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    The truth about pelvic pain and menopause, with Dr Karen Tang

    enAugust 23, 2024
    What are common pelvic health issues women face during menopause?
    How can pelvic pain affect a woman's quality of life?
    What is the link between PCOS and insulin resistance?
    What treatments are available for Polycystic Ovary Syndrome?
    Why is early detection of PCOS important for women's health?

    Podcast Summary

    • Pelvic health issuesPelvic health issues are common during menopause, significantly impacting quality of life, and require prioritization for accurate diagnoses and advocacy for health needs

      Pelvic health issues, such as urinary incontinence, pelvic pain, and menstrual abnormalities, are common experiences for women, particularly during menopause. These issues can significantly impact quality of life and should not be dismissed or ignored. Karen Tang, a gynecologist and author, emphasizes the importance of taking pelvic pain seriously and advocates for open conversations about women's health. The diagnostic process for conditions like endometriosis can be lengthy and challenging, with many women facing dismissal or lack of understanding from healthcare providers. It's crucial to prioritize understanding our bodies, seeking accurate diagnoses, and advocating for our health needs. By doing so, we can empower ourselves to thrive in later life.

    • Endometriosis diagnosisEndometriosis is a challenging condition to diagnose due to its subtle symptoms and lack of definitive diagnostic tests. Surgical removal of the disease is the only definitive way to diagnose it.

      Endometriosis is a complex condition that can be difficult to diagnose due to its subtle and varied presentations. It often doesn't show up on imaging studies or simple tests, and its symptoms can be mistaken for other conditions. The disease can manifest as small spots or blisters on the linings of the pelvic organs, or as more severe nodules or cysts. The amount of disease doesn't always correlate with the severity of symptoms, and people with mild disease can have severe symptoms, and vice versa. The cause of endometriosis remains unknown, and there are no definitive diagnostic tests or cures. The main approach to treatment is surgical, as the only way to definitively diagnose the condition is through laparoscopic surgery. The goal of surgery is to remove as much of the disease as possible, and hormonal methods may be used as an initial treatment before surgery. The condition seems to have a genetic component, but the exact cause remains a mystery.

    • Women's health and societal stigmasHormonal birth control can help manage endometriosis symptoms but may lead to reliance on multiple prescriptions. Societal stigmas have historically impacted women's health research and diagnosis, and fibroids, common in both black and white women, often go undiagnosed.

      Hormonal birth control can help alleviate endometriosis symptoms by suppressing ovulation and decreasing ovarian hormones. However, it's not a permanent solution and may lead to a reliance on multiple birth control prescriptions. Diet also plays a role in managing symptoms, particularly for those with severe bowel symptoms, as certain inflammatory foods can worsen symptoms. There is a historical link between women's health issues and societal stigmas, with women being prescribed pregnancy or excluded from drug studies due to their reproductive capabilities. Fibroids, another common women's health issue, are benign tumors that can grow to large sizes and affect up to 80% of black women and 70% of white women. While they are commonly diagnosed through ultrasounds, many women may not be aware of their presence. Overall, it's essential to prioritize women's health and challenge societal stigmas and biases in healthcare.

    • Uterine fibroids health issuesUterine fibroids can cause severe health issues like hemorrhaging, kidney failure, and infertility when they grow large. Misdiagnosis is common due to symptoms being mistaken for normal periods. Various treatments exist, but no definitive prevention method. HRT/MHT may not stimulate growth but could keep fibroids from shrinking. Fibroids can become cancerous after menopause.

      Uterine fibroids, although common during menstruation, can cause serious health issues such as hemorrhaging, kidney failure, and infertility when they grow large. These symptoms can be mistaken for normal periods, leading to misdiagnosis and delayed treatment. While there are various treatments available, including surgeries, medications, and procedures to block blood flow, there is no definitive prevention method. Hormone Replacement Therapy (HRT) or Menopause Hormone Therapy (MHT) may not significantly stimulate fibroid growth but could keep them from shrinking as much as they would in menopause. It's crucial to consider the quality of life and potential risks before making decisions regarding HRT and fibroids. Additionally, fibroids can become cancerous after menopause, so growing fibroids and bleeding after menopause should be taken seriously and evaluated for potential cancer.

    • PCOS symptoms and complicationsPCOS can cause irregular periods, acne, excessive hair growth, and hormonal imbalance, potentially leading to infertility and uterine cancer. Early diagnosis and treatment are crucial.

      Polycystic ovary syndrome (PCOS), a common hormone condition in reproductive-age women, can cause a range of symptoms including irregular periods, acne, and excessive hair growth. These symptoms can indicate a hormonal imbalance that prevents regular ovulation and can lead to complications such as infertility and increased risk of uterine cancer. If you suspect you may have PCOS, it's important to speak with a healthcare professional for proper diagnosis and treatment. This may include medication to induce ovulation, birth control to regulate periods and prevent tissue growth, or other treatments to manage symptoms. Additionally, early detection and treatment can help prevent more serious health issues.

    • PCOS and Insulin ResistanceUp to 70% of people with PCOS develop insulin resistance or diabetes. Treatment involves a team approach, including medication and diet control, with potential surgical options for some patients. PCOS can lead to metabolic issues post-fertility, requiring hormone replacement therapy for management.

      Polycystic Ovary Syndrome (PCOS) and insulin resistance are closely linked, creating a cycle of hormonal imbalance and weight gain. Up to 70% of people with PCOS develop insulin resistance or diabetes at some point. Treatment for PCOS involves a team approach, including dieticians, primary care doctors, and endocrinologists. Diabetes medications and dietary control, such as low carb diets, are common treatments. Ovarian drilling, a drastic surgical option, is a rare alternative for some patients. PCOS can continue to impact health post-fertility, causing metabolic issues like diabetes, high blood pressure, and high cholesterol. Hormone replacement therapy (HRT) can be beneficial for managing these metabolic issues. However, there is limited data on the interaction between HRT and PCOS symptoms.

    • Pelvic Health, Hormone TherapyHormone therapy can benefit postmenopausal women with low libido, but monitoring testosterone levels is crucial for those with PCOS. Pelvic floor dysfunction is common and can cause issues like urinary leakage, pain during sex, and constipation. Simple exercises and good habits can improve pelvic floor health.

      Hormone replacement therapy, specifically estrogen, can have benefits for postmenopausal women with low libido, but it's crucial to monitor testosterone levels, especially for those with Polycystic Ovary Syndrome (PCOS). Additionally, pelvic floor dysfunction is a common issue that affects both men and women, and it's essential to maintain pelvic floor muscle strength and health. Many people are unaware of the importance of the pelvic floor, which supports the entire pelvis and can cause issues like urinary leakage, pain during sex, and constipation. Simple exercises like squats and avoiding bad habits like hovering over public toilets can help improve pelvic floor health. Overall, it's essential to prioritize pelvic health, as it can significantly impact quality of life.

    • Toilet positioning and postureProper positioning and posture on the toilet can help alleviate constipation and urinary dysfunction. Seek help from specialists for persistent pelvic and gynecological pain or dysfunction.

      Taking proper positioning and posture while using the toilet, such as putting your feet on a stool to elevate your knees, can improve various bathroom-related issues including constipation and urinary dysfunction. Additionally, avoiding panic behaviors like constantly checking for the need to urinate can help train your bladder and improve control. For persistent pelvic and gynecological pain or dysfunction, seeking help from specialists like urogynecologists and pelvic physical therapists is crucial. It's important to remember that everyone's experiences are unique, and what may not be bothersome for one person could significantly impact another's quality of life. Regular check-ins with healthcare professionals and advocating for yourself in medical settings can lead to better care and understanding of your concerns.

    • Medical Appointment PreparationPrepare for medical appointments related to pelvic health concerns by understanding symptoms, potential diagnoses, and preferred treatment options to help healthcare providers focus on finding solutions and advocate for next steps if not provided.

      Preparing for a medical appointment related to pelvic health concerns can make a significant difference in the outcome of the visit. By coming prepared with a clear understanding of symptoms, potential diagnoses, and preferred treatment options, patients can help their healthcare providers focus on finding solutions rather than spending valuable time gathering information. Additionally, it's essential to advocate for next steps if they are not provided, whether that be through requesting additional testing or seeking out a specialist. Remember, every appointment should lead to the next step in your healthcare journey.

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