GUMBO Awareness; and Sexual Health is more than just Arousal.

We’re coming towards the end of the summer, and it has flown by. I remember when the “grown ups” in my life would say time flies. As a kid, I thought time went too slow. I mean, sitting in school all day, waiting months for a holiday or a whole year for your birthday! Now I’m the “grown up” telling my kids to slow down, because time flies, and they’re going to wish for days where they can live carefree as they do now. Geesh.

It's September, which means there are several national causes to bring awareness to this month. National Pain Awareness, PCOS Awareness, Ovarian Cancer Awareness, and Sexual Health Awareness. As a Pelvic Health PT, all of these hold space in the world of my clients; whether it be due to hormone imbalance, the body holding onto to trauma and manifesting itself into pain, or just not getting the education that we need about our own bodies.

Appetizer #1: People who experience chronic pain for any period of time, will tell you they would love to be without it, and how much they struggle to get others to believe it is real. When we look at pain science, the only way to explain pain, is that a signal from whenever the pain is originating gets sent to the brain, and the brain registers it as pain. The issue with this is, some providers will then run with the fact that pain is only in their head. When there was an acute trauma, whether an accident, or a repetitive force that caused the initial pain. When the pain survives for longer than the injury, the nerves are continuing to send a signal stating that this pain exists. The brain is not making that up. So we have to get to the root of why the nerves are sending the signal. It takes a provider who is willing to believe you, and go on the journey with you to help alleviate you of your pain. You are your biggest advocate.

Appetizer #2: Being that ovarian cancer begins within the pelvic and abdominal cavity, as it develops, it can cause symptoms such as urinary frequency and urgency, pain during sex or penetration, pelvic pain in general, bloating, constipation, and lower back and hip pain. All these symptoms, are forms of pelvic floor dysfunction. There is no routine screening for ovarian cancer, as there is for cervical cancer. So, if you are experiencing pelvic floor dysfunction, and, or lower abdominal pain, nausea, feeling full quickly, and fatigue for 3 weeks, please see your doctor to have testing done! Transvaginal sonography and blood serum test combined can help with early detection, which helps improve outcomes.

Appetizer #3: Polycystic Ovarian Syndrome or PCOS is characterized by an increase in androgen hormone- Androgen hormone is produced by the ovaries and helps with sexual development, metabolism, and bone and muscle growth among others. PCOS is just one of the conditions that can develop with an imbalance of the hormones, leading to multiple fluid-filled cysts on the ovaries in some, that can cause fertility issues, acne, increased body/ facial hair, menstrual imbalance and weight gain. As an endocrine disrupter, those with PCOS can also experience diabetes, heart disease, and high cholesterol. Therefore, with PCOS, you want to seek a holistic defense, including medical care, exercise, stress management, education, nutrition, and pelvic floor physical therapy to address all symptoms and gain relief.

Main Course, Gumbo and Grilled Cheese: I’ve spoken about this before, how my mom taught me abstinence, that sex led to babies; and that was it. How sex-ed in school, taught me that sex led to STDs; and that was it. I missed out on learning about what sexual hormones actually are, how they affect more in your body than just arousal. I missed out on how to truly treasure pleasure for myself, and then I would truly enjoy pleasure with my partner. I think we do a disservice to our youth when they enter the puberty stage, in not giving them a full understand of how their bodies respond and communicate back to them about sex and arousal. How sexual function is linked to your overall health. I don’t think most adults understand this either.

So, hormones run the show. The brain influences the hypothalamus, which produces gonadotropin releasing hormone which causes the pituitary to release luteinizing hormone and follicle stimulating hormone which work on the ovaries to produce estrogen and testosterone and then, there is a feedback loop that causes different structures to decrease production of hormones to ensure that there isn’t too much in the system. In terms of our cycle, we have a stable level of progesterone and estrogen during menstruation, our estrogen increases and then drops slightly right before ovulation, as progesterone rises during ovulation and continues during our luteal phase, and our estrogen rises again and both dip as menstruation starts again. So all of that means, as hormones fluctuate to cycle us through our fertile periods, because these hormones are increasing and decreasing, there are signals going to and from our brain to start and stop other functions to promote this.

So looking at cycle tracking, in a normal cycle that lasts from 24-35 days (avg 29 days), menstruation lasts from 3-7 days (avg 5 days), the follicular phase prior to ovulation is 10-23 days (avg 15 days), and the luteal phase is 10- 16 days (avg 13 days). If you do not ovulate, have a period where there is peak cervical mucus and  your basal body temperature doesn’t increase significantly after the follicular phase; if the follicular phase is stretched out for a longer period of time; if you’re having significantly shorter cycles, or menstruating twice in the time that should only happen once… Obviously the hormones are out of sync, but it can also mean that something else is going on in your body. When we pay attention to our normal cycle patterns, we are able to see when something is not right. If you have a chance, read “The Fifth Vital Sign” by Lisa Hendrickson-Jack, she breaks down how to do this. I truly believe this is a vital skill for all women to use.

Now, anyone who has ever heard of menopause and the cardiovascular risks that can occur once a woman is in menopause, knows that the decrease in estrogen doesn’t just decrease lubrication and sex drive. Estrogen promotes cellular growth (which unchecked can lead to endometrial and breast cancer), it also works to promote, brain, cardiovascular, joint, reproductive, and breast health.  Progesterone is a protective hormone, and assists with brain health, maintaining a pregnancy, bone health, and helps with sleep issues, mood swings, hot flashes, weight gain, night sweats, and fatigue. Both of these hormones drop significantly immediately post childbirth and during menopause.

So going back to PCOS, when the ovaries are delayed in releasing an egg, it can appear in your cycle as: having a delayed cycle that is lasting longer then 35 days, or you are menstruating less than nine times per year; multiple bouts of cervical mucus, where the body is attempting to ovulate, but the body can’t produce enough estrogen to trigger it; abnormally heavy or prolonged menstrual bleeding; temporary pause of ovulation and menstruation; and seven or more days of cervical mucus prior to ovulation. Other issues that affect your menstrual cycle are thyroid disorders, hypothalamic amenorrhea, small intestinal bowel overgrowth (SIBO), irritable bowel syndrome (IBS), chron’s disease, ulcerative colitis, and chronic underlying infections.

Therefore, when we see inconsistencies in our cycle, we can take that information to our providers and advocate for thorough testing to uncover what our body is trying to tell us. When we understand, that during a rise in progesterone during our luteal phase, we may experience nausea, fatigue, acne, as the body is preparing itself for a potential pregnancy; when we understand this, we can give ourself grace to not work out as hard, or to schedule time for rest during that phase. When we understand that our estrogen picks up prior to ovulation, along with an increase in cervical mucus, that this is when a lot of women have peak increased arousal, but also, we can increase our arousal through movement, gland stimulation, increasing blood flow to our pelvic floor, then we can enjoy sexual intercourse with our partners outside of our “fertile” window as well.

When we understand how our body is trying to talk to us, and we give it the nutrients and movement it craves, we are able to truly thrive out here.

I know this is a lot of information, and if you’ve made it this far, THANK YOU! This blog feels like my September, jam packed with events! I hope I gave you something to marinate on.