Posts Tagged ‘painful sex’

Maintaining cervical health

Wednesday, February 10th, 2010

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/

New Treatment for Vaginismus – Botox

Friday, February 5th, 2010

Our team just went up to New Hampshire to learn a new treatment for severe vaginismus from a wonderful Doctor. He (and his caring staff) have developed a procedure which uses general anesthesia and botox in order to help women over the first, most frightening hurdle of treatment.

When I am lecturing and trying to explain vaginismus , the analogy I use to describe how a patient feels is to compare it to what your reaction might be if I told you I was going to put a pen into your eye. 

If I said to you,”Listen, I am going to put this pen in your eye. Not to worry, it won’t hurt a bit and actually it will feel good,” you would look at me as though I had three heads and run for your life.

Patients with severe vaginismus feel that way. Often with anti anxiety medications, behavior medication, relaxation exercises we can work with a woman to help her get those first dilators in. Sometimes it just doesn’t work and it’s just too hard.

 This new procedure has the women under general anesthesia while a physician injects Botox (stops the muscles from going into spasm) local anesthesia(so that there is absolutely no initial pain) and put in a large dilator. The patient wakes up having the dilator in and that really is jumping the first few hurdles. There is still significant work for the patient. She has to work with dilators, get comfortable with the idea of inserting something into her vagina, internalize the idea that there is really no pain and then make the  transfer to intercourse.

It doesn’t solve the whole problem, but it can be a big help and relief for the right patient and we are so glad that we will be able to offer  it in our office as well.

Vaginismus

Wednesday, February 3rd, 2010

If you’ve perused this website you know that vaginismus is a condition where there is involuntary spasm of the entry muscles to the vagina, causing either pain or, in extreme cases a complete inability to penetrate.

I hope you also know that it’s very treatable and you shouldn’t’ t feel like you have to live with it. One of things I’ve noticed with vaginismus patients is that they are often scared to come  in for treatment and therefore put things off for a very long time – and suffer needlessly.

Sometimes they put things off and put things off until there is some crises, a partner leaves, they stop dating  etc.

But if that’s you— here’s something to think about:

more often than not, the fear is way worse than the treatment. Most patients say that once they got in the door, the rest was easy.

So maybe  it’s time you treated yourself!

The frustration of Sex Therapy.

Friday, January 15th, 2010

I had a patient yesterday who has zero sex drive. Zero. She has never masturbated. She has never fantasized. She has never been turned on as far as she can tell. She is sad and frustrated and it is effecting her marriage.

She spent the last two years on sex therapy. The first year was with a sex therapist who spend the entire time having her discuss the fact that she was raised by a step father, a warm, nurturing man and the only one she ever knew as a father since he married her mother when she was pregnant. Not surprisingly this didn’t help her sex drive a whole lot.

The second sex therapist did similarly. But they also spend a great deal of time talking about a dentist who paid too much attention to her and  kissed her on the cheek when she was 15. This didn’t seem to affect her sex drive much either.

 ENOUGH.  At some point we need to get smarter about the time  (and money) we are spending  on therapy.

Consider the following possibilities:  Perhaps some problems have a physical component. Maybe some are genetic. Some problems simply cannot be helped. Spending time in sex therapy grasping at straws because the therapist needs something to address,  is not only useless but detrimental to patients. If you consider these likely possibilities and their relatively direct treatments, you will be a wise consumer and an educated patient. You know if you are being helped. If you are not, stop.

In sex therapy and treatment, sometimes just talking helps

Wednesday, December 9th, 2009

I’m often struck, when first meeting with patients, how much help they get just by talking. During the first appointment, when I get a history I feel like patients relax so much. It’s like they finally had a chance to tell the truth (sometimes for the first time) to someone who doesn’t judge, doesn’t think they are strange and perhaps, for the first time, makes them feel like their concerns, habits, fears, likes and dislikes are “perfectly normal.”

In many cases, the stories patients are sharing with me, (how they masturbate, their preferred means of having sex, their “fetishes,”) are really quite common.

Then there are patients who tell me less usual stories or preferences. Again, they are often so very embarrassed about things which are not harmful and provide a source of pleasure to them.

I hope, as women explore their own sexual health, they come to believe and understand that there is just no “right” way to go about having sex!

www.centerforfemalesexuality.com