Treatments

A Pap smear, also called a Pap test, is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on your cervix. The cervix is the opening of the uterus.

During the routine procedure, cells from your cervix are gently scraped away and examined for abnormal growth. The procedure is done at your doctor’s office. It may be mildly uncomfortable, but doesn’t usually cause any long-term pain.

Who needs a Pap smear?

Screening should start at age 25. Some women may be at increased risk for cancer or infection. You may need more frequent tests if:

• you’re HIV-positive
• you have a weakened immune system from chemotherapy or an organ transplant

If you’re over 25 and have not had abnormal Pap tests, ask your doctor about having one every five years if the test is combined with a human papillomavirus (HPV) screening. Current recommendation is that people between the ages of 25 and 65 should have an HPV test every five years.

HPV is a virus that causes warts and increases the chance of cervical cancer. HPV types 16 and 18 are the primary causes of cervical cancer. If you have HPV, you may be at an increased risk of developing cervical cancer.

Women over the age of 65 with a history of normal Pap smear results may be able to stop having the test in the future.

You should still get regular Pap smears based on your age, regardless of your sexual activity status. That’s because the HPV virus can be dormant for years and then suddenly become active.

The Mirena intrauterine device (IUD) is an implant that people can use as a birth control method for up to 6 years. It may also offer up to 5 years of relief to those who have heavy periods.

This IUD works by releasing a hormone that works to prevent pregnancy. This form of birth control might be a good option for people who find it difficult to remember to take a pill every day. However, it can cause various side effects.

What to expect from an IUD fitting

Anyone considering a Mirena IUD should first discuss it with a healthcare professional. If they decide to go ahead with the fitting, this will take place in a primary care physician’s office or clinic.

A person will first need to remove all clothing from below the waist and lie on their back, usually placing their feet in stirrups. A healthcare professional will often cover the lower part of the individual’s body to try to make them feel more comfortable.

During the fitting, the doctor will clean the vagina and cervix. They will then slide a plastic tube containing the Mirena IUD into the uterus. The doctor will remove the tube, leaving the Mirena inside. Threads hang from the IUD to aid removal later, but the doctor will cut the threads to an appropriate length for now.

The doctor may also show a person how to do a thread check, which they should do once a month to check that the Mirena IUD is still in place. If an individual cannot feel the threads, or if they feel more than just the thread, they should contact their doctor right away.

A doctor will typically offer a follow-up appointment 4–6 weeks after placement.

A comparatively new method for hormone-free contraception is the so-called copper pearls ball, also called IUB™ Ballerine® by the manufacturer.

Vaginismus is a rare medical condition that causes involuntary vaginal muscle spasms. It can inserting tampons and penetrative sex painful — and, in some cases, impossible. For some, it is a condition they have always had, while others can develop it later in life due to hormonal changes (i.e. menopause), emotional trauma, or no obvious reason at all.

Until recently, treatment often involved a combination of talking therapy sessions to address the emotional aspect of the condition and physical therapy and vaginal dilators to help the muscles adapt. The goal? Make intercourse possible or, at the very least, more comfortable. Now practitioners are using Botox® to paralyze the muscles that contract as a result of the condition with promising results.

Here, we outline everything you need to know about the procedure and hear from two patients about their experiences.

How Does Botox® Treat Vaginismus?

Botox® is a brand name for BoNT-A, which is a neuromodulator that relaxes muscles when it is injected. It is used therapeutically to treat a number of medical conditions, as well as being used for cosmetic purposes. For vaginismus, Botox® is injected into the vaginal muscles that contract to cause pain and prevent penetration. By paralyzing the muscles, it effectively treats involuntary contractions — such as those experienced by people who have vaginismus. There are three main groups of muscles that can be affected by vaginismus, but Botox® is generally injected into the bulbospongiosus muscle (i.e. the muscle that surrounds the opening of the vagina).

What Does the Botox® for Vaginismus Procedure Involve?

The technique is based on the same principle as cosmetic Botox®. The product is injected into muscles that are contracting when they shouldn’t be. Your practitioner will establish which muscle groups are causing the pain and inject them accordingly. On average, 200 units of Botox® are used during a session.

While needles in the vulva may signal discomfort, procedure pain is rarely a factor. Vaginismus Botox® treatments are carried out under local or general anesthesia. For some patients, general anesthesia is the best option because the condition would make it difficult to inject the local anesthesia that is needed. Either way, the procedure is usually an outpatient procedure.

Generally speaking, it takes patients four to five days to recover from the procedure, and the full effects of Botox® are realized around one week post-op. In some cases, the injection alone will be enough to allow for painless penetration. In other cases, the treatment will be combined with the use of dilators (to address physical discomfort) and therapy — in order to address the emotional issues that, of course, can’t be treated with a procedure alone.

How Many Sessions Are Needed to See Results?

More often than not, just one session is needed for patients to enjoy the full benefits of the procedure. This long-term relief occurs despite the fact that the Botox® only lasts three to five months — the initial treatment breaks the pain cycle associated with vaginismus. Once patients are able to have painless intercourse or penetration, the body tends to relax the muscles on its own. It is possible, however, to have multiple treatments, if results from the first procedure wear off over time.

Doctors report a 90 to 97 percent success rate for the procedure, and side effects are minimal. As with any procedure, there is a small risk associated with the anesthesia. The procedure-specific risks include the potential for bladder issues and, on rare occasions, patients report botulism-like symptoms including blurred vision.

What’s Being Tested?

Hormone blood tests can look at several key female hormones:3

• Estrogen
• Progesterone
• Follicle-stimulating hormone (FSH)
• Testosterone/DHEA
• Thyroid hormones

In most cases, healthcare providers use hormone test results combined with other factors—such as symptoms, medical history, and other test results—to reach a diagnosis.