PAINFUL INTERCOURSE

• I FIND INTERCOURSE DURING SEX PAINFUL, IS THERE ANYTHING I CAN DO ABOUT IT?
  
• I CAN'T GET ANYTHING INTO MY VAGINA - OR I CAN GET A TAMPON OR FINGER INTO MY VAGINA BUT NOT A PENIS – WHAT'S HAPPENING?
  
• MY VAGINAL AND VULVAR AREAS ARE SOMETIMES (OR CONSTANTLY) IRRITATED, BURNING, ITCHING OR HURTING. WHAT'S GOING ON?

I FIND INTERCOURSE DURING SEX PAINFUL, IS THERE ANYTHING I CAN DO ABOUT IT?

There are a number of different types of painful intercourse. They can be diagnosed by the location of the pain. Although a woman may not be able to identify the specific source of the pain, it is important that she see a practitioner who is able to differentiate and help her with her specific condition.

Disorders associated with painful intercourse include:

Vaginismus – This describes a syndrome where the entry to the vagina is tight, making intercourse painful or impossible. Some women are able to put things other than a penis into their vagina (e.g. tampons, fingers) and some are unable to do this as well.

Dysparunia - This describes a deeper pain and can be present in almost any area of the vagina. Strikingly, some women feel the pain in a spot other than where the irritation actually occurs, so it is important to work with your practitioner to identify both the location of the pain and the location of the pain trigger exactly.

Any of the following can cause Vaginismus or Dysparunia which will result in painful sex:

• Insufficient lubrication can cause the penis to irritate the skin.
• Muscles may have tightened due to age, childbirth, disuse , or other reasons and they may need to be re-stretched.
• There may be a nerve positioned in such a way that the penis pushes against it during intercourse.
• A muscular or bone formation has shifted, causing pain during any type of contact.

The goal of any intervention is to eliminate painful sex. Treatment may involve increasing lubrication through topical creams, using hormone therapy or by increasing the blood flow with Viagra, a vibrator or a suction/pump.. You may want to experiment with different lubrications. Sometimes, restretching the area also helps significantly.

Additionally, certain types of physical therapy may help because if supporting muscles are made stronger, there may be less pressure on other, related muscles.

Last but not least it always makes sense to explore any psychological factors that may be contributing as well.

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I CAN'T GET ANYTHING INTO MY VAGINA - OR I CAN GET A TAMPON OR FINGER INTO MY VAGINA BUT NOT A PENIS – WHAT'S HAPPENING??

Vaginismus is the inability to get an object (penis, finger, tampon) past the opening to the vagina comfortably. There is a wide range of severity with this syndrome with some women who are able to comfortably insert objects by themselves but who have trouble with intercourse. There are some women who are not able to insert anything at all into the vagina and have therefore been unable to have a gynecological exam.

There can be a number of causes of vaginismus.In some cases, the muscles in the entry are very tight or seem to tighten spontaneously and spasm on contact.  In some cases, although the muscles around the vaginal opening do not themselves tighten, other muscles in the area: buttocks legs, stomach, do tighten up causing pain. And in some cases, even though the muscles do not seem to be particularly tense or tight, the woman is afraid of what she believes will be painful and is unable to insert anything into the vagina.

Treatment for vaginismus is dependent on the causes and the severity but includes, biofeedback, work with dilators, behavior modification, guided imagery, and exercises. In some cases, a patient might also want to work with a psychotherapist if it appears that there are psychological reasons why vaginal penetration is frightening. The good news is, that if they stick with the program, most vaginismus patients can learn to overcome their fears, retrain their bodies and achieve a satisfying sex life.

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MY VAGINAL AND VULVAR AREAS ARE SOMETIMES (OR CONSTANTLY) IRRITATED, BURNING, ITCHING OR HURTING. WHAT'S GOING ON?

Vulvodynia or Vulvar Vestibulitus are conditions where the outside of the vagina, the vulvar area, is either irritated or in pain. For some women, the pain is cyclical (worse around the time of their period), for some it is constant. In some cases, it is merely irritating, and in some cases, it is so severe it can be debilitating. Women describe the irritation as some combination of burning, itching, stinging or pressure.

Vulvodynia can be caused by a variety of factors including yeast infections, a reaction to yeast medications, tight muscles, dryness and allergic reactions. Treatments can include treatment for yeast infection, topical creams, anti-inflammatory treatments, biofeedback, acupuncture and physical therapy. Like many other conditions, the patient is working with the practitioner, sometimes on a trial and error basis, experimenting with what treatments prove most effective.

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