Atrophic vaginitis

Atrophic vaginitis

Dear Colleagues:

This month I would like to discuss the role of neural therapy in treating a case of atrophic vaginitis.  Atrophic vaginitis is common in post-menopausal women and usually easily treated with topical hormones, but this case was different. 

Atrophic vaginitis is usually caused by estrogen deficiency.  Up to 40% of postmenopausal woman may have symptoms, but it may also occur during breastfeeding, after ovariectomy or after radiation treatment.  Treatment is usually estrogen supplementation either topically or systemically.

My own approach depends on the patient's general health and whether other symptoms of estrogen deficiency are present or not.  I prefer to optimise nutritional status and lifestyle before treating with hormones.  The adrenal glands preferentially produce "stress" hormones over "sex" hormones, so reducing stress in the patient's life is a first step, if possible. Decreasing dietary sugars and other refined foods and supplementing vitamins and minerals, (especially zinc) will sometimes improve estrogen production.  A variety of herbals may also be helpful. 

If these conservative measures fail, estrogen supplementation is in order. In women whose only symptom of estrogen deficiency is vaginal dryness, topical estriol applied to the inside of the vaginal labia will usually solve the problem.  If other symptoms are present such as hot flashes, insomnia, etc. additional estrogen in the form of estradiol may be added.

Supplementary estrogen has a bad reputation in some circles because of the association with heart disease and cancer.  However this association is entirely with synthetic estrogens and has not been tied to bio-identical hormones.  In fact estriol is cancer protective, at least for estrogen sensitive breast cancers and is used in Europe post-breast cancer treatment in place of estrogen-suppressing drugs such as Tamoxifen.

So how can neural therapy play a role in treatment of atrophic vaginitis?

This 66-year old otherwise healthy married woman actually presented with chronic digestive problems.  It was during the course of investigation and management of these problems that she mentioned the vaginal symptoms.  She had had a hysterectomy at age 42, but the vaginal dryness had begun after a breast lumpectomy, chemotherapy and radiation for breast cancer at age 61.

A 24 hour urine collection to assess estrogen levels showed low estrogens overall (8.5: range 0-41), but especially of estriol (2.7: range 0-30).  The "estrogen quotient" or ratio of estriol to estradiol and estrone was 0.5, far below the recommended minimum (for cancer prevention) of 1.0.

In addition to treating her gastrointestinal problems and optimizing her nutrition, estriol cream 1.25 mgm daily was prescribed for days 1 to 25 of the month.  After two months no change in symptoms was reported so the dosage was doubled to 2.5 mgm/day.  This also resulted in no change so a careful search for interference fields was undertaken.

Autonomic response testing produced no suspect interference fields in the pelvis or in the surgical scars.  A weakening was found on touching tooth space 2.1 (left middle upper incisor).  Because this lies on an acupuncture meridian corresponding to the genitals, it was considered suspect.

Neural therapy of the tooth space (using an "energetic" Tenscam device) resulted in an immediate response in the tooth space as judged by autonomic response testing.  The patient "felt better" overall for 24 hours and the vaginal dryness improved slightly.  One month later the vaginal dryness had improved some more and again an interference field was found at tooth space 1.1.  A repeat treatment resulted in further improvement. Repeat examinations over the ensuing two months showed no return of the interference field and continued gradual improvement in vaginal health. 

The patient has now gone to a warm southern place for the rest of the winter, so I will not see her again until next spring.  Nevertheless, her response to neural therapy was a reminder of how interference fields can lurk behind all sorts of chronic conditions.  Certainly radiation and chemotherapy are well known to cause diffuse collateral damage, but the body's capacity to recover is also dependent on healthy autonomic nervous system function and unobstructed flow of energy through the acupuncture meridea.

The Neural Therapy in Practice newsletter was intended as a complement to Dr. Kidd's book, Neural Therapy: Applied Neurophysiology and Other Topics, which is still available for sale through Amazon.