Hey ladies, I’m talking to you! Are you struggling with sexual dysfunction? Do you miss the enjoyable sensations of sex? Do you suffer from pelvic floor pain? Tired of urinary incontinence? You are not alone – up to 30% of menstruating women and 40 – 50% of women in menopause have similar symptoms. In this article, I’ll list a few potential causes of your symptoms and discuss some treatment options to consider.
First, let’s consider the benefits of healthy hormone levels. Your sex hormones promote vaginal health in three ways:
- Maintain levels of collagen for tissue elasticity and thickness
- Produce mucopolysaccharides and hyaluronic acid to moisturize, hydrate and maintain an ideal pH for a healthy vaginal microbiome, which can alleviate recurring vaginal and urinary tract infections.
- Promote blood flow to pelvic floor, including vaginal and clitoral tissues, urinary tract organs, and muscles and ligaments, for optimal functioning
Whether it’s due to menopause, ovarian insufficiency, chemotherapy, or surgical interventions, shifts in hormone levels cause changes in the pelvic floor that can have a negative impact on your quality of life. Other than causing female sexual dysfunction, these changes in the pelvic floor may contribute to other symptoms, such as:
- Urinary incontinence due to changes in muscle tone.
- Recurring urinary tract infections, pain with urination, or increased frequency of urination occur as a result of shifts in vaginal and urinary microbiome.
- Unspecified pelvic pain due to dry, irritated tissues that are more vulnerable to inflammatory changes.
These symptoms can be incredibly debilitating, and you don’t have to suffer in silence. So, let’s get to the treatments for pelvic floor health.
PRP and pelvic floor health
First, let’s talk about platelet rich plasma (PRP). Most folks are familiar with using PRP to restore collagen in orthopedic care. However, we can also use PRP injections to optimize your pelvic floor health and vaginal tissue. The process starts with an application of numbing cream, to maximize your comfort. After a simple blood draw, your cells are processed to create a potent serum of your platelets. These platelets are responsible for stimulating collagen, fibrin and elastin production, increasing tissue hydration, and enhancing blood flow to essential organs, and restoring sexual sensation. I use a tiny needle to inject these platelets where you need it most. The procedure only takes about 20 minutes, with little to no down time afterward. Recent studies find the greatest benefits after 4 treatments, about 4 weeks apart.
The role of hormones in pelvic floor health
Second, let’s discuss hormones. Most of us are familiar with estrogen for vaginal and pelvic floor health. However, did you know vaginal tissues also have androgen receptors? Androgens, including DHEA and testosterone, can promote healthy muscle strength to reduce incontinence, increase blood flow and tissue elasticity, and stimulate nerve density for sexual enhancement. Topical creams or suppositories are targeted therapies that are beneficial for those who want to avoid systemic hormone replacement.
With a versatile treatment plan, most women see improvements in vaginal tissue (increased lubrication, more elasticity), sexual function (enhanced desire, arousal and more intense orgasms) and pelvic floor health (less incontinence, less pain).
I know this is a sensitive topic for many of you. Sexual health, pelvic pain, and urinary concerns are very complex and multifactorial. Perhaps your symptoms seem too unorthodox or perplexing. Or the subject of sexual health feels a bit taboo. Well, let me tell you, these symptoms can cause an unnecessary amount of physical and emotional distress. You do have options! Please don’t hesitate to reach out. I am happy to discuss your specific needs and create a treatment plan that works for you.
Gaber M, Shaltout S. Assessment of autologous platelet-rich plasma as a local therapy for female sexual dysfunction. Menuofia Medical Journal. 2021; 34(1): 61-65.
Labrie F, Martel C, Pelletier G. Is vulvovaginal atrophy due to a lack of both estrogens and androgens? Menopause. 2017 Apr;24(4):452-461.
Long, CY., Lin, KL., Shen, CR. et al. A pilot study: effectiveness of local injection of autologous platelet-rich plasma in treating women with stress urinary incontinence. Sci Rep 11, 1584 (2021).
Sukgen G, Ellibeş Kaya A, Karagün E, Çalışkan E. Platelet-rich plasma administration to the lower anterior vaginal wall to improve female sexuality satisfaction. Turk J Obstet Gynecol. 2019;16(4):228-234.
National Institutes of Health, Roughly One Quarter of U.S. Women Affected by Pelvic Floor Disorders, NIH News Release, 2008
National Institutes of Health, How many women have pelvic pain?, NIH website “Condition Info”, (last reviewed 2017)