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Below is an article that appeared in Self Magazine about Dr Glazer and his work.

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How I Used a Simple Exercise (and
Biofeedback) to Ease My Vaginal Pain

by Anne Kahn

A year ago, the pain in my vagina finally went away. After years of being misdiagnosed, unsuccessfully treated, told there was nothing wrong with me and that I was crazy, I finally found a cure. A small box of electronics gave me back my life.

I was one of hundreds of thousands of American women suffering from vulvodynia, a painful disorder that causes inflammation and intense burning in the vulvar area. Vulvodynia can make sitting, walking or even wearing tight clothing a torturous experience. Sexual intercourse is often impossible.

After two years of searching for relief, I found Howard Glazer, Ph.D., a clinical professor of psychology and obstetrics and gynecology at Cornell University Medical College in New York

City, who uses biofeedback to treat vulvodynia. He explained that many women with this disorder also have unstable pelvic floor muscles, which can cause the vulvar area to become hypersensitive, inflamed and painful.

Biofeedback treatment for vulvodynia allows women to heal themselves by strengthening and stabilizing these muscles as they monitor their own progress. Glazer's method involves inserting a sensor, which is attached to a biofeedback instrument, into the vagina. The instrument then directs patients when to vaginally squeeze and release the sensor, and provides feedback about the strength of each contraction and the amount of tension in the muscle when it is relaxed. This exercise, performed daily, stabilizes pelvic floor muscles and diminishes pain.

Early research on biofeedback's effectiveness for treating vulvodynia is promising: After nine months, all women using this method improved to some degree, and half are pain-free.

I dreaded inserting something into my already sore vagina, but I felt I had no choice. For the first few weeks, I felt no improvement and almost gave up. But after eight weeks things improved slightly; after 12 weeks, I had no pain except during sex. After 24 weeks, I could make love without pain.

Now, a year later, I still do a modified regimen of biofeedback, but my pain is just an unpleasant memory. Biofeedback made me feel as if I could understand, control and heal my own body. For further information, contact the National Vulvodynia Association, Box 4491, Silver Spring, MD 20914; or call 301-299-0775.

 

Charting Vulvodynia

Treatment Options for an
often-misdiagnosed vulvar condition.
When the National Institutes of Health convened its first expert panel on vulvodynia this year to discuss ways to improve the diagnosis and treatment of vulvar disorders, it was a breakthrough. Vulvodynia was officially identified by a small group of doctors in 1983. The complex condition, characterized by chronic burning pain in the outer area of the female genitals (known as the vulva) and other symptoms, remains poorly understood and widely underdiagnosed by most gynecologists. The condition may afflict up to three out of every 100 women, though all estimates are uncertain. This chart lists the types of vulvodynia that have been recognized, their possible causes, symptoms, and available treatments. - Jacqueline Stenson

Type

Vulvar vestibulitis Dermatological diseases Other

Symptoms

Inflamed, tender red spots near the entrance of the vagina (the vestibule)

Pain when pressure is applied to the vestibule; a defining characteristic of vestibulitis is pain upon entry during sexual penetration; some women are unable to insert a tampon.

Vulvar burning or itching

Visible pimples or other lesions on the vulva (these vary depending on the underlying skin condition — most commonly, lichen planus, lichen sclerosis or lichen simplex chronicus)

Constant or intermittent vulvar burning along the pudendal nerve in the pelvic area; pain anywhere from the clitoris to upper thighs (called pudendal neuralgia)

Pain only in the vestibule and vulva proper (called essential or dysesthetic vulvodynia).

Possible Causes

An allergic response to chemical irritants (soaps, deodorants, antifungal creams)

High urine levels of calcium oxalate crystals

Pelvic muscle spasms

Trauma to the external genitalia from surgery, accident or rough sexual activity

Autoimmune dysfunction

Irritant Contact

Genetic predisposition

Trauma to the pudendal nerve due to an accident of childbirth

Tumors of the spinal cord

Herpes virus infection

Pelvic muscle spasms

Treatments

Removal of irritants

Reduction of oxalate-rich foods (including chocolate, peanuts, celery, teas and spinach); addition of calcium citrate supplements

Electronic-based biofeedback or physical therapy to rehabilitate the pelvic floor

Topical steroids

Antihistamines to reduce swelling

Tricyclic antidepressants such as amitriptyline or desipramine (to help block pain)

Anticonvulsants or anesthetic derivatives

Nerve blocks

Electronic-based biofeedback or physical therapy to rehabilitate the pelvic floor


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