PAINFUL INTERCOURSE

• I HAVE PAIN DURING INTERCOURSE. 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 HAVE PAIN DURING INTERCOURSE. IS THERE ANYTHING I CAN DO ABOUT IT?

There are a number of different types of pain a woman may experience with intercourse. Although she 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:

Vaginismus – This describes a syndrome where the entry to the vagina either makes intercourse impossible or extremely painful. 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 is actually occurring so it is important to work with your practitioner to exactly identify both the location of the pain and the location of the pain trigger.

Any of the following reasons can be a cause of Vaginismus or Dysparunia:

• Insufficient lubrication can cause the penis can be irritating to 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 here is to reduce the pain or discomfort. Treatment may involve trying to increase 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.

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.

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?(Back to top)

Vaginismus is defined by the inability to comfortably get an object (penis, finger, tampon) past the opening to the vagina. 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 spontaneously tighten up 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 include, 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 body and achieve a satisfying sex life.

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

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, 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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