Monday, September 29, 2014

Could your birth control be causing your pelvic pain?

There has been great debate for many years about whether or not oral contraceptives may cause vulvodynia. Considering the role that hormones can play with symptoms of pelvic pain, I have followed this debate with great interest.

Image courtesy of the National Vulvodynia Association
Here is a Cliff's Notes version of this most recent update on this issue. Over the summer, a study was presented at the International Society for the Study of Women’s Sexual Health (ISSWSH) Annual Meeting, that reportedly showed that more than 90% of women with vulvodynia have pain confined to the tissue of the vulvar vestibule (Remember the little hallway to your vagina?), and not the outside vestibule or inside the vagina.  This is significant because the vulvar vestibule is comprised of a specific type of tissue that responds to testosterone or
similar androgen hormones.

Studies show that in addition to their intended purpose, oral contraceptives significantly reduce production of androgens and contain synthetic hormones that bind to the androgen receptors in the tissues so that the little amount of androgen that is still floating around has nowhere to go.

This can have negative effects on the tissue of your vestibule and cause pain in this area.

This is a pretty complicated issue, and I recommend you read this article regarding this recent update: 
Do Oral Contraceptive Pills Cause Vulvodynia?

The article was written by Dr. Andrew T. Goldstein, Dr. Jill Krapf and Zoe Belkin and is found on the Pelvic Health and Rehab Center website. 

The take-home message here is that if you have vestibulodynia and are using or have a history of using oral contraceptives, this could be contributing to your pain and you and your healthcare provider should investigate whether stopping these medications and using a topical testosterone could help in decreasing your pain. 

Monday, September 8, 2014

Feeding Your Pain - Part 2

Did you know that if you suffer from chronic pain, your diet could be a contributing factor? 

Recently I discussed the importance of vitamins and minerals in relation to chronic pain. Now I want to discuss inflammatory foods. There are certain foods that can cause or combat systemic inflammation. Unlike the redness or swelling that occurs when your body fights a chronic or low-grade infection, inflammation can lead to serious conditions like heart disease, cancer, Alzheimer’s Disease and also chronic pain. Stress, environmental toxins, physical activity, and diet all play a role in one’s inflammatory state.

Some of these foods may be obviously unhealthy, but some foods that cause inflammation are often considered healthy foods.

Inflammatory Foods:

Potatoes, eggplant, red and green peppers, tomatoes, hot peppers

Wheat, barley, rye, gluten-containing grains

Animal protein sources
grain-fed beef and pork ,processed meats: bacon, salami, baloney, cured hams, luncheon meats, shellfish, eggs           
Peanuts, peanut butter, dark or discolored nuts, nuts with a rancid odor

dried beans, peas, lentils

Dairy products and fats
all milk, cream, yogurt, cheese and other products made from cow's milk
butter, all margarine, spreads that contain trans fats, processed oils

Soda, black tea, coffee, alcohol, citrus juice

Spices and Sweeteners
Cayenne, paprika, black pepper, hot peppers, refined sugars, white and brown cane sugar, corn sweeteners, high-fructose corn syrup

So how do you go about avoiding foods that can cause inflammation and increase your pain? 
Well, many grocery stores have a natural and or an organic section. Remember healthy food is better for your body and is not just a fad or for the health conscious. It is best to do most of your food shopping at a market that offers a lot of organic and natural food choices.  
You should buy organic fruits, vegetables, milk products, coffee and free range eggs and meats whenever possible. Non organic fruits, vegetables, dairy and meats contain pesticides, and may contain other chemicals and possibly harmful metals. These chemicals can get stored in your body and stimulate pain receptors, create inflammation, free radicals, and make it more difficult to heal.

People can become very overwhelmed when looking at making large dietary changes, so it is important to start where you are and make smaller changes step by step. 

Here are some more tips to decrease inflammatory foods and products: 

1.    Minimize and ultimately eliminate partially hydrogenated oils in processed foods(use foods labeled “No Trans Fats”)

2.    Minimize or avoid eating at fast food restaurants. At restaurants choose butter based toppings on the side, eliminate sour cream and cream based dishes. Choose salads(with oil and vinegar or vinaigrette), vegetables and avoid deep  fried entrĂ©es

3.    Minimize or avoid deep fried and breaded foods

4.    Minimize sugars and starches(crackers, potatoes, rice, scones, cookies etc.)

5.    Increase healthy fruits such as apples and berries (have 2-3 servings per day).

6.    Use healthy veggies such as broccoli, bok choy, cabbage, cauliflower, kale, chard, spinach, celery, squash, zucchini, cucumber

7.    Try to choose organic fruits and veggies when your budget and the availability of these items allows.

8.    Eat protein at every meal.

9.    Try to purchase free range poultry and meat (if you are not vegetarian).

10.  Try and choose low fat and organic dairy products (milk, cheese, yogurt, ice cream, etc. if you eat dairy products)

11.  Use a good multivitamin mineral supplement(taken at meals) that requires at least 2 per day with minerals(calcium 500 mg per day and magnesium 500 mg per day) and antioxidants(A, C, E, Selenium)

12.  Try some green tea daily (other teas such as white and red are also healthy)

13.  Eliminate drinks with fructose and corn syrup.

14.  Choose veggie juices such as V8 or an Organic version

15.  If you are trying to lose weight limit juices other than veggie juices to 4-6 ounces per day.)

16.  Drink 6 glasses of filtered water(not in plastic) and or low salt veggie or other 100% fruit juices(without corn syrup or fructose) per day

It’s important to talk to your doctor about your diet and foods that could be contributing to chronic pain. It may also be beneficial to discuss your diet with a nutritionist who can help give further guidance in making healthy food choices.