGYN doctors out of shame if for no other reason.

Given the painfulness and swelling that generally occurs with the condition, which typically occurs during the course of a pregnancy, this can lead to a feeling of Vulvar Varicositiesintense pressure and pain. Some women have described this as a feeling that “everything is about to fall out the bottom”.

Most occurrences of vulvar varicosities dissipate on their own after a few months. That said, these can be a couple of extremely painful months if left untreated.

According to the Center for Vein Restoration: When they do not resolve they may cause symptoms of pain, itching, burning, dysparunia, and are perceived by some women as a cosmetic nuisance.

The Center for Vein Restoration adds the following: “Vulvar varicosities may occur as isolated tributary varicosities or may be a sign of underlying pelvic venous insufficiency. They can also be associated with Pelvic Congestion Syndrome (PCS).”

The good news is that unlike excruciatingly painful conditions such as vulvodynia, there are tested-and-prove treatment options available to women suffering from vulvar varicosities. Regardless of whether or not one is pregnant, compression therapy is an effective solution that has brought thousands of women immeasurable relief from this painfully traumatic condition. For women who are pregnant, this should be the first option and course of treatment.

The premiere compression garment available on the market is called a V2 Supporter, made by a Michigan (USA) based company. For pregnant women suffering from this dreadfully unpleasant condition, a V2 Supporter can be purchased online for a nominal fee, and delivered to one’s home within a matter of days (or even overnight if the patient is willing to pay for the shipping).

A ‘minimally invasive’ procedure known as sclerotherapy has brought tremendous relief to countless women who aren’t pregnant. Sclerotherapy involves injecting a liquid or foam into the affected area, then following up with compression therapy, typically also involving a V2 Supporter.

Women with varicose veins in the inner thighs, pubic and vaginal region should consult a doctor as soon as the pain becomes a legitimate disturbance to one’s quality-of-life. If the diagnosis is vulvar varicosities, best practices involve getting a V2 Supporter as soon as possible, and following-up with sclerotherapy then if necessary and if symptoms persist.

Additional Information:

Symphysis Pubis Dysfunction

Symphysis Pubis Dysfunction

Symphysis Pubis Dysfunction, also known as SPD, is a common health condition that causes extreme pain in the hips, back, groin and legs of pregnant women. This painful pregnancy symptom is a result of the aptly named hormone Relaxin. Relaxin helps to naturally make ligaments relaxed and stretchy in order for the baby to ease its way into the world. Many times, relaxin does its job too well, causing the pelvic ligaments to become too loose too soon. As a result,the pelvic joint becomes unstable, causing moderate to severe pain and instability.

Symphysis Pubis DysfunctionAs many as 1 in 3 pregnant women may have this condition to some degree, and may not even recognize it as a condition all its own. More often than not, it is overlooked, as women do their best to endure it as another major discomfort of pregnancy.

Pelvic girdle pain can be anything from a minor ache to a searing sensation that wraps around the back and travels down below the belly. Most women will experience this at some point or another during their pregnancy. As the ever-expanding tummy puts ever-increasing stress on the  bones, joints, and muscles in the pelvis-the pain can hit at almost any point in the pregnancy, and the impact can range from minor aches and pains to debilitating and unbearable misery.

Apart from the lower abdomen and pubic pain and discomfort, SPD may also appear in the following symptoms:

  • Severe pain that tends to get worse when you lift your legs for getting into bed or car.
  • Difficulty to move the lower part of your body when you wake up in the morning.
  • Pain that gets worse when you lie on your back.
  • Reduced range of movement of the hip bones, causing difficulty walking.
  • Pain shooting down your buttocks and legs (sciatica).
  • A clicking sound near the pelvic area while in motion.
  • Urinary incontinence (rare cases).

If you think you may be suffering from this condition, do some research and talk to your Symphysis Pubis Dysfunction 2doctor. Never just endure the pain. Many things can be done to help lessen the symptoms of SPD. Acupuncture is an increasingly  popular way to alleviate all kinds of pregnancy ills, including pelvic girdle pain. Your doctor will almost always instruct you to purchase (and wear) a pelvic support girdle, aka a maternity belt with a special pelvic support built into it.

V2 Supporter

While there are alternatives (albeit none that really measure up in terms of effectiveness, appearance or even cost), the increasingly popular choice for dealing with moderate-to-severe pain of this nature is a product known as a V2 Supporter, or a variation thereof. The V2 Supporter is sold as a standalone compressive therapeutic undergarment, and can also be purchased as a 2-in-1 combo support undergarment such as the Prenatal Cradle Plus V2 Support and the Hip Brace Plus V2 Supporter.

V2 SupporterThis undergarment will  provide much needed support for your belly (and relief for your pelvis). These same products are also used to treat a very common condition during pregnancy called vulvar varicosities, which is effectively vulvar or vaginal varicose veins. While more common among women who are pregnant, many women who are not pregnant and some who’ve never even been pregnant occasionally come down with this most unfortunate condition characterized by painful swelling of the vulvar region.

Back to Symphysis Pubis Dysfunction, heating pads and ice have been known to offer significant relief. Choose the right sleeping  position — lie on your side with a pillow between your knees to keep hips aligned. Do what works  best for you and your body. Try doing KEGEL Exercises. Yes, our old friend can do wonders in this  situation. These handy little workouts strengthen the entire pelvic floor, the muscle that stretches  like a hammock across our abdomens and essentially holds all our organs up. The stronger it is, the  better it holds up the growing baby and uterus and the less everything presses on those already  weakened bones. If the pain is severe, ask your practitioner about pregnancy-safe pain relievers (never take any medications unless specifically okayed by your practitioner). Remember, do what  makes you comfortable and what makes you feel better. Work together along with your doctor and  family to make this special experience as comfortable and enjoyable as possible. More tactics to try: Sit  down to get dressed, and avoid heavy lifting and pushing (which you should be doing anyway). Do your best to stay off your feet and try to be patient until the baby comes. For most moms, once the baby is born and relaxin production ceases, your ligaments (and your dance moves) will return to normal in no time.

 

Video: Symphysis Pubis Dysfunction

 

TTC Questions

What To Know Before You Get Pregnant

The more you know about your body and how it works, the better you will understand what to expect when you become pregnant. Planning before you get pregnant is very important. Simply put, the healthier you are as you are planning your pregnancy, the more likely you are to have a healthy baby. It is advisable to start planning for pregnancy as soon as you begin to have thoughts about having a baby.By: Katie Henderson

TTC Questions

A baby’s organs begin to form in the first few weeks of pregnancy, before you may know that you are pregnant. As this is a critical phase of development, the more planning you do, the greater the pay off can be in terms of the health of your baby. Unfortunately, there are no foolproof methods for having a healthy baby, but there are many things you can do that may improve your chances of a good outcome.

Planning your pregnancy may help you to:

  • conceive more easily.
  • have a healthier pregnancy.
  • avoid or minimize pregnancy complications.
  • give birth to a healthier baby.
  • recover more quickly and easily after giving birth.
  • have a more pleasant postpartum (post birthing) experience.
  • minimize your child’s risk of future adult health problems.

By planning your pregnancy, you will know that during this important early stage you were taking the best possible care of yourself and your baby.

Before becoming pregnant, you need to know the following:

  • If you have any existing medical conditions that might affect your ability to conceive, have a healthy pregnancy, and/or give birth to a healthy baby.
  • The health of your reproductive organs and breasts.
  • Your fertility status.
  • Your genetic history/heritage.
  • Your metabolism rate.
  • The condition of your heart, blood, lungs, urine, and hormones.
  • If you need any adult immunizations/vaccinations.
  • How current lifestyle choices could affect your pregnancy or your baby.

TTC Difficulties: Trouble Becoming Pregnant?

If a man & woman are having regular sexual intercourse, most women will conceive within 6 months. Almost all women will become pregnant in one year. If you do not become pregnant after a year, it may be time to consider consulting your doctor. Only after a year of trying to conceive would a medical doctor consider your situation as having trouble getting pregnant. All women are different however, so don’t panic – at least not yet.

Having trouble getting pregnant may be due to many factors. These include but are not limited to: timing, stress, age, premature withdrawal or pulling out by the partner, reduced vaginal lubrication, or more complicated medical factors, such as male and/or female infertility issues.

A pre-pregnancy checkup can help you identify which, if any, of these factors could be influencing your ability to conceive. This could save you and your partner a great deal of unnecessary stress. Knowing your body, particularly when you ovulate, helps you plan conception. Immediately before, during, or immediately after ovulation are the best times to conceive. Once you know you’re ovulating, you have a 24-48 hour window of opportunity to become pregnant. Remember, sperm can live 24-72 hours in the woman’s reproductive system, so conception can happen if you make love a day or two before or after ovulation.

How Will I Know When I’m Pregnant?

The most common is a missed or late period. Although, this is not a sure way to tell. About three weeks after conceiving, you will begin to notice these other signs:

  • Tender, swollen breasts.
  • Fatigue.
  • Urge to urinate more often than usual.
  • Nausea, sometimes made worse by certain smells and tastes.
  • Becoming emotional, even teary.
  • Increased vaginal discharge.

What is the soonest I can know for sure?

A blood test at a doctor’s office, 5-7 days after conception is the fastest fool-proof method of getting that definitive answer.

For those willing to wait a couple of extra days, a home pregnancy test can determine if you are pregnant in as little as 10 days after the date on which you suspect conception occurred.

Once you think you’re pregnant, it is very important to schedule an appointment with your health care provider as soon as possible.

How to successfully develop new, healthy lifestyle habits before becoming pregnant

It can take time to establish new healthy behavior patterns and break harmful habits, especially those bad habits that have been repeated for years! The best way is to be motivated by why you are doing it. Sometimes it is easier to make changes for someone you love than for yourself. Think about the baby you are planning for. Don’t indulge in any habits you wouldn’t want your child to have.

What to eat while eating for two

As part of the revised FDA national dietary guidelines for healthy eating, there are two specific recommendations for pre-pregnant women that relate to iron and folate (folic acid):

  • Consume adequate synthetic folic acid daily (from fortified foods or supplements) AND food forms of folic acid from a varied diet.
  • Whether you are planning to get pregnant or not, you must be sure to get enough folic acid.

Folic Acid, also known as folate, is a B vitamin that helps a baby’s neural tube — the part of the embryo that becomes the brain and spinal cord — develop properly. It is critical to start taking it before conception and to continue taking it through the third month of pregnancy, when the baby’s neural tube is developing, to prevent birth defects in the spine and skull.

You can get Folic Acid by taking a high-quality multivitamin daily. You will also find it in fortified breakfast cereals; citrus fruits and juices; dried peas and beans; and green, leafy vegetables.

Eat foods high in heme-iron, iron-rich plant foods, iron-fortified foods, or foods that facilitate iron absorption, such as vitamin C-rich foods.

Iron is important during pregnancy as it prevents anemia, a condition in which the body isn’t able to produce enough healthy red blood cells. Developing infants need a high level of red blood cells in order to receive enough oxygen. And, anemia in the mother can be passed on to her baby.

You can get heme-iron by eating food such as red meats, fish, and poultry (basically, food from animal sources).  Iron-rich plant foods include cooked beans, lentils, and enriched pasta.  Many breakfast cereals are also iron-fortified.

Foods that help iron absorption consist of fruits (oranges, orange juice, cantaloupe, strawberries, grapefruit) and vegetables (broccoli, brussels sprouts, tomato, tomato juice, potatoes, and green and red peppers). These are especially effective when eaten with iron-rich foods like meat, fish, and poultry.

Is my weight a consideration for getting pregnant?

A healthy body weight promotes general health and reduces the likelihood of developing heart disease, some cancers, and diabetes. Achieving and maintaining a healthy weight is making an investment in your health, your prenatal health, the health of your future baby, and the well-being of your growing family.

Weight can and will affect a woman’s fertility. Studies have shown that a woman’s ability to become pregnant may be severely compromised by two weight-related extremes:

  • excessive thinness
  • excessive obesity

Once you do get pregnant, your weight affects the baby. Underweight women often have smaller babies. Infants with low birthweight (5-1/2 pounds or less) are at a greater risk of death within the first month of life, as well as increased risk for developmental disabilities and illness throughout their life.

Overweight women may suffer from medical problems, such as high blood pressure and diabetes, that can seriously complicate a pregnancy.  If you are overweight, you have a higher risk of having a baby with certain birth defects (like neural tube defects), experiencing more difficulty during labor and delivery, delivering via cesarean section, and hemorrhaging.

While you are planning your pregnancy is the best time to try to reduce your risks through good nutrition and exercise.  We strongly recommend that you take the time now, before you become pregnant, to assess your diet and eating patterns and begin to make changes that will help you achieve a healthy weight before you conceive.  Once you become pregnant, you should not try to lose weight as it could harm your baby.

Should I have a pre-pregnancy checkup before I try to become pregnant?

A pre-pregnancy checkup is a smart idea. Even if you think you are healthy and ready to get pregnant, a pre-pregnancy checkup is a good opportunity to start asking questions. Make a list of issues before your appointment and ask your caregiver for information.  Your health care provider can help you minimize risks associated with pregnancy and any existing medical conditions that could affect pregnancy. The more you can inform your caregiver before you conceive, the better advice they can give you to help you have a healthy pregnancy.

If you are taking any prescription medications, over-the-counter medicines, or alternative or herbal remedies, your caregiver can advise you about how and why you may need to change your practices.  Some drugs, and even seemingly harmless ones like some acne medicines or certain vitamins, can actually have the opposite affect on you once you become pregnant and/or could affect your baby.

How do my partner and I know if we’re emotionally ready to have a baby?

You’re emotionally ready to have a baby if you’re having it for the right reasons, with the right person, at the right time, and go into it with realistic expectations of yourself, each other, and your relationship.

Hormones, Menopause and Weight Gain in Women

Natural Hormones and their Impact on Women’s Health, Weight

 

By: Pamela Egan, NP-C, CDE, ABAAHP

When attempting to explain the role of hormones relative to weight gain in women, the non-organic beef industry makes for a great analogy.

Commercial cattle farmers figured out how to chemically and hormonally induce weight gain many, many years ago. But what exactly is it that is done to the cows in order to get them to gain so much weight, thus increasing their value? The anwer is really quite simple. The cows are fed a potent combination of antibiotics and hormones.

BHRT (Bioidentical Hormone Replacement Therapy)

BHRT (Bioidentical Hormone Replacement Therapy)

Antibiotics and Hormones?

The antibiotics destroy the cows’ intestinal flora (“good bacteria”), disrupting and slowing the rate of digestion. This means that the animals are burning fewer calories in a given period of time than they would if their digestive systems were operating at full capacity. The result of this, barring a decrease in food intake, is that the cows gain weight as a result of the fact that their metabolism is being deliberately slowed down as a result of the antibiotics. For more information about how this works, see this post about probiotics and weight loss.

The role of hormones as it pertains to weight and in particular, weight gain, is by-and-large not well understood by the very women gaining weight as a direct result of hormonal imbalance. In order to learn how each individual hormone works, the respective properties of each hormone and their individual effect on women’s health – particularly as it relates to weight gain, please see the following primer:

Estradiol

Estradiol is our major estrogen that keeps the skin beautiful, keeps our memory sharp, vaginal moisture, hair, skin, nail, bone health and it should be noted that there are estradiol receptors on every organ in our body from our brain, heart, lungs, bladder, etc.

Estriol

Estriol is our weaker estrogen that goes up during pregnancy. This hormone builds collagen and is used in Europe to prevent breast cancer and keep the skin beautiful. (For a provider to prescribe Estriol in the US, they must be registered with the FDA.)

Estrone

Estrone is the bad estrogen that goes up during peri-menopause and menopause. This is the estrogen that wreaks havoc on the body. It causes fibrocystic breast, breast cancer, weight gain, ovarian cyst, ovarian cancer, endometriosis, etc. I make sure to check an estrone level during blood lab work. If it is too high, there are things we do to knock it back down such as aerobic exercise, DIM, and Indole-3 carbinol. Furthermore, women should never take estrogen by mouth over the age of 45. When taken orally, it has to be metabolized by the liver which increases the risk of blood clots and methylates over to estrone. When restoring hormones, estradiol and estriol should only be given topically or transdermally. It should also be noted that not all breast cancer is caused from hormones. Many toxins can cause breast cancer such as pesticides, plastics, radiation, etc.

Natural Progesterone

Natural Progesterone that the body makes during ovulation is a good hormone. It is an anti-depressant, sleeping pill, anti-anxiety, builds bone, stops the proliferation of cancer cells hence helps prevent breast cancer. It helps to keep estrogen in check which helps with weight loss and all those things that bad estrogen can cause. Again, Progestin is NOT Progesterone. Progestins that are found in birth control pills, PremPro, and other synthetic hormones make women fat, makes them psychotic, and cause breast cancer.

Testosterone

Testosterone, which is not FDA approved for women, is also important because it builds bones thereby preventing osteoporosis. It also helps build muscle, increase stamina, help memory, increase libido. A small amount of testosterone after menopause is essential in maintaining young, healthy cells and aiding in weight loss.

Growth Hormone

Human Growth Hormone, sometimes abbreviated simply as HGH, is considered the fountain of youth. It also helps with weight loss, building muscle, bone, etc. Amino Acids can be taken to help stimulate the pituitary to release growth hormone.

Dr. Pamela Egan – DNP, CDE
EGAN Wellness & Anti-Aging Clinic and EGAN Skin Care & Med Spa
1116 W. 21st Ave.
Covington, LA 70433
(985) 892-3031 – Office Phone
(985) 892-9504 – Fax
www.PamelaEgan.com

Areas Serviced: Covington, Mandeville, Madisonville, Abita Springs, Slidell, Goodbee, Lacombe, Folsom, Franklinton, Bogalusa, Pearl River, Metairie, New Orleans, Kenner, Chalmette, New Orleans East, Elmwood, Jefferson (all of Orleans, Jefferson, St. Tammany, St. Bernard, St. James, East Baton Rouge, Washington & Tangipahoa Parishes).

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Bio-Identical Hormone Therapy: Women Should Seek Out Well-Versed Practitioners

Is Your Practitioner Well Trained in Bio-Identical Hormone Therapy?

Before a patient allows just any practitioner to prescribe bio-identical hormones, make sure they are qualified and have received extensive training in this area.

Many practitioners claim to provide bio-identical hormones in their practice but have not received any formal training in hormones. One size does not fit all.

Certain hormones should not be given orally to women over 45 years old. These include Estrogen or Testosterone. Taking these hormones by mouth is too hard on the liver. The liver metholates estradiol to estrone, the bad estrogen, that wreaks havoc on the body.

Estrone is the bad estrogen that can cause breast cancer, fibrocystic breasts, ovarian cysts, fibroids, endometriosis, prostate cancer and more. It should always be checked in those women receiving hormone replacement therapy.

Bioidentical Hormone Replacement Therapy for Men and Women

Premarin, Prempro, Fem-HRT, are not bio-identical hormones. These are synthetic chemicals that the body does not recognize. Because they are in oral form, this makes matters worse, because the liver changes them over to estrone, the bad estrogen. I’ve had women present to my clinic with grossly elevated estrone levels while on Premarin and Prempro. We then try to bind the bad estrone up with DIM supplements or Ultra Indinol Plus.

There is no reason to give a women synthetic hormones this day and age. We now have FDA approved bio-identical hormones. The important point to remember is to NEVER, EVER take Estrogen by mouth! It is bad for you and will increase your risk of breast cancer. If your provider orders oral estrogen or testosterone, that is a sign that they have not received proper training in hormones. You should seek another provider who is adequately trained in this field.

The American Academy of Anti-Aging Medicine offers a Fellowship in Anti-Aging & Functional Medicine. This Fellowship Program is very extensive and takes years to complete, requires a board exam, and a preceptorship with another board certified Anti-Aging Physican.

Dr. Pamela Egan, DNP, CDE is board certified in Anti-Aging & Functional Medicine.

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Dr. Pamela Egan, DNP, CDE
EGAN Wellness & Anti-Aging Clinic + EGAN Skin Care & Med Spa
1116 West 21st Ave.
Covington, LA 70433
Phone. 985-892-3031
Fax. 985-892-9504
www.pamelaegan.com