Summary: Ovarian failure, estrogen deficiency, decreased sex drive, infertility and vaginal graft-versus-host disease are a concern for many women after a stem cell transplant. This presentation discusses what causes these problems and treatment options, particularly for women with vaginal graft-versus-host disease (GVHD).
Presenter: Nikki Samms PT, DPT, Senior Physical Therapist, The University of Texas MD Anderson Cancer Center
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To read the transcript, go to, [ Ссылка ]
Highlights:
Vulva and vaginal graft-versus-host-disease but is under-reported. Regular self-exams, seeing a gynecologist when pain or other symptoms of genital GVHD appear and consulting with a pelvic floor physical therapist can help relieve symptoms.
Symptoms of vaginal GVHD include changes in the appearance of the external genitalia; a clitoral hood that sticks to the clitoral gland; disappearance of the folds of skin around the vaginal opening (the labia); a vaginal opening that fuses together; and shortening or closing of the vaginal canal.
Pelvic floor physical therapists treat male and female bladder control issues including constipation and incontinence, pelvic organ prolapse, female and pelvic and rectal pain, and pain with sex and pregnancy. You can find a pelvic floor physical therapist at PelvicRehab.com.
May 3, 2022 Part of the Virtual Celebrating a Second Chance at Life Symposium 2022
Presentation is 17 minutes long with 40 minutes of Q & A.
Key Points:
(01:07): Premature ovarian failure is common after stem cell transplant and can lead to a number of health problems. Prescription estrogen can improve the symptoms.
(01:58): A low-dose transdermal patch can help women who have low sex drive after transplant.
(03:07): Symptoms of vaginal GVHD usually appear 7-10 months after transplant but can also occur later. Vaginal GVHD often occurs when GVHD is also affecting other parts of the body such as the skin, eyes and mouth.
(04:14): If GVHD causes the vaginal canal to close, menstrual flow may not be able to exit the body, which can lead to a medical emergency.
(04:52): There are several good treatments for vaginal GVHD including steroid creams, topical estrogen and silicone rings called pessaries.
(05:37): Physical therapy can prevent narrowing and shortening of the vaginal canal by using dilators and/or regular sexual penetration.
(07:11): A consult with a pelvic floor therapist begins with a detailed summary of symptoms and physical examination of the pelvis, skin and nerves. Patients are usually given homework – exercises to do at home to improve symptoms.
(09:39): Stretching, yoga, and guided imagery can help with pelvic floor problem
(11:33): The vulva is like a self-cleaning oven that takes care of itself. You don’t need to put anything on it, other than warm water, to keep it clean.
(14:45): Mental health experts can help with frustrations about changes in the genitalia and body image concerns
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