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health and wellness

To Medicate or Not to Medicate?

By Riva Preil

Perhaps this would have been Shakespeare’s question had the medical technology at our disposal been available to him. The questions we are able to ask nowadays far surpass those asked even one generation ago thanks to the vast amount of research performed since. One such question many women “at risk†of developing breast cancer (ex. family history or personal history of the disease) may find themselves asking is whether or not they should prophylactically take tamoxifen or raloxifene, medication that decreases the likelihood of developing breast cancer. The upside of these medications is that they interfere with effects of estrogen, which is associated with the growth of breast cancer tumors. However, the downside of these medications is that on rare occasion, they can result in stroke, blood clots, and endometrial cancer. Scary, no? Wouldn’t it be great if doctors could predict for each person, on an individualized case by case basis, how they are likely to respond to medications? Absolutely, because if that were the case, then women with an extremely low likelihood of developing the negative side effects could breathe a sigh of relief if they decide to take preventative measures by opting for the medication.

Well, thanks to Dr. James N. Ingle of the Mayo Clinic along with his international team of researchers, the answer to the question may be within reach. Dr. Ingle discovered two single-nucleotide polymorphisms (SNPs), ZNF423 and CTSO, which presented amongst the more than 33,000 high-risk participants in two different versions, a “good†version and a “bad†version. These two genes have never been linked to breast cancer in the past, however this study revealed that women with a “good†version of both genes were SIX TIMES LESS LIKELY TO DEVELOP BREAST CANCER than women who had the “bad†versions. With this promising research, doctors will hopefully have the ability to guide their patients in informed decision making to promote optimal health.

—FAQ

Frequently Asked Questions

Pelvic Floor Disorders and Treatment

What is pelvic floor dysfunction and why does it happen?

Pelvic floor dysfunction is extremely common and occurs when the muscles, tissues, or nerves of the pelvic floor are weakened, tightened, or injured by trauma, chronic strain, or overuse. Pelvic floor disorders can result from traumatic injury such as a fall, from sporting activity, surgery, or childbirth. They can also happen from more chronic issues, such as infection or chronic inflammation such as endometriosis. Pelvic floor disorders can be a consequence of poor alignment or posture, overuse, or improper movement. The pelvic floor muscles surround the urethra, rectum, vagina and prostate; therefore, if there is a dysfunction in these muscles it can result in urinary, bowel, or sexual dysfunction in people of all ages.

Who should I see to get a proper diagnosis?

Many healthcare providers don’t assess – or don’t know how to assess – the pelvic floor muscles and nerves, so it’s important to get a proper diagnosis from a practitioner who specializes in pelvic floor dysfunction and pelvic pain. Too often patients tell us that they’ve been to 10 different doctors and healthcare providers and their symptoms have not improved, or have worsened. Find a specialist right away and get on the path to healing as quickly as possible.

Why do healthcare providers miss (or misdiagnose) pelvic floor dysfunction?

Long story short, the medical practice is divided into areas of the body: Urology. Orthopedics. Gynecology. But the body itself doesn’t have walls; every system interacts with everything else. Sometimes providers are so laser-focused on what they treat that they miss the whole picture. 

As more and more research emphasizes the importance of physical therapy as part of a complete treatment regimen, more and more physicians are learning how to recognize and treat pelvic floor disorder. In the meantime, if you’re not getting relief from your current treatment, make an appointment with a pelvic floor specialist to learn more.

How does pelvic floor dysfunction affect sex?

Pelvic floor muscles have a huge impact on sex. Muscles that are shortened or tight and are unable to elongate will not allow for good blood flow into the genitals. This can result in pain, weaker erections, diminished sensation, inability to orgasm, and even decreased lubrication. Pelvic floor PT can help with these issues by enhancing blood flow and improving muscle function. 

How can pelvic floor dysfunction cause bloating?

Pelvic floor dysfunction, a condition characterized by the inability to correctly relax and coordinate pelvic floor muscles, can significantly contribute to bloating due to its impact on gastrointestinal functions. When these muscles are not functioning properly, it can impact the ease of emptying and make it difficult for your body to pass stool and gas through the intestines. This obstruction leads to an accumulation of waste and gas in the gastrointestinal tract, causing bloating and abdominal discomfort.

Is it true there’s internal massage?

There can be. We do perform internal soft tissue mobilization of the pelvic muscles that are inside your pelvis and are accessible only through the vagina or rectum. We never do internal treatment without your consent and understanding.

What makes someone a pelvic floor PT vs a regular PT?

All pelvic PTs get additional training in pelvic floor internal treatment through continuing education and at our clinic. 

We pride ourselves on the level of training we provide, not just at the beginning but throughout the time our therapists spend at Beyond Basics. We know that learning is a life-long process.  We also provide additional training in physiology of the GI system and urinary system as well as sexual health and function and nutritional training. Most PT programs and schools do not provide the depth and breadth of knowledge that we provide all our PTs at Beyond Basics.

Get help now from a pelvic floor therapist.

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