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to your Address Book or Safe List. Learn how here. | March 31, 2011 | |  |  | Arousal Disorder Is No Laughing Matter | | | The Hidden Truth About Bypass Surgery | | | Can Horticultural Therapy Help You? | | | Blood Pressure "Switch" Found on Human Body... | | | Fascinating Facts... | | | |  |  | |  | |
 | | Arousal Disorder Is No Laughing Matter When you first hear about persistent genital arousal disorder (PGAD), you may be tempted to make a joke. ("That sounds like a good time!") But I assure you that to women who experience PGAD, it is no laughing matter. This disorder is characterized by genital engorgement similar to what occurs when you feel sexually aroused -- except that, rather than being temporary and enjoyable, it instead is unrelenting, uncontrollable and uncomfortable. In fact, Irwin Goldstein, MD, director of San Diego Sexual Medicine at Alvarado Hospital, told me that patients often describe it as a "living hell." PGAD is gaining recognition in the medical community, thanks in part to its recent renaming. The former term, persistent sexual arousal syndrome, carried insinuations of lust or sexual fanaticism -- but a growing number of doctors now realize that this condition has nothing to do with true sexual desire. Even so, women often feel too embarrassed to discuss their symptoms with their physicians. This makes it hard to estimate how common PGAD is. Worse, it means that many women suffer in silence -- which is sad, because treatments are available. Recognizing PGAD You know that feeling you get right before an orgasm? The intense pressure, the throbbing, the need for release? Imagine living with that sensation, constantly or sporadically, even when you have no emotional desire or physical stimulation. For a PGAD patient, an orgasm (whether from masturbation or sex with a partner) brings little or no relief because within seconds, she is right back at that precipice, Dr. Goldstein explained. This disorder affects women of all ages. The male counterpart is similar -- unwanted sexual arousal leading to unwanted orgasm -- though more rare. PGAD may result from varicose veins surrounding the vagina and uterus... injury to the pudendal nerve in the pelvis (for instance, during childbirth or bicycling)... spasms of the pelvic floor muscles... or a congenital malformation that causes excess blood flow to the genitals. Another cause of PGAD is an imbalance between neurotransmitters (chemicals that transmit nerve impulses) that are excitatory, such as dopamine, and those that are inhibitory, such as serotonin. As a result, nerve signals travel too freely from the brain to the genitals, Dr. Goldstein said. This imbalance may be the result of abrupt withdrawal from medication that affects neurotransmitter levels, such as antidepressants called selective serotonin reuptake inhibitors (and PGAD symptoms can persist even if the medication is resumed)... or use of Parkinson’s disease medication, which increases dopamine... or use of the antidepressant trazodone (Desyrel), a serotonin modulator. If you have symptoms that suggest PGAD, see a physician who specializes in sexual medicine. Referrals: Institute for Sexual Medicine (www.SexualMed.org)... or Sexual Medicine Society of North America (www.SexHealthMatters.org). Diagnosis is based on a physical exam, medical history, psychological interview, blood tests to assess hormone levels, and/or imaging tests to check for neurological or structural problems. What brings relief In most cases, PGAD cannot be cured, but one or more of the following treatments can help control symptoms... Topical anesthetizing agents, such as ice packs or numbing gels, reduce discomfort. Also helpful: Avoid wearing tight pants. Physical therapy eases pelvic tension. Treatment may include pelvic massage... stretching exercises... and/or transcutaneous electrical nerve stimulation (TENS), in which a device transmits low-voltage impulses via electrodes placed on areas of discomfort. Medication options include varenicline (Chantix), which is FDA-approved for helping smokers quit but can be prescribed off-label for PGAD to rebalance dopamine levels... the prescription painkiller tramadol (Ultram), which raises opiate levels in the brain and inhibits arousal... certain antidepressants or dopamine receptor blockers... or antiseizure medication, such as neurontin or divalproex. Psychotherapy can improve coping skills and reduce the stress of living with PGAD. Source: Irwin Goldstein, MD, is director of San Diego Sexual Medicine at Alvarado Hospital, a clinical professor of surgery at the University of California, San Diego, and editor in chief of The Journal of Sexual Medicine. www.SanDiegoSexualMedicine.com.
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 | | The Hidden Truth About Bypass Surgery Research shows that the majority of bypass, angioplasty and stent patients don’t live a day longer than folks who skip it... Meaning that over 800,000 Americans every year are risking their lives for nothing -- suffering hideous postsurgical pain and risking serious complications, for zero benefit. Even worse, according to Dr. Michael Ozner, MD, FACC, FAHA, medical director at the Center for Prevention & Wellness, Baptist Health South Florida, bypass surgery has been found to quadruple your stroke risk. What are the options? | |
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 | | Can Horticultural Therapy Help You? You may never have heard of horticultural therapy -- I hadn’t, until recently -- but this low-tech, hands-on activity is on the rise. A far cry from "just gardening," it is in fact a carefully designed, individualized therapy with myriad restorative benefits for both mind and body, according to Barbara Kreski, a registered licensed occupational therapist and director of horticultural therapy services at the Chicago Botanic Garden. She told me that horticultural therapy is used in a variety of health-care settings to help people who are recovering from stroke, spinal cord injury or other health problems... people dealing with vision loss or the degenerative effects of aging... people who struggle with psychological issues, such as mood disorders or anxiety... and those who have developmental or other types of disabilities. Benefits: Horticultural therapy encourages rehabilitation, recovery and restoration, said Kreski. Research shows that it can promote movement, build strength, increase flexibility, and improve coordination and balance. "Studies prove that people’s respiration, pulse and even blood pressure respond positively to plants," Kreski pointed out. In addition, horticulture therapy can relieve stress, alleviate depression and promote well-being through a connection with nature. Horticultural therapy differs from "regular" gardening because it is a planned treatment program, designed by a trained therapist for an individual or a specific group of clients, with measurable goals and outcomes. "Each participant has a defined diagnosis or issue, such as rehabilitation following a stroke. Handling dirt, a pot and a plant may seem simple for most of us. But for a stroke survivor, such activities can provide challenges that engage the nerves, muscles and joints in purposeful activity, improving hand-eye coordination and motor skills. These activities also offer relief from the tedium of recovery and foster a sense of accomplishment," Kreski explained. In addition, gardens designated for horticultural therapy incorporate specific design elements. For instance, they typically are wheelchair-accessible and barrier-free... include some raised plant beds for easy reach... have plants and ponds or other water features that target the senses with color, fragrance, texture (such as a velvety leaf) and sound... and offer a variety of spaces, some for privacy and reflection and others for social interaction. Horticultural programs are available at many community and senior centers, veteran’s centers, skilled nursing facilities, hospitals, mental health clinics, schools, vocational training facilities and botanic gardens. According to Kreski, in terms of frequency and length of participation, horticultural therapy usually follows the same course as occupational therapy or physical therapy -- meaning that it continues for the duration of rehabilitation, which depends on the individual’s condition. It costs about $25 to $50 for a one-hour individual session or about $120 for an entire small group. Unfortunately, horticultural therapy usually is not covered by insurance, though some residential facilities offer it at no additional charge as part of their usual programming. For more information: Ask your health-care provider for a referral to a program or contact the American Horticultural Therapy Association (www.ahta.org, 484-654-0357). Are you fit as a fiddle? You still can benefit from horticultural therapy... by volunteering at a facility that offers such a program. Kreski noted, "One woman told me that she regularly drives 50 miles to volunteer at the Chicago Botanic Garden because, as soon as she walks in, she feels her tense muscles loosen, breathes deeply and hears people all around her exhaling with the same sense of relaxation, as if joining in a collective ahhhhhh of contentment." Source: Barbara Kreski is a registered licensed occupational therapist and director of horticultural therapy services at the Chicago Botanic Garden. www.ChicagoBotanic.org/therapy
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| | | Fascinating Facts... 5... Number of years, on average, that menopausal women experience hot flashes. 443,000... Americans who die each year from illnesses directly related to tobacco use or exposure to secondhand smoke. 19 million... US adults who received treatment for diabetes in 2007 (the latest year for which figures are available) -- more than double the number from a decade earlier.
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 |  Tamara Eberlein, the editor of HealthyWoman from Bottom Line, has been a health journalist for nearly three decades. An award-winning author or coauthor of four books, she is committed to helping other women in midlife and beyond live healthy, fulfilling lives. Her latest book is the updated, third edition of When You’re Expecting Twins, Triplets, or Quads (HarperCollins). She is also the "chief health adviser" to her husband of 25 years, college-age twins and teenaged son. |  | | Bottom Line Publications | 281 Tresser Boulevard, 8th Floor | Stamford, CT 06901
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