What a pain! - Women's Health Tasmania
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NEWSLETTER
SUMMER 2019
Inside this issue:
The Opioid Story Part I:
What a pain!
A Crisis in Tasmania����������������������������������������2
Our last magazine was focussed on sexual and
What’s on at our 25 Lefroy St centre?�����3 reproductive health. People said they liked the
‘special’ focus so we’re doing it again.
Your bunions and the proposed
Religious Discrimination Act���������������������� 4 Given all the talk recently about opioids, access to pain killers
and women’s experiences of pain we thought that pain and
The Opioid Story Part II: What part painkillers would be a good topic for our newsletter.
has Tasmania played in the
US Opioid Epidemic?������������������������������������� 5
#EndEndo���������������������������������������������������������� 6 This magazine covers the Oh yes, and then there is that
situation with opioid prescribing strange thing, the proposed
The Opioid Story Part III: The State of rates in Tasmania, the opioid Religious Discrimination Act.
Oklahoma vs Johnson & Johnson�������������7 crisis in the US and the strange A journalist from The Australian just
story of Tasmania’s connection compassionately said the staff of
Fibro — we’re not talking about
to it . . . and we also talk about the Attorney General’s department
cement sheets here���������������������������������������� 8
the flip side of this story — the who are working on it have had
Vaginismus — finally, a name for it�������� 11 strange pain conditions women the equivalent of having an angry
experience and their difficulties in possum in a hessian sack tied over
Book review: Pain and Prejudice�������������13 talking to doctors about them. their heads. It’s true, a lot of people
are very cross about it. Read on . . .
NILS Loans��������������������������������������������������������16
Getting in touch
25 Lefroy Street
North Hobart, Tasmania 7002
Open 9.15am–4pm Mon–Thurs
P: 6231 3212 F: 6236 9449
Women’s Health Information Line Free
call: 1800 675 028
info@womenshealthtas.org.au
www.womenshealthtas.org.au
facebook: womens-health-tasmania
twitter: WomensHealthTAS
WHT receives funding support from
the Tasmanian Government through
the Department of Health.
The Opioid Story Part I: A Crisis in Tasmania
Accidental opioid overdose The growing rate of hospitalisations Evidence shows Tasmania has higher
and death is a silent epidemic around the state has put a significant reports of opioid overdoses, yet is far
gripping Tasmania — but these burden on Tasmanian hospitals. less likely to overdose on the opioid
opioids are not illicit drugs. heroin than other states and territories.
Besides codeine, methadone tablets in
Some people have theorised this is
The main way people are accessing Tasmania are currently being sold at
because Tasmania has limited access
lawful opioids, such as oxycodone or two and a half times the national rate,
to heroin. This has resulted in people
morphine, is through prescriptions as and oxycodone prescriptions had an
who, in other circumstances, might
pain relief. Tasmania has the highest increase of over 100% between 2010
have used illicit opiates turn to these
prescribing rate of any state or territory and 2015.
legal forms of opiates.
in Australia. It is thought social and health
A main culprit in these cases is the drug issues such as an aging population,
codeine, used to treat mild to moderate experiencing chronic pain, and living
References
pain. Codeine became prescription only with a chronic illness like cancer have
contributed to the increased rate in www.dhhs.tas.gov.au/psbtas/
in February 2018 when it was discovered
prescriptions. However, there are also codeine_rescheduling/rescheduling_
that at least 500,000 Australians had of_codeine_a_tasmanian_perspective/
some form of codeine addiction. Up people intentionally seeking opioids
extent_of_prescribed_opioids_and_related_
until restrictions, codeine was easily to misuse them — and the number of
harms_in_tasmania
accessible over the counter. people doing so doubled between 2013
and 2016. psmag.com/ideas/opioids-limiting-the-
There is debate following the decision legal-supply-wont-stop-the-overdose-crisis
on whether prescription rates have
changed, but some pharmacists are
Trends in Opioid Use https://ndarc.med.unsw.edu.au/resource/
review-opioid-prescribing-tasmania-
claiming patients are filling scripts There are also other factors associated
blueprint-future
for higher doses because lower dose, with higher prescribing rates in these
over-the-counter codeine is no longer local areas. Prescribing rates are higher www.themercury.com.au/news/tasmania/
in regional communities (compared opioids-and-legal-pharmaceuticals-
available. This could mean a consistent
with urban or remote), and areas of low the-leading-causes-of-accidental-drug-
flow of prescriptions, but at higher doses overdose-deaths-in-tasmania/news-story/7
due to the fact the prescription provides socio-economic status.
0feaca02b712aa74b68b09845d61544
access that over the counter didn’t. There has also been a link made
www.abc.net.au/news/2019-03-11/
between experiencing chronic pain
codeine-study-finds-no-increase-in-
How many people are and higher prescribing rates. The risk prescriptions/10884252
taking opioids in Tasmania? of experiencing chronic pain increases
with age but also due to social
There are over 73,000 opioid factors, like not having private health
prescriptions dispensed per 100,000 insurance, being a woman, receiving
people in Tasmania, a 27% increase unemployment or disability benefits,
from 2013-14. Locally, the South East being unemployed due to health
Coast (the areas between Hobart to reasons and experiencing high levels
Port Arthur and Hobart to Bruny Island), of psychological stress.
Brighton and Hobart have some of
the top rates of opioid prescribing
nationally.
Consumption of codeine increased
steadily from 2000 to 2009. It is
responsible for many preventable
deaths in Tasmania, with codeine
related deaths doubling in that period.
Tasmania has the highest accidental
death rate in Australia, as well as a
higher rate of oxycodone-related
deaths in the country.
In 2017, 30 Tasmanians died of
unintentional overdose. People
presenting to the emergency
departments of 3 major public hospitals
in Tasmania (Royal Hobart, North-
West Region and Launceston General)
for opioid overdose, dependence,
intoxication or withdrawal has
increased by 32% in the four years
between 2011 to 2015.
2
What’s on at our 25 Lefroy St centre?
Monday Tuesday Wednesday Thursday Friday
AM 9:30 to 10:30am 10:30 - 11:30am 9:45–11am 10–10:30am 10am–2pm
Ageing Well Meditation Yoga (Hatha) Meditation Waste to Wonderful
with Weights Guided and safe experienced 10:30–11am Textile skill sharing
8 week courses with Jean Gilbert $8 per session Jen 0417 137 100
Discussion
Feb 17 – Apr 20 By donation Come early for a spot
Mindfulness &
Apr 27 – Jun 22
Self Compassion
Valerie 0405 329 687
10–11:30am 10:30–12:30
Fitball (beginners) Women’s Walks Come in for a
cuppa, browse
Gil Whitehouse $8 6231 3212
in our library
Calendar on or use the
the website photocopier.
11am–12pm 11am–12:30pm 11:15am–12:30pm
Tai Chi Community Yoga (Hatha)
Weekly $8 Health Nurse beginners
$8 per session
Come early for a spot
PM 1–3pm 1–1:30pm 12:30–1:30pm
No Interest Loans Meditation Feldendrais
(NILS) Loan Officer 1:30–2pm 10 week blocks
Ring Alison at WHT Feb 2 – Apr 9 and
Discussion
for appointment Apr 30 – Jul 2
Changing your Mind
Nicole 0409 896 576
with Valerie
3–4pm 3–4pm 1–3pm
Ageing Well with Ageing Well with No Interest Loans
Weights Practice Weights Practice (NILS) Loan Officer
For women who For women who Ring Alison at WHT
have completed have completed for appointment
the 8 week course. the 8 week course.
5:30–6.30pm 5:30–7pm
Yoga and Yoga and
Mindfulness Mindfulness
8 week course for 8 week introduction
participants with course – see ad on
some experience – page 15
see ad on page 15
Therapists and monthly groups
Breast Cancer Support Group NDIS Information Warped Wenches Bowen Therapy (NST)
Third Tuesday of the month Every second Thursday Third Saturday of the month and Emmett Technique
11:45 am–1:15 pm from 14 November, 2–4 pm 10am–4pm Every Wednesday
For any woman diagnosed Come in and have a cup of A group of women who love $65 per session. To make
with breast cancer who would tea with an NDIS worker to sew, and share an interest an appointment, contact
like information and support. if you have any questions in all sorts of crafts. Christine Toyama on
about the NDIS. Contact Denise 0417 808 871. 0417 363 108.
Writers’ Support Group
First Wednesday of the month
2–4 pm. New members welcome.
3
Your bunions and the proposed Religious Discrimination Act
By JO FLANAGAN
What could a podiatrist possibly The Bill doesn’t recognise the ethical And this is the kind of service delivery
be asked do to feet that might and professional obligations of these most at risk of raising a conscientious
make them need to refuse service providers. objection:
to treat the feet on religious And it doesn’t just cover doctors. The • Sexual health services
grounds? There’s no punchline to Bill covers a range of professionals: • Reproductive health services
that question – we’re genuinely pharmacists, optometrists,
• IVF services
curious. occupational therapists, psychologists,
podiatrists and physiotherapists. • Transgender health services
The proposed Religious Discrimination • Vaccination services
Act raises a lot of questions. So far, The conscientious objection laws also
debate has focussed on the fact that apply to institutions organised on • Palliative care (end of life directives)
the Bill gives people with religious religious lines. This includes hospitals • Blood transfusions
beliefs the freedom to discriminate and potentially some insurance • Drug and alcohol services
against other Australians. But there companies. Under these laws it will be
• Any general health service working
are also lots of questions about how it possible for these institutions to refuse
with a vulnerable population
will affect our access to healthcare. to treat or insure people on religious
grounds. • Any health service to a woman if
If passed, this Bill is will introduce there are religious proscriptions on
dangerous special rules which will It also creates the possibility that a gender
allow health service providers to religious hospital or health service
refuse to provide services on religious could bring a charge of discrimination The USA has seen these kinds of
grounds. against a government department dangerous ‘religious freedom’ laws
that tried to regulate the provision of flourish. It has produced disturbing
Doctors can already refuse to provide health services or set standards around examples of cruelty towards
some services. Existing laws and codes what services should be delivered. marginalised groups: the infant
of practice protect conscientious children of LGBTIQ couples refused
objection, guided by bodies such as the Who will act for the interests of medical check-ups, all hospitals in
Australian Medical Association and the patients? Mississippi given the right to refuse
Medical Board of Australia. The impacts of this are so broad- treatment to trans people and women
These codes ensure that where health reaching that it is almost impossible to refused treatment for miscarriages.
practitioners have conscientious imagine. Under the Bill a doctor could It has also produced brave whistle
objections, they must still give patients refuse to treat a patient because they blowers who report that they want
referrals and continuity of care. The are Jewish, or Muslim, or not married… to treat their patients, but they are
codes make sure there is a balance Here are some of the people prohibited from doing so by the
between the rights of doctors to and potentially affected: institutions they work for.
the rights of patients.
• Women Under Australia’s proposed Bill health
These professional codes would be practitioners will be permitted to
over-ridden by the proposed Bill. • People with disabilities
refuse to perform lawful, safe and
• LGBTIQ people and their children justifiable treatment that would
Under this Bill, employers and
regulatory bodies can’t impose • Divorced people, unmarried couples, benefit patients even if that causes
guidelines on health practitioners’ who single parents adverse impacts for the patient.
conscientiously object. That is, they • People with addictions ‘Adverse impacts’ are permitted if they
can’t require them to treat patients, or are ‘justifiable’ (to whom? the doctor?
• People with HIV
to refer them or provide pathways. the patient?).
This broad right to conscientious
objection runs the risk of a significant
expansion of discrimination and harm
to patients.
Patients’ rights to accessible and safe
care should always come before the
religious beliefs of health professionals.
It is expected the Bill will be tabled in
Federal Parliament before the end of
the year.
There is still time to let your local
members know how you feel about
the Bill. You would even have time
to contact all the members of the
Australian Parliament. Let’s make
our voices heard and exercise our
democratic rights.
4
The Opioid Story Part II:
What part has Tasmania played in the US Opioid Epidemic?
Since the 1980s Tasmania has bypass the existing morphine restriction Oxycodone made from Tasmanian-
been a significant supplier of as it didn’t apply to thebaine. The cost grown thebaine was used by Purdue
opium internationally through and effort of making oxycodone was Pharma for their patented oxycodone
its poppy crops. However, dramatically cut. pill, OxyContin. Oxycontin is sometimes
called ‘hillbilly heroin’.
its ascent to control of the This is the suspected start of the opioid
market was secured in 1994 oversupply and overdose crisis in Tasmanian Alkaloids was eventually
when a Tasmanian researcher America. sold in 2016.
from the Johnson & Johnson’s In 1997 Tasmanian Alkaloids, part of the Now, in the wake of the US opioid
pharmaceutical conglomerate Johnson & Johnson’s empire, where the crisis, blame has been directed at
bred a mutant poppy that Norman was discovered, took charge of the Tasmanian opium manufacturers
produced high levels of contracting farmers to grown Norman for the oversupply and enabling of
‘thebaine’. poppies. It has been reported that opioid misuse.
Tasmanian Alkaloids offered various
Thebaine is a key ingredient in the
farmers tens of thousands of dollars
production of heroin’s cousin, oxycodone.
in cash incentives, with some growers
Morphine is difficult and expensive to
reporting to have received luxury cars
convert into oxycodone, thebaine is
for harvesting the highest yields of drug Want to read more?
dramatically cheaper and easier.
compounds.
“How an island in the antipodes became
The poppy was named the Norman, the world’s leading supplier of licit opioids”
In a 2011 report to Australia’s
a play on “no morphine”. Pacific Standard, July 11, 2019 https://psmag.
Therapeutic Goods Administration,
Johnson and Johnson claimed com/ideas/opioids-limiting-the-legal-
The USA has established regulations to
supply-wont-stop-the-overdose-crisis
cap the amount of morphine allowed Tasmanian Alkaloids’ Norman poppy
to enter the country. After the discovery was providing 80% of the global market
of the Norman poppy, Tasmanian for oxycodone’s raw materials.
pharmaceutical companies could
5
#EndEndo
Don’t we wish we could end How is it treated? Tell your gynae your concerns, explain
endo! Endometriosis affects Currently there is no known cause or
your symptoms and create an action
around 10% of women in their plan going forward. Depending on
cure for endometriosis, only disease
reproductive years. your gynae’s knowledge and surgical
management. The types of treatment
training, you may need a referral to
The condition causes tissue, similar to options are:
another specialist who is more qualified
the lining of the uterus, to grow outside 1. Medical treatments (Medication) to treat endometriosis.
it in unusual areas throughout the 2. Allied treatments (physiotherapy,
body. When the lining grows within 3. Speak up about your suspicions!
alternative medicine, etc.)
the uterus, it bleeds and sheds during Many people feel brushed off when
3. Surgical treatments
menstruation. When endometriosis is they voice their suspicions, which can
present, this lining bleeds in unexpected Because every person and every case leave them feeling embarrassed and
places and can cause acute pain. of endometriosis is different, no single unwilling to seek help again.
treatment plan will suit all.
For most people, endometrial growth Don’t back down! You are your biggest
is found in the pelvis. These pockets of It is best to talk to your gynaecologist advocate when it comes to living with
growth can cause an array of symptoms about what is best for you, as there are endometriosis - trust yourself and what
that vary in severity, such as pelvic disadvantages, advantages and risks your body is saying.
pain, infertility, pain with sex, fatigue, associated with all treatment options.
Honestly, when faced with any
bladder or bowel incontinence, nausea, For most people, it takes trial and error
resistance, you’ll want to find a new
vomiting, heavy periods and muscle to find the right therapy or combination
doctor who will not only listen, but be
damage. of therapies to manage their symptoms.
there for you throughout your whole
However, the amount of endometriosis For example, you might take a hormone journey. It’s exhausting constantly
does not determine the type or intensity medication (like the pill or Mirena), having to push against your doctor at
of your symptoms. This means women regularly attend an incontinence every turn.
can have advanced disease and no physiotherapist, and plan for a
4. Ask for further testing
symptoms, or little disease with severe diagnostic and excision surgery
symptoms. Symptoms are not an in the future. Part of your action plan will probably
indicator of the damage caused by include getting some tests done, as well
as some lifestyle changes. If you feel
endometriosis. What if I suspect I that the current state of investigation is
have endometriosis? not enough, don’t be afraid to ask your
Would you like to know 1. Log your symptoms and when gynae for more thorough testing, such
how it is diagnosed? they occur! as the specific ultrasound (Deep Endo
The only way to diagnose endometriosis For many people, symptoms increase Scan). “If you don’t ask, the answer will
is through a laparoscopic (keyhole) or decrease at certain points in their always be no.” You have nothing to lose!
surgery and a biopsy (tissue sample). menstrual cycle. Often, symptoms and Endometriosis is a complex disease with
During a laparoscopy a surgeon uses their severity tend to flare in the lead up little understanding as to how and why
a narrow telescope (inserted through to and during menstruation. So log your it occurs. It takes an average of 10 years
the belly button – YES, it is under a symptoms and see if you can find any to receive a formal diagnosis, with lack
general anaesthetic) to see your organs patterns in your cycle, or use your data of knowledge by doctors being a huge
in the pelvis and abdomen, magnifying to try and establish your cycle if you contributor to the wait time. Don’t let
tissue so that small growths can be don’t know it. your doctors dismiss you - speak up!
seen. Tissue that is thought to be 2. Make an appointment with your Spread the word on the commonality
endometriosis is removed and tested regular gynaecologist, or your GP. of endometriosis and how to receive
for diagnosis. the best care by sharing your new
If you don’t see a gynae, make an
There are cases where diagnosis can be appointment to see your GP for knowledge with others who could be
made without surgery. An ultrasound a referral. affected by this disease.
technician might be able to see
endometrial cysts on the ovaries or
other pelvic organs.
A technician doing a specific internal Resources:
endometriosis ultrasound will probe
various organs, which should move Endometriosis Fact Sheet
freely and without resistance. https://docs.wixstatic.com/ugd/aefbed_
ebed46435f8f4d01bf96f4549b00870c.pdf
Tissue that has difficulty moving or
causes pain when probed could be
a sign of endometriosis.
The only way to be 100% sure of the
diagnosis is to have a laparoscopy
and/or biopsy.
6
The Opioid Story Part III:
The State of Oklahoma vs Johnson & Johnson
In late August 2019, an Several other US states have reached Before the trial began, the state
Oklahoma judge ruled against settlements with pharmaceutical reached a settlement with two other
one of America’s biggest companies. Currently the Ohio state defendant groups, one of which was
companies — Johnson & courts have 1500 opioid lawsuits the manufacturer of OxyContin, Purdue
before them filed by state, local Pharma. The settlement reached was
Johnson — and its subsidiaries
and tribal governments. US$270 million (AUD $398.5 million).
after finding that the company
had helped to fuel the state’s Across both Australia and America, Back in present Australia, The Greens
opioid crisis. The companies there has been a high level of party have asked for the Tasmanian
were found guilty of having concern surrounding the influence poppy industry to reconsider working
companies launched a deceptive pharmaceutical companies have on with Johnson & Johnson’s.
prescribing rates. However, it has also
campaign overstating the
been recognised that these companies
effectiveness of opioid drugs fill a gap in education delivery.
in treating chronic pain, References
and understating the risk of The Oklahoma judge ruled that Johnson
& Johnson were to pay USD$572.1 million ABC News, US opioid crisis ruling leads to
addiction. $845 million fine for drug maker Johnson &
(AUD$845 million) for the deceitful
The Oklahoma Attorney General called marketing of opioids that contributed Johnson in Oklahoma, 27 August 2019
Johnson & Johnson an opioid ‘kingpin’ abc.net.au
to the death of nearly half a million
and the human and financial cost of Americans between 1999 and 2017. AP, Spotlight on Oklahoma for start
the prescription painkiller crisis created of trial for opioid makers, May 28, 2019,
by their marketing campaigns as apnews.com
‘catastrophic’. WebMD, Judge orders J&J Pay $572 Million
in Opioid Case, webmd.com
WOMEN
WRITERS’
SUPPORT
GROUP A story about
friendship and
support.
Meets first Wednesday
of the month 2–4pm at
Women’s Health Tasmania
This group is for all women writers
— published, experienced or not!
For more information call Women’s
Health Tasmania on 6231 3212.
7
Fibro — we’re not talking about cement sheets here
Did you know that women are Fibro is a pain in the ... Symptoms of your menstrual cycle
much more likely to suffer from everything or menopause can also feel worse
fibromyalgia, with 9 out of 10 as a result of fibro. Many women
Fibro can cause an array of symptoms. experience more frequent symptoms of
diagnosed being women aged People experience few or many, and premenstrual syndrome and increased
20 – 50? And that women also at varying degrees of severity. Some period pain.
report higher levels of pain for symptoms of fibro are:
longer periods of time compared
to men?
• Widespread pain for 3 months Fibro flares!
or longer
There are times when fibro symptoms
Fibromyalgia can hurt. It’s a form of • Stronger menstrual pain will intensify - called a flare. Flares can
rheumatoid disease that can cause • Sleeping troubles (unable to fall be triggered or amplified by factors
chronic musculoskeletal pain and asleep or get restful sleep) like illness, injury, getting too tired or
tenderness. stressed, hormonal changes, changes in
• Extreme fatigue
There is no known cause or cure for treatment, travelling – even changes in
• Sensitivity to light or noise
fibro, but the evidence suggests that the weather!
an onset can sometimes be caused by • Cognitive difficulties (often
called fibro fog) and short term Triggers vary from person to person.
psychological trauma or severe stress, Discovering what your personal triggers
after having an infection or virus, pain memory loss
are can help you take action when
from injury or trauma, family history, • Morning stiffness
affected by them.
and substance abuse. • Pelvic pain
• Teeth grinding in sleep Fibro hides!
• Feeling faint or light-headed There are no x-rays, blood tests or
• Restless leg syndrome scans that can test for fibro, as the
• Tingling or numbness in the hands body’s tissues will appear normal
and feet when examined. However, your doctor
may order these just to rule out any
• Bladder and bowel problems.
other conditions. Receiving a fibro
• Tenderness at particular points on diagnosis can feel a bit like a process of
the neck, shoulder, chest, hip, knee elimination.
and elbow
8
Because fibro is often diagnosed after Managing fibro • Sleep — sleep is important, as poor
excluding other conditions, nearly sleep only aggravate symptoms. Try
There are many ways of managing
half of fibro sufferers attend 4 to 6 to keep a consistent bedtime routine
fibro, from medication to alternative
practitioners before receiving an official as part of living a balanced life.
therapies. Like other complex, chronic
diagnosis. • Nutrition — eating healthily helps
diseases, you need to tackle it in a
range of ways. you support energy levels and
Fibromyalgia & chronic improve overall wellbeing.
Usually, a management plan will involve
overlapping pain conditions a combination of:
• Staying at work — keeping your
As if fibro wasn’t enough! The crossover regular routine is beneficial for your
• Education — understanding your health and quality of life. Talk to your
of fibromyalgia with other medical
body, how fibro affects you and what doctor or other allied practitioners
conditions is common. It’s often
your triggers are. This allows you to about methods to help you get back
diagnosed in women who also have
actively manage the condition and to work or stay at work.
conditions like Irritable Bowel Syndrome
make informed decisions.
(IBS), Chronic Fatigue Syndrome, • Massage — can help relax the
interstitial cystitis or endometriosis. • Pain management — learning how muscles and help with stress
heat packs, cold packs, ointments, management.
However, doctors often treat medication, etc. affect the different
each condition individually, not • Peer support — find a peer support
types of pain helps you get on top
acknowledging the overlap. For group in your area by contacting
of pain as quickly as possible. Often,
example, fibro can increase the Musculoskeletal Australia, or go
this takes trial and error with the
pain experienced by women with online to search for a forum or
guidance of your doctor.
endometriosis, a disease in which the Facebook support group.
• Stress management — stress can
symptoms ease after menopause.
aggravate symptoms, learning how
However, fibro can interfere and still
best to relax will help avoid flaring.
cause discomfort post menopause. References
Some ideas are planning your day
Furthermore, women with fibromyalgia and its priorities, going for a gentle BOOK: Pain and Prejudice
are 40% more likely to have depression, walk, listening to music, talking to a – Gabrielle Jackson
45% more likely to have anxiety, and trusted friend, and avoiding stress.
Arthritis Australia Fibromyalgia
70% more likely to have IBS. They are • Exercise — regular exercise improves arthritisaustralia.com.au
also more likely to suffer from various the symptoms of fibro.
autoimmune diseases, such as lupus, Health line “Why does fibromyalgia
• Balance — a lot of symptom predominantly affect women’ healthline.com
rheumatoid arthritis and lower back
management is knowing how to
pain, to name a few. Healthline “How does fibromyalgia affect
spend the limited energy you have.
women differently?” healthline.com
Alternate between periods of activity
and periods of rest, breaking big
tasks into smaller ones to avoid
overdoing it.
Women’s Every Wednesday
Walks 10:30am–12:30pm
Leaves Women’s Health
Tasmania (25 Lefroy Street,
North Hobart) at 10:15am
We do a different walk every week —
for details go to the Walking Calendar
on our website or call 6231 3212.
9
Women’s Health Tasmania
Preparation for
birth, pregnancy
and parenting
FREE
SERVICE
Develop skills for
calm and confidence
with psychologist Kelly Madden
To book call 6231 3212 or email
info@womenshealthtas.org.au
10Vaginismus — finally, a name for it
It sounds like some weird Roman What causes vaginismus? How do you treat
gladiator but for some women Medical professionals aren’t exactly vaginismus?
vaginismus is the most private, sure what causes vaginismus, but in To treat vaginismus, you need a
painful secret of their lives. Here’s some cases, it is thought to be linked multidisciplinary team of health
the good news – it’s treatable, to anxiety or fear of having sex, or professionals, including:
and sometimes quite quickly. physical trauma. However, it’s uncertain
which came first, the anxiety or the A pelvic floor physiotherapist.
Vaginismus is when the pelvic
vaginismus. Also known as a continence therapist.
floor muscles around the vagina
tighten involuntarily, causing pain or Some women experience the symptoms They will teach you techniques to relax
discomfort on penetration. This makes from the very first time they try to insert the pelvic floor muscles and desensitize
it very painful or even impossible for something into their vagina, such as a the skin around the genital area. Some
women to have penetrative sex, insert finger or tampon. For other women sex methods they may recommend are
a tampon, or endure a gynaecological and insertion was fine to begin with, vaginal trainers / dilators, stretches and
examination. Often, people aren’t but something changed and caused the massage. They may also assist with the
even aware that it is their pelvic floor pain to start. muscle-brain connection by helping
causing this pain. to re-teach the brain what’s actually a
Some women experience vaginismus in pain sensation and what’s not.
Vaginismus can happen regardless if all situations, whereas others might only
you’ve been sexually active or not. experience it in certain circumstances A sexual therapist and psychologist.
with certain objects. For example, sex They can help you uncover and
You also may not know that despite its
with one partner is okay but not with understand why you might have an
name, there is no issue with the actual
others, or penetrative sex is painful but unconscious (or conscious) fear of
vagina of someone with vaginismus.
tampon insertion isn’t. penetration, and work through trauma
The vagina is just a tube with little
muscle inside it - it’s the muscles (It’s worth remembering that painful sex that may be influencing the vaginismus.
surrounding it that are spasming and might be because you’re not ready to
An understanding general practitioner.
causing discomfort upon contact. have sex or you’re not turned on by the
sex, or you don’t want to have sex but Vaginismus is a common condition but
The pain experienced by people with you might need to shop around to find
are feeling pressured into it.)
vaginismus has been described as a a GP who you feel comfortable talking
burning, tearing sensation, or like the Sometimes vaginismus is associated to, and who recognises the symptoms.
penis is “hitting a brick wall” during with some kind of trauma, such as Your fears and experiences are valid,
penetrative sex. childbirth, sexual assault, infections like and there are practitioners out there
thrush (yeast infection), or other physical who will acknowledge them.
conditions such as endometriosis.
Please don’t give up if your first
For some vaginismus sufferers, it’s a practitioner brushes you off - you
complex combination of some or all of deserve the medical attention you’re
these factors. asking for! Penetration shouldn’t be
excruciating, and you don’t have to live
with the pain.
So, thumbs down to you, Vaginismus.
You’ve been ruining women’s lives since
forever, but we’ve got you on the run.
Want to read more?
Health Direct Vaginismus
www.healthdirect.gov.au
Webmd Vaginismus www.webmd.com
11BOOK REVIEW
PAIN AND PREJUDICE
Gabrielle Jackson
By JEN VAN-ACHTEREN
Pain and Prejudice is the end product us as anything
– what started as Gabrielle Jackson’s more than an
examination of a single issue led to a inferior version
quest to discover how women, in the of themselves
past and right up to the present day, – or creatures
are failed by systems which should controlled by
ensure they are healthy and informed their uterus.
decision makers.
Some of the
Like 176 million women worldwide, accounts
Gabrielle endures the painful condition are hard to
of endometriosis. After a particularly read – like the
debilitating flare-up in 2014, Gabrielle father of modern after menopause, as a preventative
decided to attend a patient-centred gynaecology, Dr J. Marion Sims, who treatment for heart disease. The study
endometriosis conference run by the developed a technique to repair fistulas enrolled 8,314 men – and no women!
advocacy group, EndoActive. by operating without anaesthesia on Another, which examined how obesity
enslaved African-American women. He impacted on uterine and breast cancer,
There, Gabrielle discovered all the other
operated on one woman thirty times did not even include one woman.
symptoms she had been suffering were
before he got the procedure right.
in fact associated with the condition. Heart disease is the leading cause
The self-doubt, and belief that she was While some things have improved of death among women, and yet
weak or flaky, were released in a flood for women since then, many things almost everything we know about
of tears as she realised her experience remain the same. Women’s pain is still it and its treatment has been learnt
was real and had a valid explanation. often dismissed, diagnosis for many from studying men. Our medical
conditions takes a long time and is professionals have been trained to look
The tears turned to rage at the lack
often only achieved after women have for the symptoms men present with,
of awareness of endometriosis, even
endured being belittled. Hysteria and/ which we now know is not the same for
within the medical profession, the
or attention seeking is still the go-to for women.
scant research, and how symptoms are
many medical professionals when they
dismissed and often go undiagnosed Gabrielle explains the lack of research
can’t find a reason for women’s pain.
for a median of 7 years. into pain by funding bodies is driven
Then there is the lack of research into by the desire to support studies with
Her personal story led to a global
women’s health or, when it is conducted, specific, measurable results. It is difficult
investigation by the Guardian into the
being carried out on men or male to produce such results when so little is
disease, an article and this book.
laboratory animals. known about the mechanisms of pain.
While this book may have been
Excluding women from medical Reading this book will enlighten you
inspired by Gabrielle’s experience of
and science knowledge production and no doubt make you angry. It
endometriosis, it is by no means just
has resulted in a healthcare system is indeed a call to arms for women
about women’s reproductive organs and
made by men, for men. One study and their bodies. It is time to say, as
the pain which can accompany many of
described in Gabrielle’s book was on Gabrielle concludes, ENOUGH!
the conditions associated with them.
an oestrogen supplement for women,
As well as exploring many other
conditions women suffer from, often
at higher rates than men – such as
irritable bowel syndrome, rheumatoid
arthritis, Graves disease, chronic fatigue
Meditation
and fibromyalgia – it also thoroughly
analyses how women’s pain has
been dismissed and ignored over the
centuries by patriarchy and a sexist
medical profession.
I thought I had some idea of what Self-compassion — skills in how to have compassion for yourself,
women have suffered over the skills which can help when you’re having a difficult time.
centuries, at the hands of men and
Mindfulness — paying attention to the present moment with
medical professionals. But after reading
openness, curiosity and without judgement.
this book, I realise the horrors are far
worse and the oppression of women Come and learn meditation, self-compassion and mindfulness
calculated and callous, based on with Valerie, our skilled facilitator at Women’s Health Tasmania.
nothing more than men’s inability to see
Thursdays 10–10:30am
Followed by a discussion from 10:30–11am
13W OWomen’s
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You can book a phone or face to face
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Mindfulness
Introduction to Some benefits of a regular yoga and
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THURSDAY EVENINGS 5.30-7PM
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15Thinking You can get a NILs loan through
us! No Interest Loans provide
about getting affordable finance for essential
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16You can also read
