Guest guest Posted January 21, 2007 Report Share Posted January 21, 2007 Hi Dee, just by coincidence (maybe?) I developed mild (they are no longer mild) vulvar problems and now LS within two years of starting HRT. I was a strange case - partial (left ovaries) hysterectomy over 30 years ago. No systems of menopause at all - on my 63rd birthday I woke up with raging hot flashes - one every 15 minutes. I couldn't stand it - my glasses were fogged up - I couldn't see. I went on the horrible premarin and I am still on it. Now I have every vulvar problem know to man, and a few that aren't (LOL). Do you see any connection here with anything? nne > > > > HI again... (another long one) *Smile* but this is something I've sent before about how our 'receptors' work.. and it truly adds to the understanding of the previous post. > Dee~ > > 1. > Here's one I have on Estrogen and it's ''receptors'': > > August 2003 . Volume 189 . Number 2 > Original article > Lois J. Eva, MRCOG > Allan B. MacLean, MD, FRCOG > M.N. Reid, FRCOG > Kerstin J. Rolfe, MPhil > W. Perrett, PhD > > Estrogen 'receptor' expression in vulvar vestibulitis syndrome > > OBJECTIVE: A pilot study was performed to investigate the relationship between vulvar vestibulitis syndrome and estrogen receptor (ER) expression. > > STUDY DESIGN: Women with a diagnosis of vulvar vestibulitis syndrome had tissue samples taken for vulvar estrogen receptor- expression and this was compared with a control group. > > RESULTS: The study group showed a 'significant decrease'' in estrogen 'receptor' expression, and 50% of the samples did 'not' exhibit 'any' receptor expression. > > CONCLUSION: There appears to be a subgroup of women with vulvar vestibulitis syndrome who exhibit abnormal estrogen receptor- expression. This may be helpful in explaining why some women are resistant to medical treatment and may allow treatment to be prescribed more effectively. " ... Am J Obstet Gynecol. 2003;189:458- 61. END > ============================================ > > Dee here: I don't think I'd call 50% a SUBGROUP, let alone they showed some with a 'significant' decrease in E. expression and 50% of those women with V pain had " NO " E receptor expression? DUH! And estrogen is SO essential not only for our skin but our whole body including the brain. I myself wonder if many of these women were on birth control but unfortunately it didn't go into that only that they had V. pain. But check out the next one. > > AND...... here's one on the Testosterone Receptors..... > > 2. > > Androgen Insufficiency May Lead to Vulvar Vestibulitis and Genital Pain > > Yael Waknine > Oct. 26, 2004 - Androgen insufficiency may result in diminished structure and function of the vestibular glands, including decreased androgen receptor expression, leading to vestibular adenitis and dyspareunia, according to the results of a preliminary study presented last week at the 11th World Congress of the International Society for Sexual and Impotence Research in Buenos Aires, Argentina. > " Vestibulitis is a very common cause of genital pain among women, and there's a subgroup of women [in whom] it's probably related to the use of hormonal 'birth control pills' or hormonal manipulation, " > > *Comment by Dee.... A study I also have from Jan '06 showed that connection with birth control pills blocking testosterone, (and Estrogen I might add) > > Munarriz, MD, assistant professor of urology at Boston University School of Medicine in Massachusetts, told Medscape. " That a small group of women responds to androgen replacement therapy. " > > Of 3,000 women with female sexual dysfunction (FSD) evaluated by Dr. Munarriz and colleagues, 13% had dyspareunia, 66% had physical findings of vulvar vestibulitis syndrome (VVS), and 83% had concomitant androgen deficiency. > > To evaluate the possibility of a link between 'androgen deficiency' and vestibulitis, the investigators compared vestibular gland tissue excised from patients with VVS (n = 22; mean age, 36 years; 32 sections) with vestibular tissues excised from female cadavers having had no history of vestibulitis (control subjects, n = 5; 9 sections). > > Patients with VVS had significant dyspareunia as evaluated using the pain domain of the Female Sexual Function Index (mean score, 0.9 ± 0.06; maximal score = 5). > > Hematoxylin-eosin staining showed significant inflammation (P = .00009) and squamous metaplasia in the vestibular specimens of patients with VVS compared with control subjects. > > Immunohistochemical staining with antibody anti-estrogen, progesterone, and anti-androgen showed significant decreases in androgen (P = .014) and progesterone (P = .00042) ''receptor'' expression in vestibular tissue of patients with VVS compared with controls. > > " What we found is that the specimens from women who had vestibulitis had 'significant' inflammation, squamous metaplasia, and were completely 'depleted' of androgen 'receptors' - while the controls had no inflammation, and normal staining for androgens, " noted Dr. Munarriz. > > " This makes us believe that there is a link between genital pain due to vestibulitis and androgens. > > " We believe that there's a subgroup of women, particularly young women, who as a consequence of being on the birth control pill have very low androgen or testosterone levels, " said Dr. Munarriz, noting that these women also tend to have a higher incidence of genital pain. " This may be one of the pathophysiologic mechanisms [explaining] why women on the pill get pain - because they lose their ability to express androgen receptors in the genital tissue, " he said. > > " On the basis of this premise, it may be that in this subgroup of women genital pain can be effectively treated with hormones, " concluded Dr. Munarriz, adding that future studies may evaluate the benefits of testosterone therapy in this population. > > The investigators report no pertinent financial conflicts of interest.ISSIR 11th World Congress: Abstract O74. Presented Oct. 20, 2004. Reviewed by D. Vogin, MD > > ==================================== > > One last one and again I apologize for the length, but you'll see how Birth Control methods also can block those 'receptors' (by creating more SHBG which binds/blocks our receptors & explained below) By the way the shot Depo-Provera is absolutely one of the worst in my opinion and is 100% a progestin. *sigh* > > Dee > > 3. > > BIRTH CONTROL AND TESTOSTERONE PROBLEMS. > > New research indicates birth control pill could cause long- term problems with testosterone > In the January '06 issue of The Journal of Sexual Medicine, researchers have published a new investigation measuring sex hormone binding globulin (SHBG) before and after discontinuation of the oral contraceptive pill. > > The research concluded that women who used the oral contraceptive pill may be exposed to long-term problems from low values of " unbound " testosterone potentially leading to continuing sexual, metabolic, and mental health consequences. > > Sex hormone binding globulin (SHBG) is the protein that binds testosterone, rendering it 'unavailable' for a woman's physiologic needs. > > (Comment by Dee: That means the higher the SHBG the lower the Testosterone (and the estrogen) it's bound up and unavailable) > > The study showed that in women with sexual dysfunction, elevated SHBG in " Oral Contraceptive Discontinued-Users " did not decrease to values consistent with those of " Never-Users of Oral Contraceptive " . > > Thus, as a consequence of the chronic elevation in sex hormone binding globulin levels, pill users may be at risk for long- standing health problems, including sexual dysfunction. > > Oral contraceptives have been the preferred method of birth control because of their ease of use and high rate of effectiveness. However, in some women oral contraceptives have ironically been associated with women's sexual health problems and testosterone hormonal problems. > > Now there are data that oral contraceptive pills may have ''lasting'' adverse effects on the hormone testosterone. > > The research, in an article entitled: " Impact of Oral Contraceptives on Sex Hormone Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction " published in The Journal of Sexual Medicine, involved 124 premenopausal women with sexual health complaints for more than 6 months. > > Three groups of women were defined: i) 62 " Oral Contraceptive Continued-Users " had been on oral contraceptives for more than 6 months and continued taking them, ii) 39 " Oral Contraceptive Discontinued-Users " had been on oral contraceptives for more than 6 months and discontinued them, and iii) 23 " Never- Users of Oral Contraceptives " had never taken oral contraceptives. > > SHBG values were compared at baseline (groups i, ii and iii), while on the oral contraceptive (groups i and ii), and well beyond the 7 day half-life of sex hormone binding globulin at 49-120 (mean 80) days and more than 120 (mean 196) days after discontinuation of oral contraceptives (group ii). > > The researchers concluded that SHBG values in the " Oral Contraceptive Continued-Users " were 4 times higher than those in the " Never-Users of Oral Contraceptives " . > > Despite a decrease in SHBG values after discontinuation of oral contraceptive pill use, SHBG levels in " Oral Contraceptive Discontinued-Users " remained elevated when compared to " Never-Users of Oral Contraceptives " . > > This led to the question of whether prolonged exposure to the synthetic estrogens of oral contraceptives induces gene imprinting and increased gene expression of SHBG in the liver in some women who have used the oral contraceptives. > > Dr. Panzer, an endocrinologist in Denver, CO and lead author of the study, noted that " it is important for physicians prescribing oral contraceptives to point out to their patients potential sexual side effects, such as decreased desire (loss of libido) , arousal, decreased lubrication and increased sexual pain. > > Also if women present with these complaints, it is crucial to recognize the link between sexual dysfunction and the oral contraceptive and not to attribute these complaints solely to psychological causes. " > > " An interesting observation was that the use of oral contraceptives led to changes in the synthesis of SHBG which were not completely reversible in our time frame of observation. > > This can lead to lower levels of 'unbound' testosterone, (note* the unbound portion is the active and beneficial/working portion and it may 'not' be reversible. Dee T) which is thought to play a major role in female sexual health. > > It would be important to conduct long-term studies to see if these increased SHBG changes are permanent, " added Dr. Panzer. > > (NOTE* another recent study was done & showed those negative effects may last as long as several years or more! Dee) > > Dr. Andre Guay, study co-author and Director of the Center for Sexual Function/Endocrinology in Peabody, MA affirmed that this study is a revelation and that the results have been remarkable. > > " For years we have known that a subset of women using oral contraceptive agents suffer from decreased sex drive, " states Dr. Guay. > > " We know that the birth control pill suppresses both ovulation and also the male hormones that the ovaries make in larger amounts during the middle third of the menstrual cycle. SHBG 'binds' up the testosterone, therefore, these pills 'decrease' a woman's male hormone availability by two separate mechanisms. No wonder so many women have had symptoms. " > > " This work is the culmination of 7 years of observational research in which we noted in our practice many women with sexual dysfunction who had used the oral contraceptive but whose sexual and hormonal problems persisted despite stopping the birth control pill, " said Dr. Irwin Goldstein, a urologist and senior author of the research. > > " There are approximately 100 million women worldwide who currently use oral contraceptives, so it is obvious that more extensive research investigations are needed. > > The oral contraceptive has been around for over 40 years, but no one had previously looked at the long-term effects of SHBG in these women. The larger problem is that there have been limited research efforts in women's sexual health problems in contrast to investigatory efforts in other areas of women's health or even in male sexual dysfunction. " > > To better appreciate the scope of the problem, oral contraceptives were introduced in the USA in 1960 and are currently used for reversible pharmacologic birth control by over 10 million women in the US, including 80% of all American women born since 1945 and, more specifically, 27% of women ages 15-44 and 53% of women age 20-24 years. > > By providing a potent 'synthetic' estrogen (ethinyl estradiol) and a potent synthetic progesterone (for example - norethindrone), highly effective contraception is achieved by diminishing the levels of FSH and LH, thereby reducing metabolic activity of the ovary including the suppression of ovulation. > > Several studies over the last 30 years reported negative effects of oral contraceptives on sexual function, including diminished sexual interest and arousal, suppression of female initiated sexual activity, decreased frequency of sexual intercourse and sexual enjoyment. > > Androgens such as testosterone are important modulators of sexual function. Oral contraceptives decrease the circulating levels of androgens by direct inhibition of androgen production in the ovaries and by a marked increase in the hepatic synthesis of sex- hormone binding globulin, the major binding protein for gonadal steroids in the circulation. > > The combination of these two mechanisms leads to 'low' circulating levels of " unbound " or " free " testosterone. > > (and it's the unbound & free portion we need and want that is the working part. Dee) > > > > Thanks for reading it to the end..*grin* whoever made it, you must be a saint, but I do hope it helps a bit to explain why adding 'topical' natural bio-identical hormones like the E & T and used topically is rarely systemic and why most ages can use it, can be so beneficial for that V. tissue for many of us. > > Not everyone of course, and that's 'my' opinion as I realize there are other various causes but if that tissue needs rebuilt, to 'me' there is nothing is better that can do that if our own body does not respond to bring us back, than the E & T if the problem is with the skin itself. Also to say that if a woman is on HRT replacement... that it's minimal help directly for the genitals and many physicians feel there must be a direct local application (and I agree) as the systemic generally doesn't help or at best it's minimal. > > I can only say it definitely was 'my' answer after suffering thru 10 years of hell and trying so many other things that for 'me' just didn't do a thing and it just 'might' be the answer for someone else out there. I hope so. > > Hugs to all, > > Dee~ > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.