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A sea of cosmetics crowds the drugstore shelves, luring you with claims of romance, popularity and beauty. To be happy, you must use these products! Or so the advertisers would have you believe.

Do they work? Will you be the most beautiful, the most successful, and the most radiant person if you use these products? Where does the hype end and the help begin?

Cosmetics are defined in the Federal Food, Drug, and Cosmetic Act as "articles (other than soap) intended to be applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance without affecting the body's structure or functions."

The following are all considered cosmetics:

• skin care creams, lotions, powders

• perfume, cologne, toilet water

• makeup (lipstick, foundation, blush)

• nail polish, polish remover, cuticle softener

• hair coloring preparations

• deodorants

• shaving cream, aftershave, skin conditioner

• shampoos (except dandruff shampoos)

• bath oils and bubble bath

• mouthwash and toothpaste (with whiteners it is considered a drug)

Skin Care

Cosmetics can't work miracles, but they can help keep your skin clean and looking moist and soft. They also can temporarily close pores, plump up skin to make it appear smoother, and give you a rosy glow or blush.

Many cosmetic products are designed to protect the skin of people over 30 against dryness and the accompanying wrinkles. But these aren't the concerns of most teens. The biggest skin problem for most teenagers is acne. Some studies show that all adolescents have acne to some degree because when puberty hits, your skin starts secreting more oil. This contributes to blackheads and pimples, which cause your pores to stretch a little bit. Although acne cannot be avoided simply by washing your face, the oils on the surface of your skin can be diminished by frequent washing with cleansers made for that purpose. And there are many treatments available for acne both in over-the-counter and prescription strengths (see "Acne Agony" in the July-August 1992 FDA Consumer).

If, while trying to decrease the oily shine on your face, you make your skin overly dry, or if you're spending a lot of time outdoors in very cold weather, you may want to use a moisturizer. "Teens really should only use a water-based moisture lotion labeled 'non-comedogenic,' which means it doesn't clog pores," says Dr. Barry Leshin, M.D., associate professor of dermatology at the Wake Forest School of Medicine. "Heavier oil-based moisturizers can cause acne cosmetica--an [acne-like] skin condition directly attributed to the use of cosmetics."

Ingredients

What cosmetics can or cannot do for your complexion is determined by the ingredients of the cosmetics and your own complexion. Cosmetics contain ingredients from nature and from the laboratory. Some work well for cleaning, others are good for lubricating--and some don't do very much at all.

It's a good idea to read the labeling on cosmetics to find out what the product contains. Some ingredients, such as alcohol and mineral oil, are fairly common. Others seem more unusual and may require some explanation. Here are some examples.

• Liposomes: Microscopic sacs manufactured from natural or synthetic fatty substances which include phospholipids (components of cell membranes). When properly mixed with water, phospholipids can "trap" any substance that will dissolve in water or oil. Manufacturers say that liposomes act like a delivery system, depositing product ingredients into the skin. When the liposomes "melt," the ingredients, such as moisturizers, are released.

• Aloe vera: A plant from the lily family, aloe vera in large amounts has anti-irritant properties. Although it's an ingredient in many skin lotions, it would take much more aloe vera than most products contain for the anti-irritant properties to work.

• Vitamins: Foods containing vitamins A, D, E, K, and some of the B complex group are necessary in diets to maintain healthy skin and hair but, according to Dr. Leshin, "There is no evidence that vitamins or other additives are advantageous when applied to the skin."

Allergies

Overuse of some cosmetics can cause allergies and other skin problems (see "Cosmetic Safety More Complex Than at First Blush," in the November 1991 FDA Consumer). Ingredients such as fragrance and preservatives can cause allergic reactions in some people. Skin reactions, which doctors call contact dermatitis, should be taken seriously. (See "Contact Dermatitis: Solutions to Rash Mysteries" in the May 1990 FDA Consumer.) Even if you've used a cosmetic for years with no problems, you can develop an allergic reaction as you become sensitized to one or more of the ingredients.

Some cosmetics are labeled "allergy-tested" or "hypoallergenic," but products with these claims don't always offer a solution to cosmetic allergies. "Hypoallergenic" means only that the manufacturer feels that the product is less likely to cause an allergic reaction. Before placing this claim on the label, some companies conduct tests, and others simply don't include perfumes or other common problem-causing ingredients in their products. The claim "dermatologist-tested" on some cosmetic products only means that a skin doctor has tested the product to see if it will generally cause allergenic problems. Other label claims that carry no guarantee that they won't cause reactions include "sensitivity-tested" and "non-irritating."

"Natural" ingredients are extracted directly from plants or animal products as opposed to being produced synthetically. Natural ingredients can cause allergic reactions. If you have an allergy to certain plants or animals, you could have an allergic reaction to cosmetics containing those ingredients. For instance, "lanolin," extracted from sheep wool, is an ingredient in many moisturizers and is a common cause of allergies.

Marcia Sheets, a substitute teacher in Sykesville, Md., has tried to use cosmetics for years, but even those claiming to be allergy-free have created problems for her.

"I've had hives and swollen eyes, I've sneezed because of perfumes, and I've had blotchy skin--even from some products that are supposed to be gentle. If you have allergies, you just don't use the stuff. Over the years, I've figured out what I can use and what I can't."

If you have an allergic reaction to a cosmetic, you should stop using all cosmetics until you call your doctor, who will then try to determine which ingredient, or combination of ingredients, caused the reaction.

Cosmetic Safety

Serious problems from cosmetic use are rare, but sometimes problems arise with specific products. FDA warned consumers last February about the danger of using aerosol hairspray near heat, fire, or while smoking. Until hairspray is fully dry, it can ignite and cause serious burns. Injuries and deaths have occurr ed from fires related to aerosol hairsprays.

Another problem can occur with aerosol sprays or powders: If they are inhaled, they can cause lung damage.

The most common injury from cosmetics is from scratching the eye with a mascara wand. Eye infections can result if eye scratches go untreated. Such infections can lead to ulcers on the cornea, loss of lashes, or even blindness. To play it safe, never try to apply mascara while riding in a car, bus, train, or plane. Sharing makeup can also lead to serious problems. Cosmetics become contaminated with bacteria the brush or applicator sponge picks up from the skin--and if you moisten brushes with saliva, the problem is much more severe. Washing your hands before using makeup will help prevent exposing the makeup to bacteria.

Artificial nails can be a source of problems, especially when not applied correctly. Artificial nails must be completely sealed because any space between the natural nail and the artificial nail gives fungal infection an opportunity to begin. Such infections can lead to permanent nail loss.

Sleeping while wearing eye makeup can cause problems, too. If mascara flakes into your eyes while you sleep, you might awaken with itching, bloodshot eyes, and possibly infections or eye scratches. To avoid eye infections or injury, remove all makeup before going to bed.

Other safety tips are:

• Keep makeup containers closed tight when not in use.

• Keep makeup out of the sunlight to avoid destroying the preservatives.

• Don't use eye cosmetics if you have an eye infection such as conjunctivitis (pink eye), and throw away any makeup you were using when you first discovered the infection.

• Never add any liquid to a product unless the instructions tell you to.

• Throw away any makeup if the color changes or an odor develops. Preservatives can degrade over time and may not be able to fight bacteria.

Cosmetics run the gamut from eye shadow to deodorant sprays. And consumers' concerns and questions are just as varied as the products themselves.

"Consumers are so confused by the products out there because they all do so many different things," says Lynn Reniers, a licensed cosmetologist with Elizabeth Arden. "So it's important to send them away with a very clear understanding of product usage."

When FDA surveyed 1,687 consumers ages 14 and older in 1994 about their use of cosmetics, many of the responses pertained to consumer perceptions about cosmetic labeling claims. For example, many said they expect a product to prevent or slow the formation of wrinkles if it makes such a claim on its packaging. And nearly half of those surveyed felt that a product claiming to be "natural" should contain all natural ingredients. But do these products live up to their labeling claims?

Not necessarily. John Bailey, Ph.D., director of FDA's Office of Cosmetics and Colors, says, "Image is what the cosmetics industry sells through its products, and it's up to the consumer to believe the claims or not."

Behind the image, however, are real products, and consumers want to know what works and what doesn't.

An understanding of FDA's cosmetic responsibilities can help consumers make wise, rational decisions about the cosmetics they buy.

Regulatory Authority

The regulatory requirements governing the sale of cosmetics are not as stringent as those that apply to other FDA-regulated products. Under the Federal Food, Drug, and Cosmetic (FD&C) Act, cosmetics and their ingredients are not required to undergo approval before they are sold to the public. Generally, FDA regulates these products after they have been released to the marketplace. This means that manufacturers may use any ingredient or raw material, except for color additives and a few prohibited substances, to market a product without a government review or approval.

But some regulations do apply to cosmetics. In addition to the FD&C Act, the Fair Packaging and Labeling Act requires an ingredient declaration on every cosmetic product offered for sale to consumers. In addition, these regulations require that ingredients be listed in descending order of quantity. Water, for example, accounts for the bulk of most skin-care products, which is why it usually appears first on these products.

Although companies are not required to substantiate performance claims or conduct safety testing, if safety has not been substantiated, the product's label must read "WARNING: The safety of this product has not been determined."

"Consumers believe that 'if it's on the market, it can't hurt me,'" says Bailey. "And this belief is sometimes wrong."

FDA's challenge comes in proving that a product is harmful under conditions of use or that it is improperly labeled. Only then can the agency take action to remove adulterated or misbranded products from the marketplace.

The Fine Line Between Cosmetics and Drugs

The FD&C Act defines cosmetics as articles intended to be applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance without affecting the body's structure or functions. This definition includes skin-care creams, lotions, powders and sprays, perfumes, lipsticks, fingernail polishes, eye and facial makeup, permanent waves, hair colors, deodorants, baby products, bath oils, bubble baths, and mouthwashes, as well as any material intended for use as a component of a cosmetic product.

Products that intend to treat or prevent disease, or otherwise affect structure or function of the human body are considered drugs. Cosmetics that make therapeutic claims are regulated as drugs and cosmetics, and must meet the labeling requirements for both. A good way to tell if you're buying a cosmetic that is also regulated as a drug is to see if the first ingredient listed is an "active ingredient." The active ingredient is the chemical that makes the product effective, and the manufacturer must have proof that it's safe for its intended use. For products that are both drugs and cosmetics, the regulations require that active ingredients be listed first on these products, followed by the list of cosmetic ingredients in order of decreasing predominance.

Examples of products that are both cosmetics and drugs are dandruff shampoos, flouride toothpastes, antiperspirant deodorants, and foundations and tanning preparations that contain sunscreen.

Before products with both a cosmetic and drug classification can be marketed, they must be scientifically proven safe and effective for their therapeutic claims. If they are not, FDA considers them to be misbranded and can take regulatory action.

Reading Is Believing

The ingredient list on a cosmetic container is the only place where a consumer can readily find out the truth about what he or she is buying. Consumers can check the listing to identify substances they wish to avoid. And becoming familiar with what cosmetics contain can help counter some of the alluring appeal showcased elsewhere on the product.

"Our best friend is the ingredient label," says beauty consultant and 14-year veteran consumer reporter Paula Begoun. "And spending the time to read it may be all that is needed to protect ourselves from hurting our skin."

But the ingredient list, although a mandatory requirement on cosmetics, is also the most difficult part of the label to understand. Bailey admits that most of us don't recognize the names of the ingredients listed because there are thousands available to chemists creating a wide variety of products. But there's no way to change that, he says, and still accurately identify the substances that are used.

Consumers can, however, obtain specific information about a cosmetic ingredient in various references, such as the International Cosmetic Ingredient Dictionary and Handbook, published by the Cosmetic, Toiletry, and Fragrance Association, available at many public libraries. FDA recognizes the association as a reliable source of facts on substances that have been identified as cosmetic ingredients, as well as their definitions and trade names.

Cosmetic ingredient declaration regulations apply only to retail products intended for home use. Cosmetic samples and products used exclusively by beauticians in salons are not required to include the ingredient declaration. However, these products must state the distributor, list the content's quantity, and include all necessary warning statements.

They Can Be Irritating

Almost all cosmetics can cause allergic reactions in certain individuals. Often the first sign of a reaction is a mild redness and irritation. There is no list of ingredients that can be guaranteed not to cause allergic reactions, so consumers who are prone to allergies should pay careful attention to what they use on their skin.

Nearly one-quarter of the people questioned in FDA's 1994 cosmetics survey responded "yes" to having suffered an allergic reaction to personal care products, including moisturizers, foundations, and eye shadows.

"Because of the almost limitless combinations in all sorts of mixtures and formulations, it is virtually impossible to know if, when, or how anyone's skin will react to any cosmetic," Begoun says. She advises consumers to "buy with a healthy dose of skepticism," and to stop using an offending product and return it to the place of purchase. "Returning the product gives the cosmetics company essential information about how these formulas are working."

What Lies Behind the Meaning

FDA has tried to establish official definitions for the use of certain terms such as "natural" and "hypoallergenic," but its regulations were overturned in court. So companies can use them on cosmetic labels to mean anything or nothing at all. Most of the terms have considerable market value in promoting cosmetic products to consumers, but dermatologists say they have very little medical meaning.

Some of the more common terms that consumers should be aware of include:

• Natural: implies that ingredients are extracted directly from plants or animal products as opposed to being produced synthetically. There is no basis in fact or scientific legitimacy to the notion that products containing natural ingredients are good for the skin.

• Hypoallergenic: implies that products making this claim are less likely to cause allergic reactions. There are no prescribed scientific studies required to substantiate this claim. Likewise, the terms "dermatologist-tested," "sensitivity tested," "allergy tested," or "nonirritating" carry no guarantee that they won't cause skin reactions.

• Alcohol Free: traditionally meant that certain cosmetic products do not contain ethyl alcohol (or grain alcohol). Cosmetic products, however, may contain other alcohols, such as cetyl, stearyl, cetearyl, or lanolin, which are known as fatty alcohols.

• Fragrance Free: implies that a cosmetic product so labeled has no perceptible odor. Fragrance ingredients may be added to a fragrance-free cosmetic to mask any offensive odor originating from the raw materials used, but in a smaller amount than is needed to impart a noticeable scent.

• Noncomodogenic: suggests that products do not contain common pore-clogging ingredients that could lead to acne.

• Shelf Life (Expiration Date): the amount of time for which a cosmetic product is good under normal conditions of storage and use, depending on the product's composition, packaging, preservation, etc. Expiration dates are, for practical purposes, a rule of thumb, and a product may expire long before that date if it has not been stored and handled properly.

• Cruelty Free: implies that products have not been tested on animals. Most ingredients used in cosmetics have at some point been tested on animals so consumers may want to look for "no new animal testing," to get a more accurate indication.

The list of ingredients, once again, can help consumers determine if there is any significant difference between products labeled similar to the above, and competing brands that don't make these claims.

Since the cosmetics industry often produces new, reworked versions of old ingredients, a wise consumer will take the time to read the labels to know what's in a product and how to use it safely. After all, consumers are likely to try other products with the same recognizable names. Once you have all the information, you can begin to make your own decisions about what products work best for you.

"There is really very little that's new under the sun," Bailey concludes, "and that certainly applies to cosmetics."

Carol Lewis is a staff writer for FDA Consumer.

Beauty on the Safe Side

Serious injury from makeup is a rare occurrence, according to John Bailey, director of FDA's Office of Cosmetics and Colors. But it does happen. Good common sense and a few precautions can help consumers protect themselves against hazards associated with the misuse of cosmetics.

• Never drive and apply makeup. Not only does it make for dangerous driving, but hitting a bump in the road and scratching your eyeball can cause bacteria to contaminate the cut and could result in serious injury, including blindness.

• Never share makeup. Always use a new disposable applicator when sampling products at a cosmetics counter. Insist that salespersons clean container openings with alcohol before applying their contents to your skin.

• Never add liquid to a product to bring back its original consistency. Adding other liquids could introduce bacteria that can easily grow out of control.

• Stop using any product that causes an allergic reaction.

• Throw away makeup if the color changes or an odor develops. Preservatives degrade over time and may no longer be able to fight bacteria.

• Do not use eye makeup if you have an eye infection. Throw away all products you were using when you discovered the infection.

• Keep makeup out of sunlight. Light and heat can degrade preservatives.

• Keep makeup containers tightly closed when not in use.

• Never use aerosol beauty products near heat or while smoking because they can ignite. Hairsprays and powders may cause lung damage if inhaled regularly.

Helping the Buyer Beware

Despite many questions about their safety, alpha hydroxy acids (AHAs) and beta hydroxy acids (BHAs) have become widely used in recent years. AHAs are derived from fruit and milk sugars, and are among the popular ingredients that attract customers with their claims to reduce wrinkles and age spots, and help repair sun-damaged skin. (See "Alpha Hydroxy Acids" in the March-April 1998 FDA Consumer.)

FDA recommends that consumers take precautions with AHA and BHA products:

• Test any AHA/BHA-containing product on a small area of skin before applying to a larger area.

• Avoid the sun when possible.

• Use an effective sunscreen when using an AHA-containing product, even if you haven't used the product that day.

• Follow use instructions on the label.

• Do not exceed recommended applications.

• Do not use on infants and children.

Prohibited Ingredients

The following ingredients, because of the dangers they impose, are either restricted or prohibited by regulation for use in cosmetics:

• bithionol

• mercury compounds

• vinyl chloride

• halogenated salicylanilides

• zirconium complexes in aerosol cosmetics

• chloroform

• methylene chloride

• chlorofluorocarbon propellants

• hexachlorophene

• methyl methacrylate monomer in nail products

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Overactive Bladder Syndrome
www.OveractiveBladderSyndrome.com

What is Overactive Bladder & Overactive Bladder Syndrome?

Overactive Bladder Syndrome, also known as Female Urinary Incontinence or Stress Urinary Incontinence, is the loss of bladder control. 

Symptoms of Overactive Bladder Syndrome can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it is more common in women who have had at least one vaginal childbirth, and becomes even more of a problem during menopause. 

Overactive Bladder Syndrome happens when genitourinary muscles are too weak or too active. If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh or lift a heavy object. This is stress incontinence. If bladder muscles become too active, you may feel a strong urge to go to the bathroom when you have little urine in your bladder. There are other causes of Overactive Bladder Syndrome, including nerve damage and pelvic organ prolapse.

Doctors in Genitourinary Medicine are specialists in Overactive Bladder Syndrome.  Treatments for Overactive Bladder Syndrome depends on the type of problem you have and what best fits your lifestyle. It may include simple exercises, medicines, special devices or procedures prescribed by your doctor, or surgery.

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Pelvic Organ Prolapse
www.PelvicOrganProlapse.com

Pelvic Organ Prolapse & Pelvic Prolapse Information, Resources and Doctor Referrals

What is Pelvic Organ Prolapse?

Pelvic Organ Prolapse or Pelvic Prolapse, is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapsee in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor dysfunction, urogenital prolapse, vaginal relaxation or vaginal vault prolapse.

Pelvic Organ Prolapse
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What is Pelvic Prolapse?

Pelvic Prolapse is another term used for "Pelvic Organ Prolapse."  Pelvic Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor dysfunction, urogenital prolapse or vaginal vault prolapse.

What are the symptoms that indicate a woman is suffering from  Pelvic Organ Prolapse?

• Loss of bladder control.

• Loss of bowel control.

• Increasing need and frequency to urinate - and then difficulty in completely emptying your bladder.

• The feelings that your of pelvic or vaginal heaviness, bulging, fullness and/or pain, or a feeling that something is "dropping."

• Recurrent bladder infections.

• Excessive vaginal discharge.

• Pain or lack of sensation during sex

But Pelvic Organ Prolapse is a real, common and treatable problem. Consider this:

About half of all women over age 50 suffer from some degree of Pelvic Organ Prolapse.

One in 10 women undergo surgery for Pelvic Organ Prolapse by age 80.

What is Pelvic Reconstruction?

Pelvic Reconstruction is a surgical procedure performed by gynecologists or uro-gynecologies to repair pelvic organ prolapse and vaginal vault prolapse, among types of prolapse, and to correct the problem(s) and relieve the symptoms. 

Typically, Pelvic Reconstruction is performed vaginally and uses an implant to reinforce the strength of the weakened pelvic tissues. 

What is a Prolapsed Uterus?

A Prolapsed Uterus refers to a collapsed uterus, or descended uterus, or other change in the position of the uterus in relation to the surrounding structures within the pelvis. The pelvis contains many soft tissue structures vital to normal body functions, supported primarily by the diaphragms, layers of muscles, fibrous coverings called fasciae, and various ligaments and tendons. These soft tissues of the pelvis derive their ultimate support from the bony pelvis. 

A Prolapsed Uterus may be one of three types, depending on the severity:

• First-degree prolapse occurs when the uterus sags downward into the upper vagina.

• Second-degree prolapse occurs when the cervix is at or near the outside of the vagina.

• Third-degree prolapse (sometimes referred to as total prolapse) occurs when the entire uterus extends outside the vagina.

What is Gynecologic Urology?

Gynecologic Urology, also referred to as Uro-gynecology, is a subspecialty within the field of Obstetrics and Gynecology. Uro-gynecology's specialty is female pelvic disorders such as pelvic organ prolapse (bulges that extend from the uterus into the vagina or extend out of the vagina), urinary incontinence, fecal incontinence and constipation. 

Doctors that complete their residency in Obstetrics and Gynecology, then go onto complete fellowship training in Uro-gynecology, where they spend several years focusing only on Uro-gynecology and female pelvic disorders.

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What is "Nerve Stimulation" and how does Nerve Stimulation help patients?

There are various types of nerve stimulation, each with its own protocols for treating various ailments and conditions.

One type of nerve stimulation is for treating people with moderate to severe depression.  Depression can be a very serious and life-threatening condition that may require life-long management and treatment.  Treating depression may sometimes have a lower than hoped for success rate and estimates indicate that more than half of all patients with depression have relapses. Anti-depressant drugs and medication may lessen symptoms but may not relieve all of the symptoms in some patients.

Seizures also do not always respond to treatment. Some patients have tried two or more medications and still have seizures, as well as side effects from the drugs, both of which affect their quality of life.

Vagus nerve stimulators are a small medial device that are implanted under the skin of the chest.  A very small wire runs to the patient's vagus nerve, which is then stimulated by the device, in the same manner a pacemaker works.  In general, patients with depression normally experience an improvement in alertness, energy. memory, their depression improves as a result. better mood. These quality-of-life benefits improve over time. 

Vagus nerve stimulators, in general, have proven to be a safe and effective way to control seizures and lessen the severity of depression.   Because Vagus nerve stimulators are used, drugs are usually not required, and there are no side effects that are associated with anti-depressant or seizure-control medications.

See:  www.DepressionHelp.net  for more information about depression.

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What is Adhesiolysis?

Treatment for the removal of Pelvic Adhesions is through a surgical procedure called "adhesiolysis."  The adhesiolysis procedure may involve cutting and releasing the adhesions during a laparoscopy procedure or treating the adhesions during a laparotomy.

What are Pelvic Adhesions?

Pelvic adhesions are the cause of many gynecological problems including significant pain, infertility and conception. Pelvic adhesions are irritations of a woman's pelvic organs as a result of a "pelvic inflammatory event" or from trauma to the area such as in the case of pelvic or gynecological surgery.

Examples of a pelvic inflammatory event include; fallopian tube infections that might occur from endometriosis, removal of an ovarian cyst, sexually transmitted diseases such as gonorrhea, post surgery infections, and even appendicitis and appendectomies.

As a woman's body's pelvic area recovers from an inflammation, trauma or surgery, it begins the healing process and starts to repair itself.  The woman's body and its' healing process may cause some tissues and structures in the pelvis to become unintentionally "stuck" to another tissue or structure. In a normal woman's healthy pelvis, this space is lined with a tissue called the peritoneum, which also covers the outside of organs located in the abdomen and pelvis. In the pelvis of a non-injured/non-irritated woman, the peritoneum can be very "slippery" with the the organs and structures lying immediately next to each other that "slip" off each other and do not become bonded together. With a woman who has had a pelvic inflammation, trauma or injury, her body's healing process starts a sequence of events that may result in some of the pelvic tissues becoming "stuck" to or "adhering" to tissues or organs next to the inflamed, or injured tissue, and when this occurs, the outcome may be pelvic adhesions.

What is Pelvic Inflammatory Disease?

Pelvic inflammatory disease, or "PID" is an infection of a woman's pelvic organs which include the uterus, fallopian tubes, and ovaries. 

Bacteria causes pelvic inflammatory disease. Bacteria can move upward, from a woman's vagina or cervix - which is the opening to the uterus, or womb - into her fallopian tubes, ovaries and uterus, which then cause an infection. Many types of bacteria can cause pelvic inflammatory disease. But bacteria found in two common sexually transmitted diseases - chlamydia and gonorrhea - are the most frequent causes of pelvic inflammatory disease. 

After a woman becomes infected, it can take from a few days to a few months to develop pelvic inflammatory disease. 

The major symptoms of pelvic inflammatory disease are lower abdominal pain and abnormal vaginal discharge. 

Other symptoms of pelvic inflammatory disease may include one or more of the following; fever, pain in the right upper abdomen, pain during vaginal intercourse, and irregular menstrual bleeding.  

Pelvic inflammatory disease, particularly when caused by chlamydia, may produce only minor symptoms or no symptoms at all, even though it can seriously damage the reproductive organs. 

Untreated, pelvic inflammatory disease causes scarring and can lead to infertility, tubal pregnancy, chronic pelvic pain, and other serious problems. 

Pelvic inflammatory disease is more common and more aggressive in HIV+ women than in uninfected women. Pelvic inflammatory disease may become a chronic and relapsing condition as a woman's immune system deteriorates. 

Women can play an active role in protecting themselves from pelvic inflammatory disease disease by following these steps and precautions: 

*  Call your doctor if you have discharge with odor or bleeding between cycles. 

*  Use either male or female condoms during sex. 


What is Pelvic Floor Dysfunction?

Pelvic floor dysfunction, which is also referred to as outlet obstruction or outlet delay, refers to a condition in which the pelvic floor muscles of a woman's lower pelvis - that surround the rectum, do not function normally. It is not known why these muscles fail to work properly in some women, but they can make the passage of stools difficult even when everything else seemingly is normal.


What Causes Pelvic Floor Dysfunction?

Women with pelvic floor dysfunction find that muscle pain occurs when muscles are tense, strained, traumatized and/or otherwise inflamed. Their pelvic muscles are no exception. Causes of pelvic floor dysfunction can include:

*  Chronic faulty posture with weak core musculature 
*  Trauma (fall on tailbone, old tailbone fracture, auto accident)
*  Inflammation or infection
*  Pelvic organ disease (endometriosis, irritable bowel syndrome, interstitial cystitis) 
*  Repetitive motion injuries such as those from gymnastics, volleyball, soccer, ballet or ice
    skating
*  Abdominal muscle wall weakness or hernias 
*  Chronic constipation
*  Pregnancy or complicated vaginal delivery 
*  Abdominal or pelvic surgery such as a hysterectomy 


Do I have Pelvic Floor Dysfunction?

Women with pelvic floor dysfunction often have changes in their spine and/or pelvis.  Symptoms or conditional might include; scoliosis, short leg, swayback or a "torsioned" sacrum. The most common symptoms of pelvic floor dysfunction include one or more of the following:

*  Vaginal pain 
*  Pain with urination 
*  Urinary urgency and frequency 
*  Rectal pain 
*  Pain during vaginal intercourse 
*  Pain with sitting, standing, walking 
*  Pain and/or difficulty getting up from a seated or lying down position
*  Hip pain often with loss of range of motion in hips 
*  Deep pain in lower back radiating to legs, thighs, groin, hips 
*  Abdominal and lower abdominal/intestinal pain
*  Pelvic pressure or a feeling like your vagina or uterus are "falling out."
*  Involuntary loss of urine or stool 

What is Menorrhagia?

Menorrhagia is the medical term for women (and young girls first starting their menstrual cycles) that excessive menstrual bleeding. Excessive menstrual bleeding is defined as having a period that lasts 7 or more days each menstrual cycle (period) or is so heavy that you saturate your menstrual pad and/or tampon and need to change your feminine hygiene product(s) every one to two hours.  It is very important to inform your doctor if you have excessive menstrual bleeding! 

Women that are suffering from Menorrhagia may experience; anemia, fatigue,  embarrassing menstrual accidents, and feel that you have to restrict your life and social activities to such an extent that you "miss out on life."  Many women prefer to stay close to home so as to avoid embarrassment due to their need to go to the restroom so often so that they can change their feminine hygiene products before they become too saturated and cause even more embarrassment.


How many women have Menorrhagia?

Approximately 1 in 5 women have Menorrhagia.

Are there any treatments or therapies for Menorrhagia?

Yes, there's hope and help for women with Menorrhagia!

Here are a few of the options and therapies you will want to discuss with your doctor.

Hormone therapy - also known as "both control pills," and/or other medications may be prescribed to treat hormone imbalance. Hormone therapy is effective about 50% of the time, and may be required for a long period of time. 

Uterine Balloon Therapy - Also known as Thermal Balloon Ablation) (see below for more information)

Dilation and curettage - also referred to as a "D & C" - is a surgical procedure whereby the doctor scrape the inside of the woman's uterus to remove the lining. For most women with Menorrhagia, a D&C is temporary and reduces excessive bleeding for only a few periods.

Endometrial Ablation is another possible therapy but only if you and your husband don't plan to have children in the future. Typical Endometrial Ablation removes the lining of the uterus with an electrosurgical tool or laser. Like any surgical procedure, there are risks, which include perforation of the uterus, bleeding, infection, or even heart failure due to fluids used to open up or distend the uterus.

Hysterectomy is the surgical removal of the uterus.  As a hysterectomy involves the removal of the woman's uterus, Menorrhagia will no longer be a problem. Hysterectomy is also a surgical procedure and also involves risks. The recovery period after hysterectomy is 3 to 6 weeks. 

What is Female Sexual Medicine?

While a gynecologist or family physician may be knowledgeable and able to diagnose disease and disorders of a woman's vulva and care for her reproductive and vulvovaginal health, he/she may lack the requisite education as it relates to "female sexual dysfunction," which is a growing area of medicine known as "Female Sexual Medicine" which treats women and the various ailments and disorders which interfere with female sexual satisfaction, including;

Female Erectile Dysfunction - see:  www.FemaleErectileDysfunction.com

Female ED - see:  www.FemaleED.com

Female Sexual Arousal - see:  www.FemaleSexualArousal.com

Female Sexual Arousal Disorder - see:  www.FemaleSexualArousalDisorder.com

Female Sexual Dysfunction - see:  www.FemaleSexualDysfunction.net

Female Sexual Function - see:  www.FemaleSexualFunction.com

Hypoactive Sexual Desire Disorder - see:  www.HypoactiveSexualDesireDisorder.com

Pelvic Organ Prolapse - see:  www.PelvicOrganProlapse.com

Sexual Pain Disorder - see:  www.SexualPainDisorder.com

Vaginal Relaxation - see:  www.VaginalRelaxation.com

Vaginal Vault Prolapse - see:  www.VaginalVaultProlapse.com

Vulvar Vestibulitis - see:  www.VulvarVestibulitis.com

Vulvovaginal Health - see:  www.Vulvovaginal.com

It is important to note that 43% of American women -- about 40 million -- have physical and/or emotional distress relating to enjoying sex.  This is manifested in loss of interest in sex, no longer finding sex enjoyable, or providing the enjoyment sex used to bring, or the inability to complete a sexual encounter to orgasm.  or it just is not as enjoyable as it used be. Many women also report diminished sexual sensations in their vulva, vagina or clitoris while other women have pain during intercourse.

What is menopause?

Menopause is a normal change in a woman's life when her period stops. That's why some people call menopause "the change of life" or "the change." During menopause a woman's body slowly produces less of the hormones estrogen and progesterone. This often happens between the ages of 45 and 55 years old. A woman has reached menopause when she has not had a period for 12 months in a row.

What is hormone therapy for menopause?

Hormone therapy for menopause has also been called hormone replacement therapy (HRT). Lower hormone levels in menopause may lead to hot flashes, vaginal dryness and thin bones. To help with these problems, women are often given estrogen or estrogen with progestin (another hormone). Like all medicines, hormone therapy has risks and benefits. Talk to your doctor, nurse, or pharmacist about hormones. If you decide to use hormones, use them at the lowest dose that helps. Also use them for the shortest time that you need them.

What are the symptoms of menopause?

Every woman's period will stop at menopause. Some women may not have any other symptoms at all. 

As women begin reaching the age of 40, their bodies are preparing for menopause, or the stopping of their monthly menstrual periods.  Menopause never happens all at once.  As young ladies approach their first period and monthly menstruation, her body's hormones are "transitioning" to producing hormones levels that will support monthly menstruation for about the the next 35 years. Similarly, as women reach their 40's, their bodies' hormone levels begin to change, and in preparation of menopause. 

Women will know they are approaching menopause, as they will notice the following symptoms:

• Changes in your period - time between periods or flow may be different.

• Hot flashes ("hot flushes") - getting warm in the face, neck and chest.

• Night sweats and sleeping problems that lead to feeling tired, stressed or tense.

• Vaginal changes - the vagina may become dry and thin, and sex may be painful.

• Thinning of your bones, which may lead to loss of height and bone breaks (osteoporosis).

Who needs treatment for symptoms of menopause?

• For some women, many of these changes will go away over time without treatment.

• Some women will choose treatment for their symptoms and to prevent bone loss. If you choose treatment, estrogen alone or estrogen with progestin (for a woman who still has her uterus or womb) can be used.

What are the benefits from using hormones for menopause?

Hormone therapy is the most effective FDA approved medicine for relief of hot flashes, night sweats or vaginal dryness.

Hormones may reduce your chances of getting thin, weak bones (osteoporosis) which break easily.

What are the risks of using hormones?

For some women, hormone therapy may increase their chances of getting blood clots, heart attacks, strokes, breast cancer, and gall bladder disease. For a woman with a uterus, estrogen increases her chance of getting endometrial cancer (cancer of the uterine lining). Adding progestin lowers this risk.

We would strongly suggest that women with vaginal dryness or other menopausal symptom review the Natural Hormone Cream website at:  www.NaturalHormoneCream.com  and consider a trial period of this alternative to synthetic hormones.

Should I use estrogen just to prevent thin bones?

You can, but there are also other medicines and things you can do to help your bones.

Should I use hormone therapy to protect the heart or prevent strokes?

No, do not use hormone therapy to prevent heart attacks or strokes.

Should I use hormone therapy to prevent memory loss or Alzheimer's disease?

No, do not use hormone therapy to prevent memory loss or Alzheimer's disease.

Do hormones protect against aging and wrinkles or increase my sex drive?

Studies have not shown that hormone therapy prevents aging and wrinkles or increases sex drive.

How long should I use hormones for menopause?

You should talk to your doctor, nurse or pharmacist. Again, hormones should be used at the lowest dose that helps and for the shortest time. (For example, check if you still need them every 3-6 months.)

Does it make a difference what form of hormones I use for menopause?

The risks and benefits may be the same for all hormone products for menopause, such as pills, patches, vaginal creams, gels and rings.

Are herbs and other "natural" products useful in treating symptoms of menopause?

At this time, we do not know if herbs or other "natural" products are helpful or safe. Studies are being done to learn about the benefits and risks.

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