Some women suffer with irritation consisting of dryness, chafing and itching intermittently for years thinking that it’s a mild yeast infection or sensitivity to irritants in the products that touch the vulvar tissues when in fact it’s not. Instead an vulvar condition called Lichen Sclerosus can elude doctors during it’s early stages for years causing these symptoms. Changes in the skin start out as subtle wrinking, shinyness and stickyness of the skin. As it progresses, the tissues lying adjacent to each other such as the periclitoral tissues, the interlabial folds and the base of the vagina can fuse together causing linear fusion lines. If pulled apart these fused areas can crack open causing small paper-cut fissures which brings a new symptom of burning & stinging. Also the tissues surrounding the vaginal opening can turn slightly blanched-white. This can include the peri-anal area. The whitening can be splotchy or smooth with symmetric bilateral outlines. Many doctors including gynecologists can entirely overlook the early signs of the condition. Consider the plight of the patient below:

“I was diagnosed by Dr. Fowler 3 1/2 months ago with Lichen Sclerosis. I had seen 5-10 doctors trying to figure out how to help me with the symptoms I was having, and get a diagnosis. I was so frustrated and felt like nothing was going to help me relieve my symptoms. After seeing Dr. Fowler, he helped me know exactly what I needed to do to improve, and answers came! I started feeling better quickly and learned how to manage my symptoms feeling like I can lead a normal life again! Overall I'm 80% better at this point." J. Sahuarita, AZ

Even when general gynecologists make the correct diagnosis, commonly they prescribe superpotent corticosteriods on an intermittent basis. While suprapotent corticosteriods have their role, using them each time the condition flares is not the best way to effectively mamage the condition. Lichen Sclerosus belongs to the family of dermatoses. Other conditions in this diagnostic category which are better known include ezcema, psoriasis, and seborrhea or dandruff. These conditions are chronic meaning they cannot be cured so they must be managed on an on-going basis. Its best to get the condition suppressed then continue a maintainence cream to keep it in check. Another common mistake that even gynecologists make is that they tell patient that it requires a biopsy to confirm the diagnosis. This could not be farther from the truth. The only time a biopsy is necessary is to exclude the possibility for precancer or cancerous transformation. Whenever there is thickening known as leukoplakia then this site warrants biopsy. To learn more about Lichen Sclerosus, contact Fowler Gyn International (FGI). They have developed effective treatment protocols for Lichen Sclerosus which is the result of years of clinical observation and research by the founder, board certified gynecologist, Dr. R. Stuart Fowler. Contact them at http://www.fowlergyninternational.com/contact-us to learn more.

BLOG NOVEMBER 7TH, 2015

Patient with vaginal burning, ask me all the time, “How did this happen to me?” Most of my patients have seen multiple doctors and have been told there is nothing that they can identify which is wrong. Meaning all the tests they have at their disposal come back negative. This is a common scenario with the condition known as vulvodynia. See if you relate to the patients testimony below:

“It all started at the lake with a UTI. The burn never went away after taking antibiotics.  The symptoms went on for 5 years, and now oh my gosh, I don't believe it after 8 months of using Dr. Fowler's protocol I'm 70-80% better. There are so many more good days than bad which is so awesome. I have a life again, I didn't have a life, it was depressing for sure. I'm happy. Nothing worse than feeling discomfort everyday. No body knowing what was wrong with me made me feel crazy. I saw about about 10 doctors. It became very depressing, not one Doc could find out what was going on with my body. Every test was negative, but the burn that I had I knew that something was wrong. I had seen so many Dr's and it is so emotionally draining to hear "nothing is wrong with you!” It would keep me up at night, any forms of exercise would be too much. It affected my marriage, I would burn for days after sex. After feeling like there was no other choice I went to the Mayo Clinic is AZ. It was there I learned of Dr. Fowler. Dr. Magrina at the Mayo Clinic referred me to Dr. R. Stuart Fowler at his private practice. Dr. Fowler changed my life!!! With intercourse I don't burn at all any longer! If you have symptoms that I had of burning, stinging, and pain, go see him! The money I spent was nothing compared to the freedom I feel being pain free. My husband adds, "She's a new woman." B. Boulder City, Nevada.

Lets take a closer look at her comments. It’s not uncommon for vulvodynia to start after a course of antibiotics in the women with the propensitivity to do so. Antibiotics alter the relative concentrations of the bacteria bathing the skin at the opening of the vagina known as the vestibule. Overall most women will not be affected by exposure to antibiotics but there is a very small percentage that have a propensitivity of having skin that is easier to sensitize than the general population. The reason they have not experienced the burning before in their lives despite the underlying propensitivity is that uaually it takes two or more contributing factors to occur at the same time.

At Fowler Gyn International (FGI), they have developed effective treatment protocols for vuvodynia which is the result of years of clinical observation and research by the founder, board certified gynecologist, Dr. R. Stuart Fowler. Contact them at  http://www.fowlergyninternational.com/contact-us to learn more.

A lady in Alaska found our practice, Fowler Gyn International (FGI) online. Out of desperation for help after treatment from 3 different doctors she traveled all the way to Phoenix, Arizona to see me. How common is this? This happens every week at FGI with women coming from all over the United States. Why? Because here at FGI we use advanced diagnostic techniques. We test differently and we treat differently. The success of the approach in unprecedented and documented by numerous testimonies of women who have seem multiple other doctors and undergone multiple therapies before coming to FGI. Here are her comments:

"I've had pain with intercourse for the last 4 years, which has been very frustrating. I've seen 3 different doctors trying to resolve the problem with no success. In fact surgery was suggested as a possibility or steroid injections in the vagina, neither was a choice I wanted. Finally one of my doctors suggested I seek help from a specialist in the lower 48. I got online to research doctors and found Dr. Stuart Fowler. I first saw him in November of 2012, again for a follow up in June 2013 and now November 2013 I have no pain!!! It took awhile and a lot of dedication to the protocol I was put on, but well worth the result.” Thank you Dr. Fowler from both my husband and myself." L. - Eagle River, Alaska

We DO NOT USE the same treatments being advocated by even the other vulvovaginal specialists here at FGI. WHY? Because none of them consistently work. So if you come here you WILL NOT GET...one of the tricyclic antidepressants such as amitriptyline, desipramine, imipramine, or anti-seizure medication such as gabapentin, or recommendation for pelvic floor muscle PT or biofeedback, or recommendation for surgery, i.e. vestibulectomy. Come for a visit and SEE THE DIFFERENCE in approach. We believe we have discovered the sine qua non for successful treatment.

The condition of Vulvodynia has perplexed gynecologists for over a century. It is known as one of the most distressing gynecologic conditions next to cancer that a woman can experience. It manifests as spontaneous or provoked burning, stinging and rawness of the vulvar tissues. The burning pain can be so intense that it controls every lifestyle decision from the type of activities able to be engaged in, to the types of clothing tolerated, to the loss of desire and/or inability to have intimate relations. Also, it can make it difficult to focus and concentrate in the work place. Only sleep can lead to escape from being conscious of the vulvar pain. Countless relationships, marriages and job positions have been thrown in havoc and/or disrupted over the problem.

Support groups, societies and conventions have been organized throughout this country to draw attention to the condition and entice researchers to find the etiology. To the present date, the medical literature and most authorities, Dr. Fowler not included, state that the cause of vulvodynia is “idiopathic” or of unknown etiology. In fact, for a patient with vulvar pain to be diagnosed with “vulvodynia” some experts boldly claim that there can be no associated finding other than variable redness of the vestibule or the condition is not vulvodynia. Dr. Fowler finds this absurd, inferring that an underlying aberration at whatever microscopic or biochemical level for vulvodynia does not exist.

The first case suggestive of vulvodynia was reported in a London address by J. Marion Sims, MD in 1861. Thereafter, a number of reports appeared during the Victorian Era in the United States. Nearly a century passed with less than a handful of articles published. Then a resurgence of cases manifest in the 1980’s prompting Dr. A. W. Young to report these occurrences to the International Society of the Study of Vulvovaginal Disease  (ISSVD) task force in 1984.

The first-ever national awareness campaign was launched by the National Institutes of Health in October of 2007 at the National Press Club in WashingtonDC. This campaign was spearheaded by the NIH Office of Research for Women’s Health in consultation with the National Vulvodynia Association, a non-profit organization and was joined by 30 governmental agencies and health organizations. The topic has been a matter of discussion on the Oprah Winfrey Show as well as Dr. OZ. Twenty-nine years from the first report to the ISSVD, the general medical community is no closer to understanding the etiology then it was at that time. Looks like researchers perused the wrong leads.

Dr. Fowler has been a member of the International Society for the Study of Vulvovaginal Diseases (ISSVD) since 1996. Having actively participated in the World Congress meetings, he has had privy to the latest research and discussions. He has noted that physicians around the world have been mislead by the location of the pain in trying to determine its etiology. It’s not so much being shortsighted as it is a lack of advanced diagnostic equipment and skills to determine other significant contributing factors. At the offices and laboratory of  Fowler Gyn International in PhoenixArizona, Dr. R. Stuart Fowler uses advanced microscopic diagnostic techniques and treatment protocols that consistently result in marked to total resolution of symptom in the majority of women with vulvodynia; lack of response is the exception to the norm. When Dr. Fowler polled the audience of the world’s experts at the World Congress XVIII meeting of the ISSVD in New Zealand, only 4 other providers affirmed they even had the equipment to diagnose with the same capability as Dr. Fowler. Given the expense of the equipment, the discipline needed to master the skill set, the unpopularity of dealing with vulvar pain by general gynecologists, and the poor reimbursement rates for office microscopy, it’s no surprise that few gynecologists have a working knowledge of vulvodynia let alone how to effectively treat the condition. Testimonies of women with vulvodynia successfully treated by Dr. Fowler can be found at FowlerGynInternational.com. The large number of testimonies is an indicator that Dr. Fowler may well have solved the mystery of this perplexing condition i.e. what is the underlying etiology. After all, this needs to be understood before effective treatment can be directed towards the inciting factor/s.