Girlfriend s Guide to issues Below the Belt!
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1 A GIRLFRIEND S GUIDE TO- ISSUES BELOW THE BELT! Girlfriend s Guide to issues Below the Belt! Dona Caine Francis, MSN, PMH- NP/CS Nurse Practitioner &Sex Therapist Dona Caine Francis, RN, MSN, PMH- NP/CS-BC Nurse Practitioner & Sex Therapist
2 DISCLAIMER: THE SPEAKER DOES NOT HAVE A CONFLICT OF INTEREST WITH THIS PRESENTATION.
3 OBJECTIVES Identify 6 problematic pelvic health concerns for today s woman and treatment options List 3 sexual dysfunctions affecting women Review 3 proven strategies to spark the sexual relationship beyond pelvic health concerns
4 HOW IMPORTANT IS PELVIC HEALTH?
5 TODAY IS YOUR OPPORTUNITY TO EXPLORE! Various pelvic conditions Opportunities for sexual well-being
6 SEX IS BIG NEWS!
7 CONDITIONS THAT CAN INTERFERE WITH SEXUAL WELL-BEING!
8 PELVIC CONDITIONS Menorragha Endometriosis Uterine fibroids Pelvic organ prolapse Urinary incontinence Interstitial cystitis Genital Human papillomavirus (HPV) Genito-pelvic pain/penetration disorders
9 PELVIC HEALTH CONDITIONS Menorragha-excess menstruation Affects 3 in 10 women of reproductive age-due to hormone imbalance, fibroids, meds, IUD Treatment- meds, hormones, D&C, ablation, surgery
10 PELVIC HEALTH CONDITIONS Endometriosis-tissue usually located in the lining of the uterus grows outside the uterus can be found in the ovaries, fallopian tubes, bowel, pelvic cavity or outside the cavity One of the most common problems for womencramps, menstrual pain, pelvic pain, pain with intercourse, infertility No cure, various treatments-meds, OCP, hormones, surgery
11
12 Endometriosis
13 PELVIC HEALTH CONDITIONS Uterine Fibroids- benign tumor, occur in onefourth of women Grow underneath the uterine lining, inside the uterine wall or outside the uterus Some do not experience symptoms, others have excessive bleeding, abnormal periods, pain, discomfort, frequent urination, infertility Treatment-meds, hormones, surgery interventions
14 Fibroids
15 PELVIC HEALTH CONDITIONS Pelvic organ prolapse- a hernia of the vagina, bulging of the bladder out of the vaginal canal making everyday activities extremely uncomfortable Caused by-weakness of vaginal tissue often associated with pregnancy or childbirth, repetitive heavy lifting, chronic constipation, chronic cough, poor tissue Treatment-pelvic floor muscle exercises, PT, surgery
16 Pelvic Organ Prolapse
17 PELVIC HEALTH CONDITIONS Urinary incontinence-loss of bladder control leading to urinary accidents Affects 1 in 3 women, common types-urge incontinence, stress incontinence Treatment-meds, exercises to strengthen pelvic floor muscles, nerve stimulation, limit caffeine, bladder training
18 PELVIC HEALTH CONDITIONS Interstitial cystitis- a long-term chronic inflammation of the bladder wall Cause unknown Symptoms-frequent urination, urgency, pain with intercourse, pressure in the bladder and can be debilitating Treatment-no cure, meds, pain killers, bladder training, PT, biofeedback, diet, surgery
19 Interstitial cystitis
20 PELVIC HEALTH CONDITIONS Genital Human papillomavirus (HPV)-most common STI, more than 40 types, can infect genitals, mouth & throat, most people infected do not know they have it Symptoms-genital warts, cervical changes/dysplasia, cancer, usually no symptoms until quite advanced. Vaccines are available to protect from some types-gardasil & Cervarix Treatment-evaluate dysplasia for options-leep, laser, cryotherapy, genital warts-topical creams. Thus the importance of regular Pap exams and safe sex practices
21 HPV Virus
22 GENITO-PELVIC PAIN/PENETRATION DISORDERS 2015 Consensus Terminology of Persistent Vulvar Pain A. Vulvar pain caused by a specific disorder Infections Inflammation Neoplastic disorders B. Vulvodynia-3 months duration Localized Provoked Onset Temporal pattern Neurologic pain Trauma Iatrogenic Hormone deficiencies
23 PELVIC HEALTH CONDITIONS Vulvodynia-pain localized to the vulvar region of the pelvis, associated with burning or cutting pain. Pain can persist for hours, days following intercourse engendering a sense of hopelessness and depression. Even insertion of a tampon, riding a bike can cause pain and it can be constant. Diagnosis- cotton swab test, rule out bacterial/viral infections, nerve involvement Treatment-meds, PT, biofeedback, nerve blocks, and sex therapy
24 VAGINAL VANITY Vaginal rejuvenation-to improve sexual function, correct deformities both naturally and occurring after childbirth, and reduce self consciousness Labioplasty, reduction excess prepuce Rescultping fatty bulges in labia Hymenoplasty-reconstruction G-Spot injection-to improve orgasm & sexual pleasure
25 MONA LISA TOUCH Recent procedure to restore vaginal health 3 five-minute treatments at six week intervals No anesthesia In office procedure Co2 laser with vaginal probe generates new collagen Utilized for: Vaginal dryness Itching/burning Vaginal atrophy Pelvic pain Post chemo/radiation therapy Annual follow up Cost approximately $2,000
26 SEEK A PROVIDER THAT WILL LISTEN TO YOUR CONCERNS! Do not suffer needlessly seek professional advice for your options Be descriptivesymptoms, duration, intensity, type of painsharp, dull What produces the symptom What makes it better, worse What you have done thus far!
27 PELVIC HEALTH CLINICS IN NORTH CAROLINA Carolina Pelvic Health Center- Raleigh (919) Duke Pelvic Health Center Durham (919) Novant Health Carolinas Pelvic Health Center Winston- Salem (336) Results Physiotherapy-Cary (919) UNC Pelvic Health-Chapel Hill (919) UNC Rex Pelvic Health Therapy-Raleigh (919) Wake Forest Baptist Pelvic Health (336) Women s Center for Pelvic Health-Charlotte (704)
28 SEXUAL DYSFUNCTIONS Sexual Interest/Arousal Disorders Female Orgasmic Disorders Genito-pelvic pain/penetration Disorders
29 SEXUAL INTEREST/AROUSAL DISORDERS There is absence or diminished feelings of sexual interest or desire Absent sexual thoughts or fantasies and a lack of responsive desire Absence of or markedly diminished feelings of sexual arousal (sexual excitement & sexual pleasure) from any type of sexual stimulation
30 FEMALE ORGASMIC DISORDERS Despite the selfreport of high sexual arousal/excitement there is lack of orgasm Markedly diminished intensity of orgasmic sensations Marked delay of orgasm from any kind of stimulation Antidepressants can cause retarded orgasmic function
31 GENITO-PELVIC PAIN/PENETRATION DISORDERS Sexual pain redefined by DSM 5 in Consensus terminology and classification of sexual pain Treatment options Vulvar care measures Topical medications Oral medications Injections Biofeedback/physical therapy Dietary modifications Cognitive behavioral therapy Sexual therapy
32 SEXUAL RESPONSE CYCLE
33 Interest WILLINGNESS To Receive Stimulus To Respond to Stimulus AROUSAL (Senses Engaged) RESOLUTION Time DESIRE Connection in Coupling Afterglow ORGASM Rosemary Basson Sexual Response Model
34 SUMMARY OF BASSON MODEL Desire to be sexual is neutral at the onset Motivation or interest in sexual activity Willingness - to receive stimulus & to respond to stimulus Allowing arousal to build Desire is triggered with the intensity of arousal Orgasm After glow!
35 SEXUAL STATISTICS-DID YOU KNOW? Frequency of coitus for couples 2.5 times/week Calories burned- 100 per 6 minutes of activity 75% of males reach orgasm within 2 minutes of penetration Duration of male orgasm 3 to 5 seconds Speed of sperm 28 miles/hour million sperm/ejaculate Amount per ejaculate 4 cc or 1 teaspoon Sperm take 5 minutes to cross the 6 inch territory of vagina to cervix Durability of sperm- survive 48 hours in the female body
36 Female Sexual Statistics: Less than 4 minutes to reach orgasm with masturbation, with coitus anywhere from minutes Orgasm duration is 5-20 seconds 80% of women fake orgasm at least once Female egg will remain fertile hours Women have a set amount of ova determined at birth, 400 released over a lifetime, but the quality deteriorate over time
37 ENHANCING SEXUAL WELL-BEING
38 THREE PROVEN STRATEGIES TO SPARK THE SEXUAL RELATIONSHIP! Communicate-create a climate to share sexual concerns Back to Basics-explore options for sexual connection Make the sexual relationship a priority
39 CAUSES OF SEXUAL PROBLEMS Sexual problems relating to partner and relationship Sexual problems due to psychological factors Sexual problems due to medical factors
40 KILLERS OF SEX DRIVE Stress Unresolved issues Alcohol Too little sleep Parenting Medications Poor body image ED Depression Menopause Too little intimacy
41 TAKE THE TIME TO COMMUNICATE YOUR SEXUAL NEEDS
42 BASIC CONDITIONS EXERCISE Have the sex talk -preferences change over time, discuss them! Attend to the preconditions Basic components for sexual satisfaction Time Location Sound Lighting Privacy Mood Fantasies Process Sensory Experience Sexual Accessories Exercise provided by Dona Caine Francis, MSN
43 BACK TO BASICS
44 Revitalize your sexual menu Appetizers Appetizers Appetizers Side Side Dishes Side Dishes Dishes Sexual Sexual Sexual Menu Menu Menu Main Main Course Main Course Course
45 TROJAN True Romance Kit
46 Zestra-Essential Arousal Gel
47 MAKE THE SEXUAL RELATIONSHIP A PRIORITY! Be intentional with your time & energy Share your sexual needs Create variety & maintain romance!
48 MAKE TIME TO BE SEXUAL How much time does it take for sex? 75% males orgasm in 2 minutes Women orgasm with intercourse in minutes Put aside the dishescreate the 30 minutes for loving!
49 VARIETY IS THE SPICE OF LIFE! Laura Corn the queen of romantic opportunities! Book provides- Kiss of the week Lovers coupon Sets the scene & provides the ingredients
50 THREE PROVEN STRATEGIES Communicate Back to basics Make the sexual relationship a priority!
51 May your days be filled with romance, the heart of your relationship be fed with intimacy, and the journey possible due to a playful spirit.
52 RESOURCES Anderson, AB. Associations Between Penetration Cognitions, Genital Pain, & Sexual Well-being. J Sex Med 2016; 13 (3) Boardman, LA. Sexual Pain. Clin Obstet Gynecol; 2009; Dec; 52 (4) Bornstein, J ISSVD, ISSWSH, & IPPS Consensus Terminology & Classification of Persistent Vulvar Pain and Vulvodynia Goldstein, AT. Vulvodynia: Assessment & Treatment. J Sex Med 2016; 13 (4) Melville, JL. Urinary Incontinence in US Women: a population-based study. Arch Intern Med 2005; 165 (5):
53 Contact Information Dona H. Caine Francis Queen Anne Sunset Beach, NC (704)
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