Estrogen VS Pelvic muscle biofeedback, how it helps.

[Guest guest]

This is from the J. of reproductive medicine.

And shows how the use of estrogen (like the Estrace cream a topical estradiol) can help lower that 'pain threshold' perhaps even better than pelvic biofeedback, so I would imagine using them together the benefits one might have. Esp. since Estrace or estrogen can give that skin it's tensile strength and stretchability or 'give' and lowers that pain threshold as well.

I added this definition to hopefully help explain a bit when you read the article.

Mechanoreceptor is a receptor which responds to mechanical pressure or distortion; e.g., receptors in the carotid sinuses, basically the touch receptors in the skin that feel pain.

Dee~

==================================

Title:

The Effect of Topical Estrogen and Pelvic Muscle Biofeedback on Mechanoreceptors of the Vulvar Vestibule: A Prospective, Double-Blind, Placebo-Controlled Trial

Authors: D. , M. Palmer and J. Marks Thirty-nine postmenopausal, unestrogenized women with mixed lower genitourinary tract complaints were placed into four treatment arms by permuted block randomization.

Group 1 underwent topical estradiol cream and pelvic muscle biofeedback,

group 2 underwent topical estradiol cream and a sham questionnaire,

group 3 underwent placebo cream and pelvic muscle biofeedback, and

group 4 underwent placebo cream and a sham questionnaire.

Mechanoreceptors of the vulvar vestibule were tested for sensory threshold by Von Frey hairs, prevalidated by test-retest analysis. Vaginal atrophic index, cytologic maturation index and serum estradiol were ascertained at three points through the study.

Thirty of 39 subjects completed the data set upon which statistical analysis was based.

Linear regression analysis found a 'significant' lowering of the mechanoreceptor threshold by -6.2 g/mm2 following four weeks of daily topical estradiol cream (t=2.46, P=.02).

Pelvic muscle biofeedback training 'failed' to demonstrate a significant effect on mechanoreceptor threshold +1.2 g /mm2 (t=.137, p=.73).

Topical estradiol therapy significantly cleared parabasal cells on the maturation index (exact, P=.046), and significantly improved the vaginal atrophic index (t=2.43, p=.03) as compared to placebo.

We could not demonstrate a dose-response relationship between serum estradiol and the mechanoreceptor threshold (r=.08, t=.36; NS), vaginal atrophic index and mechanoreceptor threshold (r=.03, t=.88; NS) or maturation index and mechanoreceptor threshold (r=.19, t=.82; NS).

RESULTS:

The results suggest that lowering the mechanoreceptor (touch) threshold of the vulvar vestibule results from a rapid-acting, direct effect of topical estradiol cream upon mechanoreceptive nerve fibers and that mechanoreceptive threshold was 'not' affected by pelvic muscle biofeedback.

Such findings help to clarify the therapeutic effect of estrogen and pelvic muscle biofeedback in postmenopausal women with lower genitourinary tract complaints as well as in women with vulvar pain syndromes. This study was funded through the National Institute of Nursing Research Division of Intramural Research.

Dee~