Your age and nerve healing

[Rosemary]

Hi

Just a post to ask anyone about nerve healing in the pelvic area being affected by your age.

I have a nerve problem in the vulva - i am using pain medication, a tens machine and localised hrt (oestrogen only) because i am postmenopausal, female and in my late fifties.

I know nerves do take time to heal - i have seen little change in three years - when irritated the nerves cause muscle tightening and pain and i have the foreign body feeling in my vagina.

Is there any hope that nerves might heal or is it more a case of drug dependancy and hrt because of my age and location of the nerves - is nerve healing in the pelvic area oestrogen dependant ? I can't find much on researching this - only a small study done on rats.

A gynaecologist i saw has said hrt for life for me now.

Thanks for any replies

Rosemary x

[Karyn]

Hi Rosemary! Welcome to HOPE!
To the best of my knowledge, nerve healing isn't dependent on estrogen or age. How did you incur the pelvic nerve damage?
Who diagnosed you and with what, exactly?
Kind regards,
Karyn

[Rosemary]

Hi Karyn

Best described as trauma to the upper inside edge of one vulva.Seen gynaecologist given amitripty;ine & hrt - after 2yrs would be ok but to continue hrt. Not ok after two years - feeling of object in vagina led me to see Dr Greenslade - given gabapentin - one unguided pudendal nerve block at local pain clinic no result - told localised nerve problem now on nortriptyline & gabapentin but still have feeling of object in vagina . Now hoping that time is kind.

I realise my problem is small beer compared to others on here.

Is your knowledge about oestrogen, age and nerve healing based on anything Karyn ? - i don't mean that to sound rude by the way.

Maybe it is just the vaginal area and not all the pelvic nerves that may be affected by oestrogen (mainly lack of it) and age ?

Rosemary x

[Karyn]

Hi Rosemary,

told localised nerve problem

I'm not sure what this means, hon. The pain you're describing sounds as though you have PN symptoms and I don't agree your problem is small, compared to others.

Is your knowledge about oestrogen, age and nerve healing based on anything Karyn ? - i don't mean that to sound rude by the way.

No offense taken! My knowledge regarding nerve healing comes from this very site. We've had people with PN symptoms ranging in age from children, to teens, to young adults and an older population. Pelvic nerve pain doesn't appear to be discriminate. Theremay be a connection with the estrogen, but if there is, I'm not aware of it.

Maybe it is just the vaginal area and not all the pelvic nerves that may be affected by oestrogen (mainly lack of it) and age ?

Well, the PN effects the vaginal area and it's possible not all of the pelvic nerves are affected. You mentioned having a trauma to this area, so your symptoms make sense.
I'm unclear why you think your symptoms are related to age and/or HRT?
Hugs,
Karyn

[Rosemary]

Thanks Karyn

I have followed the routes here in UK to getting a PN diagnosis because of my symptoms but that hasn't happened - at least i have got pain medication.

I think when you are postmenopausal you are more susceptible to a trauma causing more of a problem and maybe that is due to the lack of oestrogen.

I have only been on hrt since having this nerve problem - managed to avoid it before !!

Rosemary x

[Karyn]

You're welcome, Rosemary. There are other community members here who are patients of Dr. Greenslade. It is my hope they'll come forth with some suggestions about getting you properly diagnosed.

I think when you are postmenopausal you are more susceptible to a trauma causing more of a problem and maybe that is due to the lack of oestrogen.

Maybe. However, as I stated above, pelvic nerve pain is nondiscriminate. A trauma is a trauma, regardless of age or gender.
Best,
Karyn

[nyt]

I have read some published peer reviewed scientific literature that suggestions decreases in estrogen due to menopause may result in increased pain or pain syndromes in women. Most of these I have seen are fibromyalgia. There is alot of literature that demonstrates the loss of estrogen to the vaginal epithelial can cause pain due to drying out of the tissue and many women find partial to full relief of some of their vaginal pain especially pain with intercourse when they start using vaginal estrogen creams or suppositories. The vaginal epithelial becomes very fragile after menopause due to the loss of estrogen and just taking HRT orally isn't enough for the vagina so one really needs the addition of estrogen directly to the vagina by direct insertion. My gyn who prescribes my HRT has been reluctant to wean me off because he is concerned it will exacerbate my current pain status. Of course, each case is different because of the risk of breast cancer especially if you have one of the BRCA gene variants that is known to cause breast cancer or you have a family history of breast cancer.

There are also thoughts/statements in the literature that after the age of 50 nerve healing/repair is slower. That makes perfect sense to me because as we age are healing processes are not like a 20 year old. For example, as we age are arteries become stiffer and that is why most individuals end up with high blood pressure.

I'll try to find some of these references for you and post them later.

[nyt]

J Peripher Nerv Syst. 2000 Dec;5(4):191-208.

Influence of aging on peripheral nerve function and regeneration.

Verdú E, Ceballos D, Vilches JJ, Navarro X.


Source

Department of Cell Biology, Physiology and Immunology, Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain. everdu@servet.uab.es


Abstract

Aging deeply influences several morphologic and functional features of the peripheral nervous system (PNS). Morphologic studies have reported a loss of myelinated and unmyelinated nerve fibers in elderly subjects, and several abnormalities involving myelinated fibers, such as demyelination, remyelination and myelin balloon figures. The deterioration of myelin sheaths during aging may be due to a decrease in the expression of the major myelin proteins (P0, PMP22, MBP). Axonal atrophy, frequently seen in aged nerves, may be explained by a reduction in the expression and axonal transport of cytoskeletal proteins in the peripheral nerve. Aging also affects functional and electrophysiologic properties of the PNS, including a decline in nerve conduction velocity, muscle strength, sensory discrimination, autonomic responses, and endoneurial blood flow. The age-related decline in nerve regeneration after injury may be attributed to changes in neuronal, axonal, Schwann cell and macrophage responses. After injury, Wallerian degeneration is delayed in aged animals, with myelin remnants accumulated in the macrophages being larger than in young animals. The interaction between Schwann cells and regenerative axons takes longer, and the amount of trophic and tropic factors secreted by reactive Schwann cells and target organs are lower in older subjects than they are in younger subjects. The rate of axonal regeneration becomes slower and the density of regenerating axons decrease in aged animals. Aging also determines a reduction in terminal and collateral sprouting of regenerated fibers, further limiting the capabilities for target reinnervation and functional restitution. These age-related changes are not linearly progressive with age; the capabilities for axonal regeneration and reinnervation are maintained throughout life, but tend to be delayed and less effective with aging.

[Rosemary]

Hi Nyt

Thanks for your reply and for finding the abstract - kind of you to take the time - reading through - as expected but the last few words give some hope.

I have read a lot on vaginal atrophy since having to use the hrt pessaries - i don't have va as such but had noticed that the vulva area often stung after using a strong shower gel - so maybe the effect of low oestrogen was beginning.

If as suggested lack of oestrogen and pain/nerves are linked - can only hope that the hrt is enough to help correct things.

Don't know about you but i wouldn't mind being 20 again.

Rosemary x

[nyt]

Pain. 2001 May;92(1-2):229-34.

The association of hormone replacement therapy with experimental pain responses in postmenopausal women.

Fillingim RB, Edwards RR.


Source

University of Florida College of Dentistry, Public Health Services and Research, 1600 SW Archer Road, Room D8-44A, P.O. Box 100404, Gainesville, FL 32610, USA. rfillingim@dental.ufl.edu


Abstract

Considerable experimental research suggests that ovarian hormones can influence pain perception, and recent epidemiologic and clinical research suggests that exogenous hormone use may influence the prevalence and severity of clinical pain among women. However, to date no studies have examined the influence of hormone replacement therapy (HRT) on experimental pain responses and recent pain complaints among postmenopausal women. In this study, self-reported recent pain and general health were obtained, and thermal pain responses were assessed in three groups of healthy older adults: (1) women on HRT, (2) women not on HRT (No-HRT), and (3) men. Results indicated no group differences in recent pain complaints or self-reported health, but differences emerged for measures of thermal pain perception. Specifically, HRT women showed lower pain thresholds and tolerances than No-HRT women and men, and the latter two groups did not differ from each other. The potential explanations and limitations of the observed findings are discussed.