WOMENS-HEALTH Messages for March, 2000: Re: ?Nerve damage to Bartholin's??

Re: ?Nerve damage to Bartholin's??

From: D. Ashley Hill, MD (anonymous@obgyn.net)
Fri, 24 Mar 2000 08:59:58 -0600 (CST)

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At Fri, 24 Mar 2000, anonymous wrote: >
>My question is this,when radical pelvic surgery is done is it possible
>to damage the nerves that would control the Bartholin's glands to
>produce lubrication??

Although the Bartholin glands do produce a little fluid, there is no evidence that they are responsible for any signficant lubrication to sexual relations. Rather, it is much more likely that "transudation" (kind of like sweating) through the walls of the vagina is responsible for adequate sexual lubrication. This process diminishes during menopause and breastfeeding, both situations with decreased estrogen. Although each person is different, it is very unlikely that that the Bartholin glands release visible fluid during orgasm. However, some women seem to "ejaculate" fluid during orgasm, although this is controversial. The exact source of this fluid is under debate.

In my experience a number of women who undergo vaginal surgery or removal of the ovaries initially experience difficulty with lubrication. However, once prescribed estrogen, this situation usually resolves. If this is not the case, you might want to discuss vaginal estrogen with your doctor. You did not give your age, but older women will not usually respond as well to vaginal estrogen as when they were younger, which reflects the normal aging process of the vulva and vagina. However, estrogen usually helps. Further, I'm not sure what you mean by "radical pelvic surgery" since to a gynecologist this implies cancer surgery, like a radical hysterectomy. Some patients undergoing a radical hysterectomy may note transient bladder paralysis from trauma to pelvic nerves, but, to my knowledge, it is not common to experience orgasmic dysfunction due to nerve damage (some women, however, might note orgasmic dysfunction due to altered body image, post-operative depression, etc.).

Best wishes,

--
David Ashley Hill, MD
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
http://home.mpinet.net/dahmd

My apologies, but due to time constraints I am unable to answer private e-mails.

Next message: Harvey S. Marchbein, M.D.: "Re: progesterone"
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In reply to: anonymous: "?Nerve damage to Bartholin's??"
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