Posts Tagged ‘painful intercourse’

Seeing Vaginismus Everywhere

Monday, August 29th, 2011 by Bat Sheva Marcus LMSW MPH PhD

My husband claims I see vaginismus everywhere. Okay. Maybe he’s right. Maybe I do….it kills me. When I see a woman who is totally avoidant of relationships I suspect she is fearful of penetration. When I see a young girl fearful of tampons, I suspect she is panicked at the idea of putting something inside.  What kills me is that I know how unbelievably treatable the condition is!! And it kills me that anyone is letting it ruin their relationships or their life.

Anyhow, last weekend I was reading a book by AS Byatt, Possession. It’s a beautiful book about two modern English researchers who are studying 2 Victorian poets who they discover had a clandestine love affair. (By the way, writing this book was no easy feat since the author had to write poems that were supposedly written by 2 separate Victorian poets in addition to writing the book around their work!) Anyhow, back to my point that my husband suspects I see vaginismus everywhere. “Hey,” I gasp, “one of the characters has vaginismus.” He smiles knowingly… “No really.” I  say. “Here. You read it!’

 

A few flames made their sinuous way upwards. She remembered her honeymoon, as she did, from time to time, and deliberately.

She did not remember it in words. There were no words attached to it, that was part of the horror. She had never spoken of it to anyone, not even to Randolph, precisely not to Randolph.

She remembered it in images. A window, in the south, all hung about with vines and creepers, with the hot summer sun fading.

The nightdress embroidered for these nights, white cambric, all spattered with lovers’ knots and forget-me-nots and roses, white on white.

A thin white animal, herself, trembling.

A complex thing, the naked male, curly hairs and shining wet, at once bovine and dolphin-like, its scent feral and overwhelming.

A large hand, held out in kindness, not once, but many times, slapped away, pushed away, slapped away.

A running creature, crouching and cowering in the corner of the room, its teeth chattering, its veins clamped in spasms, its breath shallow and fluttering. Herself.

A respite, generously agreed, glasses of golden wine, a few days of Edenic picnics, a laughing woman perched on a rock in pale blue poplin shirts, a handsome man in his whiskers, lifting her, quoting Petrarch.

An attempt. A hand not pushed away. Tendons like steel, teeth in pain, clenched, clenched.

The approach, the locked gateway, the panic, the whimpering flight.

Not once, but over and over and over.

When did he begin to know that however gentle he was, how-ever patient, it was no good, it would never be any good?

She did not like to remember his face in those days, but did, for truthfulness, the puzzled brow, the questioning tender look, the largeness of it, convicted of its brutality, rejected in its closeness.

The eagerness, the terrible love, with which she had made it up to him, his abstinence, making him a thousand small comforts, cakes and tidbits. She became his slave. Quivering at every word. He had accepted her love.

She had loved him for it.

He had loved her.


So, he did read it – and agreed I was right and it wasn’t my imagination.

I was moved because Byatt describes so dramatically and poignantly the pain and psychological damage associated with Vaginismus.

But all I could keep thinking that night and the next day was: We could have helped her! We really, really could have.

Alas and alack, there is little to no market for “fixing” fictional characters. And then poor AS Byatt would have had to rewrite the entire book.

 

Echo: that pain in your vagina is NOT in your head!

Monday, September 27th, 2010 by Shannon Bertha, ACS, PhD

If you search our archive, you will find a number of blogs discussing this topic.  Although this subject has been touched upon, we continue to hear it from our patients each and every week, and not only are patients getting frustrated, but I am too.  How can any practitioner, therapist or doctor see an ulcerated vagina and conclude that the pain and discomfort the woman has been suffering from is . . . drum roll please . . . in her head?

It’s not in her head . . . there are physical symptoms!  Now, of course there is a connection between what goes on in your brain and how that translates to your body and psychosomatic symptoms, but this is not always the case.  But when there is a physiological symptom, why would anyone recommend  cognitive therapy to treat a raw, irritated vagina?  If I broke my arm snowboarding, would the treatment be to go to therapy to see why I decided to go snowboarding to begin with . . . or would the treatment be to set and cast my arm?  It never ceases to amaze me how when it comes to female sexuality, we forget the biopsychosocial approach and just treat the woman as an emotional creature or think psychologically she is being affected.  What happened to the biological component??? 

Therapists can be quick to find that red flag, that ah ha moment, the root of a particular emotional response to a given situation.  But most therapists work in the psychological realm, talk therapy, and I have yet to meet a therapist who can “talk” to anyone’s vagina and rid them of rawness and irritation.  Although therapist’s intention is to help, I wonder if gynecologists realize how recommending talk therapy when a painful situation exists affects the patient or client. 

Do these women believe it is indeed in their heads and therefore can never be cured?  Do they rack their brains trying to find that one instance that caused or triggered the problem and in essence blame themselves?  Many of the women I see at the Women’s Center are suffering from various issues including low desire, trouble with arousal, difficult time achieving orgasm and pain.  In every category, I’ve heard a woman say, “My doctor said it must be in my head”, when there is clearly a real physical issue going on.  I think that is the benefit of a place like the Women’s Center.  You get the chance to work with both a sexuality therapist and a nurse practitioner who are both trained in sexual issues.  So if you would like to explore your situation beyond “it’s in your head” make an appointment so we can treat all of you, not just one part.

How long is too long: the average time for intercourse

Thursday, June 17th, 2010 by Bat Sheva Marcus LMSW MPH PhD

Okay ladies (and the men who may be looking over their shoulder.) The average time for intercourse is 3-5 minutes. So if your partner is thrusting inside of you for 25 minutes and your vagina hurts or gets sore, there is nothing wrong with your vagina. There is something wrong with your timing! Now… lets respond to all the possible women’s reactions:

 “But I LIKE intercourse for 30 minutes” Great!! You’re just not average. If you and your partner enjoy prolonged intercourse and you’re not having pain afterwards – go for it! Have fun.

 “But he needs 25-30 minutes to ejaculate” – Try exploring other stimulations for 15-20 minutes. Rubbing against your body, using your hands, using your mouth, him using his hands are all good possibilities. Then when he comes inside of you he may only need 5 minutes or so.

 “He really needs 40 minutes inside of me to ejaculate.” This is where I think you need to bring in a male sexual dysfunction specialist to have him evaluated.

 Bottom line. Don’t always blame your vagina!!

“IT’S ALL IN YOUR HEAD!” and other myths about painful intercourse

Friday, May 14th, 2010 by Shannon Bertha, ACS, PhD

I’m tired of doctors telling patients “it’s all in your head,” a quick response to a problem because they do not know what to say or how to help. Although this may be true in some circumstances, shouldn’t doctors acknowledge what a patient tells you? How do you know what they are feeling, emotionally or physically?

The other day I had a woman state that she had been to numerous doctors, who told her the pain she was experiencing was “in her head.” Rather than acknowledge this issue or explore it, they dismissed her, her feelings, even her symptoms!

What does this patient do? Feeling hopeless, as if pain during intercourse is something she would have to endure the rest of her life, she goes to the internet and finds something called vaginismus, painful intercourse . She reads testimonials on various websites, and learns that other women also experience pain during intercourse and this is not something “in her head.”

These women are, in fact, able to find treatment with specialists who have decades of experience with treatments, and which also house the newest solutions to this problem. At the Medical Center for Female Sexuality, we are able to treat patients with vaginismus relatively quickly in most cases; and most patients complete their treatment and go on to have satisfying, pain-free intercourse.

I commend women on their tenacity to find an answer to this problem and to not settle for “it’s in your head,” even if it comes from a powerful influencer such as a medical doctor. We know our bodies better than anyone can because we feel what is happening. So, trust those feelings and if you feel something that doesn’t seem quite right or the way you thought it should be, search until you get your answer or until you can find someone who can answer and acknowledge and treat this condition.

Maintaining cervical health

Wednesday, February 10th, 2010 by Melissa Ferrara FNP

We happened upon this easy-to-read article on maintaining cervical health and found it to be a reasonable answer to the question of how often should a woman get a Pap smear.  This is particularly relevant given the report in the September 2009 Journal of Obstetrics and Gynecology suggesting some women can wait three years in between Pap smear tests.

Women who come to the Center generally have their own primary gynecologist for routine cervical screening.  That said, when we treat women with vaginal pain, painful intercourse or  vaginismus (a condition that results in extraordinary pain when anything is inserted  into the vagina) one of the first things that crosses our mind is, “how long ago did she have a Pap smear?”.  Women with vaginal pain or vaginismus often avoid pelvic exams and Pap screening because they fear the pain it may cause. 

If you or someone you know is avoiding a Pap because it’s impossible to imagine a speculum entering the vagina without intolerable pain, there is help.  There are different kinds of treatments – from creams to dilators to Botox injections under general anesthesia – that can help a woman take care of her health in every possible way.

http://www.annarbor.com/health/understanding-the-guidelines-for-maintaining-your-cervical-health/

Is Sex Therapy Psychological or Physical? Yes!

Friday, December 4th, 2009 by Bat Sheva Marcus LMSW MPH PhD

 Often sexual problems are the result of both physical obstacles and emotional issues. Before committing to sex therapy to uncover the causes and stresses connected to sexual dysfunction, you may want to rule out any physical conditions that can be treated with relative ease and in a short time period.

In recent years, research into the area of female sexuality has become more focused. We are beginning to understand the complicated physiology of blood vessels and nerves in the pelvis and how surgeries, childbirth, illnesses, medications, hormonal changes and aging may affect a woman’s sexual experience.

When these conditions exist, in conjunction against the emotional backdrop change (marriage, childbirth, menopause or other lifestage developments), only an integrated approach to diagnosis and treatment will be successful.

So, yes.  Read more information on our full website: www.centerforfemalesexuality.com