Wine Makes My Lady Parts Whine

Has anyone else ever experienced this problem?  I'm not a big drinker; I don't really like it that much.  But when I do have wine or a mixed drink (can't say about beer cause I think it's gross so I never drink it), my vagina starts to burn.  Just a few sips and a minute or two and that's all it takes for my vagina to start burning with small amounts of alcohol.  My husband says it must by psychosomatic because how could a sip of wine affect me just a few seconds after I've swallowed it?  And I sort of agree, because how could a sip of wine get through my system that quickly?

But then we went to Italy.  I had 1-2 glasses of wine almost every night with dinner and it did not make my vagina burn.  You might think that that supports the psychosomatic theory because maybe being in a different place made me not think about it so much.  But then that last night we were in Italy I had a couple sips of wine and there it was!  The burning!  So now I'm not so sure it's just all in my head.  But I can't figure it out.  There must be some ingredient in some wines and not in others that makes my vagina burn.  It's not a cheap/expensive thing because we always drink cheap wine, here and in Italy.  And it's not an Italian wine thing because I've had wine in America that was imported from Italy.  I've had French, Italian, Chilean, Californian, etc. and they all have that effect.  Why did all the wines in Italy not make it burn, except for the last one?

Does anyone have a clue about this?  So weird.

Back to PT, Back to Dilators

Well I took a three month hiatus from PT and dilators (doctor's orders) to focus on healing the atrophied tissues in my vestibule.  The atrophy is healing quite nicely due to the Estradiol gel.  It's not healed all the way, but healed enough that Dr. G. gave the go ahead to start back with PT.

What the EMG readout looks like (flexing versus resting)

During my first 'back at PT' appointment, we did sort of an overview.  I was hooked up to the EMG machine to find out my resting PC muscle number and PC strength number.  The last time I did this EMG thing, my resting number was 7 (I don't know the units, sorry).  The goal is to get it around a 3 so I was pretty far off.  Now I'm at a 5.  Making progress!

PC Muscles

My PT also did a general internal exam with her finger to check out the situation.  She could definitely tell that there was much improvement.  It's funny because I didn't do any muscle work in the last 3 months, but just healing those tissues made my muscles relax significantly.  I'm so glad I went to the specialist.  We could have been going on and on with PT forever and never really solving the problem because the healing had to start with the atrophy, not the muscles.

So here is my homework from PT:

1) I must stretch every day, including legs, back and any stretches that really get into those PT muscles. 

2) I'm supposed to stretch with my husband!  We are supposed to sit back to back with our legs out (and believe me, just that is a true stretch for both of us since we are the two most inflexible people on earth) and then bend forward towards our toes.  Then we're supposed to sit up, put our arms out to the side parallel with the floor and pivot left to right. I admit we have not tried this yet, but we better since my next appointment is tomorrow!

3) About 2 times per week I need to dilate - using small dilator internally to make circles, figure-eights and putting pressure around the pelvic clock at each hour. With a slightly larger dilator, I'm supposed to do a prolonged stretch (leaving it in there for 10ish minutes).  Oh, and by the way, the day I don't have to dilate anymore will be a glorious day. I am so tired of that lubey gloppy mess!

4) Kegels.  Quick Flicks (clench 3 seconds, release 3 seconds about 10 times per day) and Long Holds (clench 10 seconds and release 10 seconds about 10 times per day). 

Lots of homework!

I dilated for the first time yesterday.  It was actually a little tough, but I'm hoping that I just need to get back into the swing of things.  It was painful to go around the pelvic clock and I think I went too big on the prolonged stretch.  I'm going to try a size down next time.  My PT told me that there should be no pain and if there is, it's too big.  So I'll just work my way up. 

I will not be discouraged!  I know that this time around will be different.  I have a lot of hope and confidence that PT will work this time and that it won't even take that long.  I can just feel it.  The key was getting those tissues healed.

Positive thoughts - I'm getting better at those these days.

Making Progress

I had my three month follow-up appointment with Dr. Goldstein yesterday.  It went very well.  Before I tell you what happened in the appointment I'll tell you the changes that I have personally noticed since starting the Estradiol:

-the overall burning problem has all but disappeared.  I occasionally have it, but that's a drastic difference from feeling the burning almost all the time.

-Sitting for long periods of time does not make my vagina burn (there's still a bit of discomfort, but no burning) - I recently went to Italy and the 9 hour plane rides did not cause burning.  :)

-My vagina feels more moist in general - it's not a "I'm turned on and my vagina is moist" thing, it's just a general moistness.

So when I had my feet up in the stirrups (they were animal print and furry this time, by the way, and quite comfy) the first thing Dr. G. said was that my vagina visually looked better.  He could tell just from looking at it that the tissue was healing. 

Then he did the Q-tip test.  In almost all the places that I had originally given a grade of 7 out of 10 on the pain scale had NO PAIN AT ALL when he touched them with the q-tip.  There was one area that is still sensitive and I know why, because I haven't been putting the estradiol there when it turns out I should have been.  But this is really something.  I mean, 3 months ago that q-tip made me cringe in pain and yesterday, other than that one spot, there was zero pain.  He also tested my muscles and even they were improved even though I haven't been doing PT in the last 3 months.  However, it makes perfect sense that when there's less pain, the muscles won't involuntarily clench as much.

They took blood in order to check my hormone status now.  I have a feeling that it may be higher, but still not as high as it should be.  In Dr. G's words, I did have the hormones of a 45 year old menopausal woman, so I'm hoping to at least be down to a 40 year old pre-menopausal woman at this point (I'm 27 in reality).  Dr. G. asked me if I've been feeling any more desire or even had any sexy dreams or anything like that.  Unfortunately, no.  However last night I had one of those naked in public dreams, does that count?

Dr. G. still doesn't seem like he thinks that there is any need for me to be on anxiety meds, but he said he was okay with it.  So I will continue to take those and see if they can just give me the nudge I need to break through my sexual fear.

So I'm supposed to continue using the Estradiol, especially in the spot that I've been missing, and I'm also supposed to start back with PT to get those muscles where they should be.  I feel very encouraged and hopeful about all the physical stuff.

And I continue to hope that once the physical stuff is solved, the mental stuff will start loosening up too.

Another doctor added to my Medical Team

Well I have just returned from my first appointment with a psychiatrist.  As I've mentioned before, my therapist really thinks that anti-anxiety medicine might be very helpful for me in just trying to calm myself down during this process.  The appointment wasn't as horrible as I was anticipating.  I did cry of course, because I can't get through anything without crying.  Hey, maybe the drugs will help with that.  That would be wonderful.  I hate the fact that I can't get through any kind of serious conversation without breaking into tears.

He asked me a lot of questions, had me rate my anxiety level now compared to before I had all these vagina problems, and he determined that I should indeed try out some drugs.  He actually wants me to try two!  This is like whoa because I've never taken any kind of mind-altering drug before.  The first one is called Clonazepam and it's for my general anxiety and it supposed to work more long-term.  He also gave me a prescription for another one (forgot the name) that is for anticipatory anxiety.  I'm supposed to take this 30 minutes to an hour before I do something that causes me high anxiety, in my case anything sex related.  We'll see how helpful this is right now considering that we are nowhere near having any kind of sex, but I do think that it could be really helpful later on when we start trying to have sex.

The doctor seems very confident that the drugs will help lower my anxiety and I'm anxious (ha!) to see how it goes.  I've never really been a big fan of the idea of taking any kind of drugs, but it really would be nice not to feel this tension and nervousness all the time.  He said it would take about a week for me to feel any difference and I have a follow-up appointment in two weeks.  I'm hopeful that it will help me out.  I'll let you all know how it goes.

Tomorrow I go back to Dr. Goldstein so I'll also write a post about that soon.

Update

It's been a while since I wrote anything on this blog.  I guess I just wasn't in the mood.  But I do have some updates.

I started using the Estradiol gel about 6 weeks ago.  I'm supposed to apply it to the vestibule twice a day.  At first, I couldn't do it that frequently.  It burned and itched like crazy.  I was applying it three times on, one time off for a while, but it was still bothering me.  Finally, I called the doctor to find out if there was anything I could do to relieve the discomfort.  He told me to lower the frequency because the last thing he wanted was for it to become unbearable to me.  I asked him about using Vitamin E down there, but he said he really didn't want me putting anything down there except for the Estradiol.  So anyway, I don't know what happened, but it's like all I needed to do was talk to him and the irritation basically stopped!  It's so weird.  But it really doesn't bother me at all now.  So I've been applying it twice a day for several weeks now.  I guess I just needed to build up a bit of resistance for it.

On a possibly related note, you might remember that I was on my period (blah!) when I saw Dr. Goldstein 6 weeks ago, but the weird thing is that I haven't had my period since!  I stopped taking birth control about 9 months ago, but BC or no BC, my period has always been very regular.  I can only remember maybe one other time in my life when my period was this late.  Is it just a coincidence or could it be related to the fact that I'm putting hormone gel on my vagina?  If anything, I would think that the attempt to bring my hormone levels back to normal would help in making my period more regular because that's part of their job.  I dont' know, it's weird.  I keep feeling like I'm having cramps, so I put in a pad expecting it to start any minute, and then nothing.  I don't know what's going on with that.  In the back of my mind I'm thinking, okay well I'm going to Italy in a month so maybe if my period can wait another week or two I won't have to deal with it while I'm overseas.  But hey, do our periods ever choose the convenient option?  I don't think so!

On the emotional side, we are making slow, but steady, progress.  We have moved up to having genitals back in the picture.  Whoa!  It's been a long time.  We are doing what the therapist calls the "quiet hand".  This is where I place my husband's hand on the vagina area and he just rests it there.  No rubbing, no insertion of anything, it just lays there.  You wouldn't believe how emotional the first time made me.  It seems so simple, but it was really hard for me.  I don't know why.  I trust my husband completely; I knew he wouldn't go any further than what we agreed, but I was still scared.  I have built up some serious fear in my head through all of this.  After the first time we tried the quiet hand, I burst into tears.  At first I was disappointed that I didn't feel any kind of desirous feelings; even though I knew there was no possible way I would, it was still sad to me that I still can't feel that.  But we've done the quiet hand a couple more times and it's much better now.   Slow baby steps.

Lastly, Dr. G said that I wouldn't feel any difference with the Estradiol for at least 6 weeks.  Well it's been 6 weeks.  Sadly I do not feel any more horny at all.  I guess that part takes longer.  But I will say that my vagina is more moist these days.  Not a turned-on kind of moist, but just a general moistness.  So I guess that gel is doing something.

Testing Hormones

I mentioned earlier that my husband read somewhere that the way they test hormones is based on men. We have since found where he read that. It was in Dr. Goldstein's book Reclaiming Desire and here's what it says:

"[...] although total testosterone is important, free testosterone is the most clinically significant value.  Unfortunately, measuring a woman's free testosterone is difficult.  The tests currently offered by the major commercial laboratories in the United States were developed for men, because men have much higher levels of circulating testosterone.  This means that what's considered 'normal' for the tests is based on the testosterone levels of men, not women.  Any test loses accuracy when measuring levels far beyond its normal range.

This becomes a more significant issue when you consider that free testosterone accounts for only about 2 percent of a woman's total testosterone.  In other words, free testosterone is even further outside the normal range that the tests are designed to measure."

This is an outrage.  Why do we even go to gynecologists?  Aren't they supposed to be women doctors?  I'm not a doctor and even I know that testosterone is a significant hormone for women, even if it comes in small doses.  Why has no one taken the steps to makes these tests for women?  This explains the huge discrepancy between the test they did at the GYN and the test done at Dr. G's office, why they told me at the GYN that my testosterone was normal and why I've now found out that it's way way low.  Now I just have to figure out why the estrogen number was also so inaccurate.

Maybe other doctors ARE idiots...

I'm just kidding about that; I don't really believe that all other doctors are idiots. But I have had my hormones tested 2 times prior to going to Dr. Goldstein and both times the doctors told me that everything was normal. I've gotten my results back from the blood test that I had at Dr. G's and they tell a very different story. My estradiol is 40 when it should be at 70 and my testosterone is .2 when is should be .6. I'm no scientist but that seems like a huge difference! I know this may sound weird, but I am so relieved that my hormones are, in fact, low. It gives me something to grasp onto as a possible reason for my problems. Not only can I attribute my pain to low hormones, but it might actually have something to do with my non-existent libido as well. This gives me so much hope that I really will be able to feel desire again once I get my hormone levels where they should be.

Finally, I have something concrete that I know can be fixed. If I wasn't at work right now, I would just break down and cry from the relief.