Betty, a 40 year old social worker, presented to my clinic because she was having a constellation of vague bladder symptoms since the birth of her now two year old son. She was experiencing a discomfort near her urethra mainly when lying down at night to go to sleep. She was quite busy during the day and she said she usually only noticed this when she stopped and often that was when she went to bed. She found this bothersome and it was impacting her sex life with her husband because sex hurt in most of the more pleasurable sex positions so they had to resort to the missionary position which she found quite boring. She was also experiencing small bladder leaks that were not so bothersome to her. Her symptoms waxed and waned and she was becoming a bit of a mystery to her doctors.
Betty’s doctor had prescribed a sedative for her to help her sleep. Not only was this ineffective, it made her feel hungover the next morning. The urologist suspected overactive bladder and prescribed an anticholinergic medication. Betty said the area around her urethra felt dry and itchy and I suspected that the root of Betty’s problem was vaginal dryness. I suggested that she try RepaGyn®, a hormone free personal moisturizer, as it would do no harm and may work. I advised Betty that RepaGyn takes 2 months to optimize but if it was going to work, she would probably start to feel better in a few weeks.
Betty returned to my clinic for bladder testing one month later and when I asked her how she was doing, she told me that she had stopped the anticholinergic because it did not work at all. She said the thing that worked was RepaGyn®. We talked further… She realized that her vagina had been feeling drier since the birth of her son and had begun many years before, which is not uncommon for women. Vaginal dryness may begin as early as age 31.
I did Betty’s bladder testing which revealed stress urinary incontinence defined as small bladder leaks with an increase in abdominal pressure when running, coughing, sneezing or jumping. Finally a diagnosis! Proper diagnosis is vital so that proper treatment is initiated.
Betty was thrilled to learn there were treatments for the stress urinary incontinence such as kegel exercises, a pessary (small device inserted into her vagina) and/or a surgical procedure. She decided she would wait on this as she wanted to have another baby. For now, Betty was delighted to continue with RepaGyn® for her vaginal dryness and do kegel exercises before trying the pessary. I assured her that this treatment plan would help her to get back to the bedroom with her husband trying all sorts of different positions.