- Women’s Health
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- Nurse Barb
By Nurse Barb Dehn
Disclosure: I was invited to attend an event about IBS-D by Salix Pharmaceuticals and am working with them to help get information out about how to talk about IBS-D symptoms and treatment options. Salix provided me with a stipend and paid for my travel and accommodations related to the event; however, all opinions are my own.
I really like this photo of models who’ve had their tummies painted to represent what it’s like to have Irritable Bowel Syndrome with diarrhea (IBS-D). Between the cramping, bloating, pain and let’s face it, the frequent and unpredictable trips to the bathroom, if you have IBS-D, this might be exactly how you feel.
Could you have IBS-D? Take Nurse Barb’s Quiz
If you answered yes to these questions, then you should talk to your healthcare provider and ask if you could be like the up to 16 million Americans with IBS-D. Your HCP should evaluate your clinical history, perform a physical examination, ensure diagnostic criteria for IBS-D are met and that alarm features are absent before making a diagnosis.
Experts weigh in on IBS-D – It’s unpredictable
Recently I attended an informational event with Dr. Mark Pimentel, Executive Director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai Medical Center in Los Angeles, California.
Dr. Pimentel explained that living with IBS can be enormously frustrating and that people with IBS-D don’t often know when they’re going to need to visit the bathroom, which can cause people to limit their lives for fear of not being able to find a restroom.
Imagine getting up and not knowing if you’ll visit the bathroom once or let’s say 12 times that day and not knowing when the urgent need to use the restroom will come up.
If you have IBS-D, then you don’t have to imagine this, you may know what it’s like to not know when you have stop what you’re doing and find a bathroom––Quickly. No wonder people start to stay home and skip doing the things they love.
And, despite a lot of well-meaning advice about what foods to eat and which ones to avoid, people with IBS-D may find that they are unable to predict if they will experience symptoms on any given day. It can be frustrating and depressing.
Quick Facts on IBS
• Some people with IBS experience constipation in more than 25% of bowel movements and diarrhea in more than 25% of bowel movements, this is known as mixed IBS.
What Causes IBS-D
– Aha! Could this information help us find effective treatments?
– Stay tuned.
Find a Gastrointestinal specialist
If you think that you might have IBS-D, then DO find a gastrointestinal specialist, known as a GI specialist, who has experience with IBS-D. Your primary care provider may not be as familiar with the latest research and treatments.
I know that this may be embarrassing to talk about, but the talk doesn’t have to be as uncomfortable as the symptoms. I really like this website: LetsTalk-2 that has resources and a list of questions for you to talk to your health care provider about.
My tips for preparing to talk to your health care provider about your symptoms
Questions about IBS-D for your health care provider
Treatment options for IBS-D
Dr. Pimentel presented data about a treatment option for IBS-D that has helped provide significant relief of both abdominal pain and diarrhea. Click here to learn more about an IBS-D treatment option.
If you’re asking this question, you’re not alone. If you’re under 30 about 1/3 of women use something slippery (lube or lubricant) to help everything glide and slide with sex. If you’re in your 50’s or beyond, it’s more like 50- 75%.
Which lubricant is best? Well that depends. Most of the manufacturers of lube have several different varieties for any situation. Here are some guidelines:
– These include Good Clean Love, KY, Sliquid, Aloe Cadabra, Sylk, Yes
– These can be used with any toy made out of anything
– Ok with all condoms
– Available in sugar-free flavors
– If you’ve used a water based lubricant and it’s feeling a little dry, instead of applying more lubricant, you can use a little bit of water to rehydrate the lubricant. (hint- your saliva will also work)
– Won’t stain the sheets and rinses off with water
Here are the facts:
Myth #1: All “Milks” are the Same
Myth #2 Milk is loaded with….. (more…)
There’s lots of reasons why sex might be painful after you turn 50. For many women as estrogen levels decline during midlife, their vaginas become much more dry and don’t have the same elasticity or ability to stretch.
What you might notice
I hear from a lot of women who are suddenly ready to have a baby. They want to be pregnant as soon as possible. Others are considering pregnancy and trying to get prepared.
Stop All Birth Control
It may sound obvious, and that’s because it is! If you’re ready to become pregnant, then the first thing to do is to STOP using any birth control.
With most birth control methods once you stop using them, your menstrual cycle will start up again. It may take a few weeks to see a period return, but the process that leads to your period resumes as soon as you stop birth control.
Has the switch flipped and you’re starting to think about becoming pregnant? Have you started to notice more pregnant women everywhere you go?
Does it seem like there’s a new mom pushing a stroller on every street corner? Do you see Dads with little ones in carriers? If so, you just might be starting to think about becoming a mom yourself. This is sometimes known as the pre-contemplative phase where ideas take seed and start to grow in your mind.
Questions to consider
Every woman approaches this process from their own unique perspective. Here’s some questions to consider:
It’s important to note that guidelines are just that, guidelines based upon data from large populations, however they may not apply to every woman that you encounter, especially to those who have unique circumstances and let’s face it, are more challenging and more rewarding as we provide personalized, individualized care.
The current American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines for pap smears differ from those of the US Preventive Services Task Force (USPSTF)
The USPSTF guidelines recommend that Pap smears be stopped at age 65 if there have been adequate prior screens, however it’s not clear what the definition is of adequate prior screens.
There are as many different experiences of menopause as there are women. For some women, menopause arrives like a gentle breeze with barely a feeling of warmth or any other bothersome symptom, while others experience menopause like a Class 5 Tropical storm with overnight drenching hot flashes and night sweats, mood changes and a complete disruption in life.
While many clinicians understandably and appropriately focus on hot flashes and night sweats, many women may be more concerned with sleep disturbances, weight gain, loss of libido, vaginal dryness, incontinence and mood changes.
When women come to my office with any one or all of the following complaints from no periods to excessive bleeding, difficulty losing weight, excessive hair growth and acne or infertility, I see this as an important opportunity to change a woman’s life for the better. Many of these women have seen many other health care providers, who more often than not aren’t able to provide a diagnosis or who may not be able to provide a comprehensive plan of care. Many women with PCOS have symptoms that impact their appearance, their self-esteem, sense of shame and guilt as well as fears of infertility.
Using the Rotterdam Criteria for diagnosis provides an objective starting point for evaluating women. A diagnosis of PCOS can be made if 2 out of the following 3 conditions are met: Signs of hyperandrogenism such as hirsuitism, acne, absence of regular ovulation and/or seeing 10 or more small cysts on 1 or both ovaries with an ultrasound.