Category: Vaginismus

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6 Questions to Ask Your Doctor About Sex after 50

— Vaginal dryness, erection challenges, safe sex and more

By Ellen Uzelac

With most physicians ill prepared to talk about sexual health and many patients too embarrassed or ashamed to broach the subject, sex has become this thing we don’t discuss in the examining room.

“So many doctors talk about the benefits of nutrition, sleep, exercise — but they don’t talk about this one really essential thing we all share: our sexuality,” says Evelin Dacker, a family physician in Salem, Oregon, who is dedicated to normalizing sexual health in routine care. “We need to start having this conversation.”

Starting the conversation about sexual health

Sexual wellness experts suggest first talking about a physical problem such as a dry vagina or erectile challenges and then segueing into concerns about desire, low libido and intimacy.

As Joshua Gonzalez, a urologist and sexual medicine physician in Los Angeles, observes: “Patients sometimes need to be their own advocates. If you feel something in your sex life is not happening the way you would like it to, or if you are not able to perform sexually as you would like, never assume that this is somehow normal or inevitable.”

Often, there are physiological issues at play or medications that can alter your sexual experience. “If you’re interested in having sex,” Gonzalez says, “there are often real solutions for whatever the problem may be.”

Here are six questions to help steer the conversation in the right direction.

1. What can I do about unreliable erections?

Erectile dysfunction is common in older men — 50 percent of men in their 50s will experience erectile challenges, Gonzalez says, and 60 percent of men in their 60s, 70 percent of men in their 70s, and on up the ladder.

The good news: There are fixes. “This doesn’t mean giving up on having pleasurable sex at a certain age,” Gonzalez says. The two primary things he evaluates are hormone balance and blood flow to the penis. A treatment plan is then designed based on those results.

Some older men also find it often takes time and effort to ejaculate. Gonzalez suggests decoupling the idea of ejaculation and orgasm. What many men don’t realize: You can have an orgasm with a soft penis and without releasing any fluid at all. “Your orgasm — the pleasure component — is not going to change.”

Also good to know: Sexual health is a marker of overall health. As an example, erectile dysfunction can be a predictor of undiagnosed health issues such as heart disease and diabetes years before any other symptoms arise, says Gonzalez.

2. Sex is different now. My body is no longer young but I still have sexual urges. How do I accommodate this new normal?

Dacker often asks her older patients: How is the quality of your intimacy? Is it what you want it to be? Have you noticed a shift as you’ve gotten older and what does that mean to you?

“Naturally, as we age our bodies start working differently,” she says. “I like to reframe what it means to be sexual by expanding our intimate life, doing things that maybe you haven’t thought of doing before.”

Dacker, who teaches courses on how to be a sex-positive health care provider, suggests exploring each other in new ways: dancing, eye gazing, washing one another while bathing, giving hands-free coconut oil massages using your stomach, arms and chest. She’s also a fan of self-pleasure.

“There’s so much pleasure that doesn’t involve penetration, orgasm and erections,” she adds. “It’s not about performance, it’s about pleasure.”

3. My vagina hurts when I have penetrative sex to the point that I’m now avoiding it. What can I do?

A lack of estrogen in older women can cause the vaginal wall to get really thin, resulting in dryness, irritation and bleeding when there is friction.

“It can be uncomfortable with or without sex,” says Katharine O’Connell White, associate professor of OB/GYN at Boston University and vice chair of academics and the associate director of the Complex Family Planning Fellowship at Boston Medical Center. “What people don’t realize is that what they’re feeling is so incredibly common. A majority of postmenopausal women will experience this.”

White offers a three-part solution for vaginal dryness: If you’re sexually active — and even if you’ve never used a lubricant before — add a water-based lube during sex play. Also, consider using an estrogen-free vaginal moisturizer, sold in stores and online, to help restore the vaginal lining. Finally, think about adding back the estrogen that the body is craving through medically prescribed tablets, rings or creams that are inserted into the vagina.

White also advises patients to engage in 20 to 30 minutes of foreplay before penis-in-vagina sex. “The whole body changes and the vagina gets wet, wider and longer, which can go a long way to alleviating any discomfort,” she says.

4. Urinary incontinence is interfering with my sex life. How can I control it?

Because the bladder is seated on top of the vagina, the thinning of the vaginal wall can also impact the bladder. When you urinate, it can burn or you will want to pee more often, symptoms typical of a urinary tract infection, according to White.

Some women feel like they need to urinate during sex, which, as White says, “can pull you out of the mood.” Her advice? “Pee before sex and pee after sex.” She also suggests using vaginal estrogen to plump up the walls of the vagina and, by extension, the bladder.

5. I’m interested in dating again. What screenings for sexual wellness should I get — and require of a new partner?

Fully understanding the importance of reducing your risk for sexually transmitted infections (STIs) should be front and center as you reenter the dating scene, according to nurse practitioner Jeffrey Kwong, a professor at the School of Nursing at Rutgers University and clinical ambassador for the Centers for Disease Control and Prevention’s “Let’s Stop HIV Together” campaign. 

“Individuals should be screened if they’re engaging in any sort of sexual activity — oral, vaginal, anal — because many times, some of these conditions can be asymptomatic,” he says. “You can transmit without symptoms and vice versa.”

Screening may involve a urine or blood test or swabs of the vagina, throat or rectum. With STIs soaring in older adults, Kwong suggests testing for HIV, hepatitis C, hepatitis B, chlamydia, gonorrhea and syphilis. In early 2024, the CDC reported that syphilis cases had reached their highest level since the 1950s.

6. My doctor was dismissive when I brought up sex, basically saying, At your age, what do you expect? What should I do now?

Sex is a special part of life no matter how old you are. “If you’re with a doctor who brushes aside any of your concerns, it’s time to find a new doctor,” White says.

Finding a good doctor, she adds, is no different from looking for an accomplished hair stylist or a reliable mechanic: Ask your friends.

“I’m horrified when I hear about things like this,” she adds. “Any good doctor really wants you to bring up the things that concern you.“

Complete Article ↪HERE↩!

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‘Between pleasure and health’

— How sex-tech firms are reinventing the vibrator

British firm MysteryVibe’s original vibrator was designed to alleviate pain in the vagina.

A new wave of sex toys is designed to combine orgasmic joy with relief from dryness, tension and pain

By

At first glance, it could be mistaken for a chunky bracelet or hi-tech fitness tracker. But the vibrations delivered by this device will not alert you to a new message or that you have hit your daily step goal. Neither are they strictly intended for your wrist.

Welcome to the future of vibrators, designed not only for sexual pleasure, but to tackle medical problems such as vaginal dryness, or a painful and inflamed prostate gland in men.

“The current standard of care if you go to a therapist, gynaecologist or urologist, is they will insert one or two fingers to reach the painful areas and massage them to alleviate the pain,” said Soumyadip Rakshit, CEO and co-founder of sex-tech company MysteryVibe.

“We bring together the best of biomedical engineering to recreate what currently works, so people can access these therapies easily, discreetly and cost effectively.”

MysteryVibe is not the only company that is striving to alter our relationship with sex toys. A “smart vibrator” developed by the US-based startup Lioness contains sensors that measure women’s pelvic floor movements, allowing them to track how their arousal and orgasms may be changing over time or in response to stress or alcohol. An “erection ring” developed by US company FirmTech claims to enhance men’s performance while tracking the duration and turgidity of their erections and the number of nocturnal episodes they experience – an indicator of cardiovascular health.

Dr Rakshit in the lab. MysteryVibe is funding research to back up their scientific claims.

“There are a number of different products that are now sort of skirting the line between pleasure and health,” said Dr Rachel Rubin, a urologist and sexual medicine specialist based in Washington DC. “These companies today are focusing on [pelvic] anatomy and physiology, and using what we know to try to enhance pleasure, joy, intimacy and fun.”

MysteryVibe’s laboratory – the only facility conducting vibrator research and development within the UK – is incongruously housed in a former dairy in a rural business park near Guildford, Surrey. The first clue that this is no standard office unit is an issue of Playboy tucked behind a magazine about technology startups. Then I spot a tray of wand-shaped mechanical devices, in various states of undress, their bright components resembling children’s Duplo blocks.

These are stripped-back Crescendo vibrators, MysteryVibe’s original product, which was designed to target and release tender areas inside the vagina and alleviate pelvic pain, for example in women whose pelvic floor muscles have been damaged as a result of childbirth.

“The simple answer to pelvic pain is physiotherapy. But most mums either are unaware of this, or don’t have the time and/or money to pay for it,” Soumyadip said.

Registered as medical devices, and marketed at scientific conferences, such products are a far cry from the oversized dildos traditionally stocked by sex shops. MysteryVibe is even funding research to back up their scientific claims. Preliminary results from a small trial involving 11 women with genito-pelvic pain or penetration disorder – where the muscles around the vagina contract whenever an attempt is made to penetrate – suggested that using the Crescendo device three times a week for 12 weeks resulted in significant improvement.

Larger randomised trials are needed. But other scientific evidence supports the use of vibrators in various female health conditions too. According to a recent review by Dr Alexandra Dubinskaya, a urologist at Cedars Sinai Medical Center in Los Angeles, and colleagues, they can improve pelvic floor muscle function, facilitate the treatment of vulvar pain and enhance women’s sexual experiences.

“We know that vibration causes vasodilation, meaning the vessels that bring blood to the organs get wider and can bring more blood. It also promotes neuromodulation, meaning it can retrain the nerves – especially those nerves responsible for pain perception,” Dubinskaya said.

Such products are also finding favour with pelvic health physiotherapists such as Katlyn Nasseri at Rush University Medical Center in Chicago, US. She said that people experience pelvic pain due to overactive muscles, stress, anxiety, conditions such as endometriosis and polycystic ovary syndrome, and childbirth injuries.

Trauma or inflammation can cause the pelvic floor muscles to become overly toned, resulting in pain. Nasseri likens using a vibrator to using a massage gun to relieve stiff muscles elsewhere in the body: “Vibration is great for muscles; it helps them to relax really well. The same principle applies to the muscles of the pelvis.”

MysteryVibe’s latest products, scheduled for release later this year, are a vulval vibrator for women experiencing vaginal dryness and/or low libido, and a prostate vibrator designed to be inserted into the anus to relieve pain in men with inflamed prostate glands.

The MysteryVibe lab is the only place conducting vibrator research and development in the UK.

“The three common things that happen to men are that the prostate becomes larger as they become older, or it gets a cancer, and the third is prostatitis – inflammation, pain or infection in the prostate gland. Of these, perhaps the most difficult to treat is prostatitis,” said Prokar Dasgupta, a professor of urology and MysteryVibe’s medical director.

“One of the treatments is regularly massaging the prostate. This allows the congealed secretions inside the prostate that are the cause of the problem to come out. Rather than a urologist doing this manually, it can be done by the patient themselves using this device.”

Men also have pelvic floor muscles and can hold tension in them, just like women, said Rubin: “This can cause symptoms such as urinary frequency or urgency, pain with ejaculation, erectile dysfunction or premature or delayed orgasm.

“In addition, the prostate is very rich with nerves and pleasure spots that can really aid in orgasm and arousal.”

MysteryVibe’s vulval vibrator is designed to sit outside the body, can be moulded to a woman’s physiological dimensions, and can even be worn during intercourse. Whether it actually counters menopause-related dryness or reduced libido is as yet unproven, but menopause expert Dr Shahzadi Harper of The Harper Clinic in London suspects it might.

“We often say use it or lose it, but when you’re feeling tired, when your hormones change, when you’ve got so many other things going on, sex can slip down the sort of priority list. This is a nice gentle way to get confidence back in your body, reignite those nerve endings and boost blood flow to the clitoris and pelvic area, which stimulates the cells that help with lubrication.”

Dr Paula Briggs, chair elect of the British Menopause Society and a consultant in sexual and reproductive health at Liverpool Women’s NHS Foundation Trust, said that a vulval vibrator could stimulate collagen-producing cells in the vaginal wall to become active again, reversing some of the thinning that occurs following menopause. Although regular sex can achieve a similar thing, “the difference with a vibrator is that the woman is in control”.

She now advises patients to experiment with a small, tapered vibrator because penetration can be difficult, and often very painful, for such women. Briggs cautioned that vibrator use alone was unlikely to combat vaginal dryness in women whose arousal issues stem from psychological causes, including physical or emotional trauma or stress.

Kate Walsh, physiotherapy lead at Liverpool Women’s Hospital, agreed. Combined with other techniques such as mindfulness and breathing exercises, a vibrator can help women to “reprogram” the way their bodies process sensation, helping to make sex pleasurable again.

“Women will come in with all sorts of gadgets and gizmos that they’ve spent money on, but if they don’t understand the context of why they’re doing this, it is unlikely to work,” she said.

“I’m not saying that someone who is struggling with pain or arousal needs to jump straight into psychosexual counselling, but they’ve got to understand that what’s feeding it isn’t always just a physical thing – the physical and psychological interact.”

Complete Article ↪HERE↩!

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Why does sex hurt?

14 common reasons why intercourse is painful, plus how to prevent it

By Ally Head

So, why does sex hurt? Good question – and, sadly, not one that there’s a straightforward answer too.

Getting intimate and then feeling a stabbing, burning or, well, any kind of pain down there can be a bit of a mood killer, can’t it? Not to mention a worry.

Sex can hurt for a number of reasons, from underlying infections to hidden health conditions. That highlighted, it’s definitely better to deal with it sooner rather than later – no point gritting your teeth and hoping it will go away.

Known medically as dyspareunia, as obstetrician, gynaecologist and ambassador for Wellbeing Sisters doctor Larisa Corda explains, painful sex affects one in ten British women, as per an International Journal of Obstetrics and Gynaecology study.

And, according to doctor Shree Datta, gynaecologist for intimate wellbeing brand INTIMINA, there are two main types. Superficial dyspareunia – pain at the entrance to the vagina or within it at the point of penetration – or deep dyspareunia – which occurs deep in the pelvis. “Remember that pain can range from a mild irritation to debilitating pain, meaning sex can’t be tolerated, and it may be temporary, intermittent or a long term problem,” she explains.

Both female experts stress that it’s important to discover it sooner rather than later why you may be suffering from pain during sex. Keep reading to decode why does sex hurt, once and for all.

1. Too little lubrication

FYI, one of the most common reasons you’re having to Google, ‘why does sex hurt?’, is because you have too little vaginal lubrication during sex. This is totally normal – a lot of women experience vaginal dryness.

Your vagina lacking moisture can be down to the amount of foreplay before penetration, or even a lack of hormones such as oestrogen around the time of menopause, explains Datta. “If you suffer from medical conditions such as diabetes or depression, this can also affect your sexual libido and enjoyment,” she shares.

Bottom line: many women simply do not produce enough vaginal lubrication, including younger women, adds Samantha Evans, sexual health expert, former nurse and co founder of luxury sex toy retailer Jo Divine.

Try this: Rather than keep Googling why does sex hurt, Evans shares that the use of lubricants can really help. Often GPs will prescribe a hormonal cream or pessary, but many gynaecologists advocate using vaginal lubricants to help nourish the delicate tissues of the vagina. Read out guide to the best lubes to buy over the counter, while you’re here.

2. You may be suffering from a skin condition

Did you know? Underlying skin conditions can actually cause irritation during sex, and condoms may also cause discomfort or burning, particularly if you have an allergy, explains Datta. If your vagina burns after sex, you may have eczema and other genital skin conditions, such as lichen sclerosis.

Try this: Make sure you visit your GP to get your skin condition defined, if you think you may be suffering. From there, they can help you decide the best course of action, explains Corda.

3. You may have vaginismus

Ever heard of vaginismus? If you haven’t, it’s the tightening of your vaginal muscles automatically at the time of penetration, explains Datta. But why does this happen? “It can be caused by a combination of physical and psychological issues,” explains Corda. “Physical causes can include urinary tract infections, sexually transmitted diseases, vulvodynia, skin conditions such as psoriasis or eczema, menopause, and birth trauma.”

Psychological problems, on the other hand, can be caused by emotional or sexual trauma. “A previous painful experience with sex might make it harder to feel aroused and enjoy touch,” explains a spokesperson from Brook Advisory. “It can also make the muscles around the vagina and anus clench (to protect you from the pain you’re worried about) and make penetration difficult and more painful.”

Try this: With the appropriate medical intervention and counselling, the experts share that the problem can be alleviated to enable penetrative sex. Treatment usually involves specialist counselling, pelvic floor exercises, biofeedback training with a women’s health physiotherapist and use of medical dilators or a vibrator or dildo to slowly encourage the vagina to relax and open.

4. You may have an STD

Pain during or after sex can also be a sign of a sexually transmitted disease (STI) or vaginal infection, like a urinary tract infection like cystitis.

“Stinging or burning during sex may be as a result of a sexually transmitted infection, especially if you also experience an unusual vaginal discharge, or an unusual odour,” says Professor Ellis Downes, consultant obstetrician and gynaecologist and spokesperson for vSculpt. “If you have a new sexual partner and have had unprotected sex with him, and are experiencing these symptoms it would be a good idea to have it diagnosed and treated by your GP or at a sexual health clinic.”

Try this: STIs such as Chlamydia or gonorrhoea can have little to no symptoms but vaginal itching or burning, as well as painful sex, might be a sign that you are infected. Visit your GP or GUM clinic for a test. Treatments usually involve antibiotics but your doctor can recommend the next course of action.

5. You might have thrush

Three out of four women will suffer with thrush at some point in their lives, although it’s other infections, such as bacterial vaginosis. As above, UTI’s are also a common reason as to why sex is likely to hurt. Vaginal thrush, in particular, is a common yeast infection, and the main symptoms include painful sex, itching, soreness, stinging, burning when peeing and an odourless discharge.

Try this: You can pick up a DIY test in most pharmacies to determine whether you have thrush or BV, and your pharmacist will be able to recommend the best course of action. It’s usually treated with anti-fungal cream, pessaries, pills or a combination.

6. You could be going through the menopause

According to Corda, during the menopause, women experience a reduction in sex hormones which can lead to both vaginal dryness and sexual pain.

Do note here: Don’t feel embarrassed about this or suffer in silence – as Datta points out, lots of people experience sexual problems at different stages of life. “There is a lot of help out there, so there is no need to deal with this difficulty alone,” she shares. Do book an appointment with your GP if you think your painful sex may be because of menopausal symptoms.

7. Your vagina may be irritated

You’ll likely know that genital irritation can be caused by spermicides, latex or vaginal douching. Some women are allergic to certain products or even their partner’s sperm. Latex products, such as condoms or sex toys, can also cause an allergic reaction, so if you’ve ever experienced an itching or burning sensation when trying new products, then you might’ve had an irritation or allergic reaction which can, in turn, lead to painful sex.

Try this: do be aware of what you are applying to the delicate skin of your genitals. Glycerin – which is often found in flavoured lubes – as well as parabens and aspartame, can cause irritation. Similarly, alkali or acidic lubes can mess with the pH balance of your vagina and cause dryness and itching. Instead, switch to a water-based (not silicon-based) lube, such as Pjur. Another alternative is Sliquid, which is also glycerin- and paraben-free.

Similarly, opt for latex-free condoms and, when using a sex toy, make sure you clean if after use (read how to clean your sex toys, here), recommends Downes. “Some cleaning substances can irritate the vaginal lining, though, so do note that it’s best just to use hot water and natural soap.”

8. You may just not be aroused

“If you’re not physically aroused, touch of any kind can be uncomfortable, especially if it’s somewhere sensitive, like your clitoris or the tip of your penis,” says a spokesperson from the Brook Advisory Clinic. “Being well-lubricated, relaxed and with lots of blood flow in the area (you want either an erect penis or a vulva swell) helps with this, so put plenty of focus on foreplay,” they recommend.

FYI, women especially need warming up before penetrative sex, both physically and emotionally. “If you’re not feeling turned on – that is, if you’re not mentally aroused – touch can be unpleasant. For example, being tickled when you’re feeling playful and silly is usually more fun than when you’re tired or angry,” adds the Brook spokesperson.

Try this: The sexpert suggests spending time enjoying foreplay to significantly improve your sexual pleasure. “There may be times when penetrative sex is not possible, but you can still have great sex without intercourse,” they share.

Corda also adds that, if you’re worried about your lack of libido, counselling could be key to treating these factors and reviving the pain associated with sex. But in the first instance, it’s important to see your doctor to rule out medical causes first and provide the correct treatment.

9. You may be injured

Did you know? “Painful sex can be a sign of damage from previous sex, such as tearing or soreness,” explains a spokesperson from the Brook Advisory Clinic.

Think about it – you wouldn’t go running if you’d twisted your ankle, so try not to have sex super quickly after a particularly enthusiastic session, as it may have resulted in friction that has left you sore.

10. He may be too big

“Even if you’re well lubricated and fully aroused, you may experience pain if a man inserts his penis too quickly or deeply,” says Evans. “The vagina relaxes as you warm up to having sex, and will open more comfortably if the penis enters slowly. Guiding your partner in at your own pace can really help avoid any pain.”

Try this: She explains that often, having sex doggy style can be painful, so try backing onto the penis at your own pace. The same can be said when going on top. Don’t let your partner to pull you down onto their penis if you suffer from painful sex: instead, she recommends slowly lower yourself, controlling the speed and depth of insertion that is comfortable. Got it?

11. You may have a female health condition like endometriosis

Painful sex is a common symptom for women with endometriosis symptoms, which affect two million women in the UK, making many avoid sex altogether. Up to 50% of women with endometriosis have cited painful intercourse, ranging from sharp, stabbing, needle-like pain to a deep ache. It can feel mild to intense, either during sexual intercourse or up to 24 to 48 hours post-coitally, or both.

As well as endometriosis (when the lining of the uterus grows outside the uterus or is thicker than normal), painful sex can also be caused by fibroids (growths of muscle and tissue inside the uterus) growing close to your vagina or cervix, irritable bowel syndrome and constipation.

Try this: Endometriosis – and its flare ups – are unpredictable, so often it feels like there’s no knowing when they may occur. Some women experience pain throughout the month whereas others only experience it at certain times, likely – but not definitely – related to their menstrual cycle. There is no cure for endometriosis but there are treatments that can help with the pain – do visit your doctor if you fear you may have it.

12. If you’ve just given birth, your vagina may be recovering

Wondering why does sex hurt after just giving birth? FYI, giving birth is a beautiful and emotional thing – but also an emotional and physical challenge, too, and you’ll need to take time to recover afterwards. “Childbirth is a formative experience for any woman, and for some it can be traumatic,” says Dr Becky Spelman, psychologist and We-Vibe‘s relationship expert. “Insensitive care practitioners or a difficult or dangerous birth can give rise to a heightened fear of birth, pregnancy, and even sexuality itself. Women who have experienced a traumatic birth often struggle to re-engage with their sexual selves, even when they have recovered physically, and can experience pain with no obvious physical cause,” she explains.

So why exactly is sex painful after giving birth? A number of reasons, from bruising to the vaginal wall is a common reason, explains Downes. “You may also have experienced a tear which will need time to heal completely before you have sex again – doctors recommend at least six weeks but it often takes longer,” she shares.

Why is sex painful? Woman with Legs Raised wearing white shorts lying on bed

13. Your relationship might be under strain

Arguing a lot or working through a stressful patch in your relationship? Ill feeling can actually totally cause painful sex, FYI – it’s a vicious cycle.

“Experiencing emotional pain as a result of conflict within your relationship could lead to painful sex,” says Evans. “Many couples go through an emotional disconnect if one of them is unable to have sex, which in turn can increase the pain levels, thus creating a vicious circle.”

Try this: The sexpert advises that consulting a couples’ counsellor or sex therapist may help – and remember, you are not alone.

14. You could have a hidden health condition

Often painful sex is a sign of a more unusual, difficult to diagnose health issue, explains Evans. Some of the lesser known conditions that could be causing you discomfort during sex include:

  • Lichen Schlerosus – a common condition generally affecting postmenopausal women thought to be linked to an overactive immune system.
  • Vestibulodynia – a condition that makes you feel a burning pain thought to affect 12-15% of women.
  • Vulvodynia – spontaneous burning without an itching sensation.

If you’re worried you have any of the above, do see a doctor.

Is painful sex normal?

Now you’ve read the expert answer to why does sex hurt, we’re sure you’re keen to know if pain during intercourse is actually common. Short answer: yes, but it’s important to see your doctor if sex is painful repeatedly. “It can stop you from enjoying sex or lead to you avoiding sex altogether,” shares Datta – which is not good.

“This can be isolating, affect your mood and cause distress,” she shares. “It could also cause problems in your relationship over time. You may be referred to see a Gynaecologist and we may need to examine and exclude both physical and psychological problems.

Bottom line: pain during sex can be down to a number of different causes. “That’s why sometimes a multi-disciplinary approach is needed to reach an adequate diagnosis and to offer appropriate support,” explains Corda. “This may include psychologists, urologists, gynaecologists, and even dermatologists.”

They’ll be able to allow you to explore the various issues affecting your ability to have or enjoy sex, and your relationship with your partner.

Complete Article ↪HERE↩!

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Think You Can’t Have Good Sex After a Chronic Illness Diagnosis?

Think Again!

Your sex life shouldn’t be halted because of bad advice, embarrassed doctors, or a lack of knowledge.

by Amy Mackelden

Receiving an unexpected diagnosis can affect every aspect of your life, including your sex life.

There are so many misconceptions when the topics of chronic illness and sex converge, making it a potentially scary subject for anyone learning to live within their “new normal.”

I was diagnosed with relapsing-remitting multiple sclerosis (RRMS) 2 weeks after my 30th birthday, and I had a plethora of questions on my mind, some of which involved my sex life.

Multiple sclerosis (MS) is a chronic condition in which a person’s nervous system attacks itself, creating lesions on the brain and spine, often damaging the nerve pathways. This can result in numbness, tingling, itching, nerve pain, spasticity, mobility changes, and many other symptoms.

As a result, I knew my sex life was going to change, but I had no idea how.

It took some time, but I eventually discovered it was possible to have a satisfying sex life while living with a chronic illness and disability.

It might seem obvious to anyone who’s living with a lifelong condition or disability that sex is often an important aspect of our lives. However, when it comes to seeking medical advice following a life altering diagnosis, sex regularly goes unmentioned.

Research shows that many healthcare providers have limited knowledge of and confidence in talking about sexuality and chronic illness and disability. They’re also commonly really uncomfortable bringing it up with patients.

Meanwhile, research is limited on sexual dysfunction related to chronic illness. It makes sense, then, that some medical professionals may be uncomfortable addressing the subject with patients.

However, this lackluster response can sadly make those of us with chronic conditions feel as though we’re asking too much, or that the support we need just isn’t available.

If, like me, you’ve broached the subject of sex with a medical professional, it’s likely that you’ve also had mixed results.

Some suggestions have been helpful, from “use more lube” to “have sex earlier in the day to avoid fatigue.”

Others have made me question whether my sex life is important, and more specifically, if anyone else believes that my sex life is worth saving.

However, it’s crucial to find the right healthcare provider who understands the unique needs of someone facing a difficult diagnosis or lifelong condition.

It’s impossible to explore all of the ways that a chronic illness or disability might affect a person’s sex life, especially as each individual will be affected differently.

After finding out that I have MS, my sex life changed, first for the worse, and then for the better.

I had a major relapse that affected both of my legs and caused numbness from the waist down. This made sex an uncomfortable experience for several months afterwards, and I lost the ability to feel orgasms.

There were times I wondered whether I’d ever experience an orgasm again. Sex itself felt strange and made me tingle all over, not in a good way.

My body has also been affected by pain, mobility changes, and fatigue, but I’ve persevered in spite of any difficulties because I didn’t want to give up on having a sex life.

While I’ve spoken to some wonderfully supportive doctors and medical professionals, it’s also been suggested that companionship is more important in a relationship and that I should make the most of what I have, even if it doesn’t involve sex.

The implication, of course, was that sex was somehow less important to a person with an incurable illness, but that’s simply not the case.

When it comes to disability, people often speak of accessibility, so why shouldn’t the same parameters extend to having sex?

Here are some of the things that might make sex more accessible (and more fun!) if you’re living with a chronic illness.

Communication is key

While it might sound obvious, communication is key in any relationship.

“Some people believe that if two people love each other, sexual activities should automatically feel mutually wonderful and satisfying,” says Lee Phillips, EdD, LICSW, a licensed clinical psychotherapist and AASECT certified sex therapist.

“The number of sexual problems reported by people with chronic illness demonstrates all too conclusively that there is nothing automatic about sex,” says Phillips.

It’s all too easy to feel frustrated when sex and intimacy don’t magically happen the way we want it to.

When one or both partners in a relationship have a disability or chronic illness, it’s more important than ever to talk through any issues or concerns there might be.

For instance, sometimes my condition affects my ability to physically feel anything during penetrative sex, and I always let my partner know about any new symptoms or changes I’m experiencing.

“Sexual communication is critical because it can address sexual likes and dislikes, turn-ons and turn-offs, sexual needs and desires, sexual fears and concerns, past positive sexual experiences, and past negative sexual experiences,” says Phillips. “It is the key ingredient for enhancing a sex life.”

Explore intimacy and your ‘new normal’

While not everyone will be interested in therapy after receiving a surprising medical diagnosis or adjusting to life with a disability, finding a therapist who understands your needs could make all the difference.

“I always call therapy the safe container,” says Phillips, who hosts the Sex & Chronic Illness podcast.

“It is the place where people who are chronically ill feel safe and it is a place where they are not judged. It is the place where they can learn the skills in using their voice. This helps them become more aware and assertive in expressing their sexuality.”

If you’ve recently received a diagnosis, then it’s possible you’re feeling shell-shocked and lacking in confidence.

This is why considering therapy and finding a specialized therapist could be particularly helpful, especially if you’re dealing with relationships, intimacy, and sex.

“We have to realize that when so much changes in a person or a couple’s life due to chronic illness, a satisfying sex life can be one way to feel healthy and normal,” says Phillips.

Get creative

Whether you’ve always hoped to explore your sexuality in more depth, or you’re looking to spice things up post-diagnosis, it’s always possible to create more fun, excitement, and surprises in your sex life.

“When living with a chronic illness, sex can be a powerful source for comfort, pleasure, and intimacy,” Phillips says. “Therefore, I always say that you have to get curious about your partner and get creative with your sex. People start to look at this as a new sexual adventure because so much has changed due to chronic illness.”

If, like me, your physical sensations have changed with your chronic illness, you might need to try new positions and techniques to achieve orgasm or feel good during sex.

If you can, try viewing this as a positive thing rather than a burden and an opportunity to create greater intimacy with a partner.

Depending on your illness or disability, you may not be able to restore sensation to certain part of your body. That doesn’t mean pleasure isn’t possible.

“Focus should be on stimulation to the chosen area without any plans of moving to any other areas or having sexual intercourse,” says Phillips. “These exercises place the emphasis on intimacy and pleasure over the goal of performance and orgasm.”

If your body has changed because of a chronic condition or disability, then using toys or props might help. (If you have regularly bemoaned the lack of fully accessible sex toys, a new company, Handi, might soon have the answer.)

Don’t give up if you don’t want to

Perhaps the most important thing to remember is that the choice of whether to have a sex life is yours and yours alone.

Whether you’re working on your orgasm solo (like I needed to do), or you’re embracing sexual intimacy with another person, your sex life is yours.

It shouldn’t be halted because of bad advice, embarrassed doctors, or a lack of knowledge.

Complete Article ↪HERE↩!

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Vaginismus: the common condition leading to painful sex

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The social and cultural messages we receive around sex give the impression everyone’s “doing it” and it’s always fun and enjoyable. But for many people, having sexual intercourse is extremely painful or impossible. One of the leading causes of painful sex is vaginismus.

Vaginismus is an extremely common condition, that can have a huge impact on women, their partners and relationships. Yet many with it feel alone and without hope as it’s rarely talked about.

But women don’t need to live with it — it’s easy to diagnose and it’s treatable.

Painful sex

Australian research shows about 20% of women and 2% of men experience painful sex.

Male sexual problems, such as erectile dysfunction, have been in the public awareness since the advent of “the little blue pill” — Viagra. But sexual difficulties in women are missing from the story.

Without the push of pharmaceutical industries, awareness and knowledge about sexual difficulties in women (or people with vaginas who don’t identify as women) has not advanced in the same way as it has for men.

A recent study, which is not yet published, found, in 2019 57% of female patients who attended the Sexual Medicine and Therapy clinic (Monash Health) attended because of painful sex. 60% of them had Vaginismus. Almost half of these women had experienced this for more than five years, and it had occurred in around one in five of these women for ten or more years.

What is vaginismus?

Vaginismus occurs when someone has persistent or recurrent difficulties in allowing vaginal entry of a penis, finger or any object, despite her wish to do so.

Some women experience fear, difficulties or pain from the first time they try to insert something into their vagina and instead of getting better, it can get worse over time. This is called “primary vaginismus”.

Others can be fine for years and develop pain at some later date. This is “secondary vaginismus”.

Vaginismus can be mild, moderate or severe. The pain is often described as burning, cramping, or a tight feeling. And for some, nothing can go into the vagina. Sufferers describe it as like hitting a brick wall.

The impact of vaginismus

Those with undiagnosed vaginismus can feel embarrassed or abnormal which can deter them from seeking help. And undiagnosed vaginismus can significantly impact self-esteem, and lead to anxiety or depression.

Those with vaginismus may avoid being sexual, as it can be a very painful experience. They also may avoid any intimacy for fear that it may lead to “sex”. This can significantly impact relationships, leading to distance and conflict.

Couple fighting in bed.
Women with vaginismus may avoid any intimacy for fear it may lead to painful sex. This can significantly impact relationships leading to distance and conflict.Shutterstock

It can also inhibit single people from forming relationships. They may avoid socialising, dating and meeting new partners, feeling burdened with a “shameful secret”.

Causes

When it comes to sex (and life), you can’t separate the mind and the body. Vaginismus is no exception. Underlying causes are extremely variable and often influenced by multiple factors.

Sometimes there is no obvious cause, but common factors in the development of primary vaginismus include:

  • fear or anxiety: about pain, pregnancy or sexually transmitted infections. Generalised anxiety or other anxiety disorders can also cause vaginismus
  • taboos: cultural or religious taboos around sex, or inner conflict about whether to be sexual or not
  • unaroused sex: having sex when you don’t really want to
  • history of abuse: a history of physical, emotional or sexual trauma or abuse
  • unrealistic expectations: of sex leading to fear of not being “good enough”.

Secondary vaginismus can occur due to any of the above or after anything that leads to painful sex, such as:

  • relationship problems: leading to lack of libido or arousal
  • infections or skin problems: vaginal infections, such as thrush and vulval dermatological (skin) problems or Vulvodynia can cause vaginismus
  • gynaecological problems: such as endometriosis, gynaecological (or breast) cancer and it’s treatment or pelvic surgery
  • pregnancy: vaginismus can occur after pregnancy, delivery or as a new parent.

A normal reaction to any anxiety and fear is a tightening of muscles, and vaginismus occurs when this happens in the pelvic floor muscles. A strong pelvic floor is important, but we also need to learn how to relax it, when we want to.

Diagnosis

Vaginismus can usually be diagnosed by taking a careful history and looking at which factors may be causing it.

Women sitting on bed speaking with a doctor.
A physical examination is important for anyone experiencing painful sex, so no other contributing physical conditions are missed.Shutterstock

Those who suspect they may have vaginismus should initially seek help from GPs, gynaecologists, pelvic floor physiotherapists, sexologists or psychotherapists who have experience with this condition.

Medical professionals who are experienced in treating the condition will do an examination in a gentle, empowering way, only when the woman is ready to, so she is not distressed or traumatised in any way.

Treatment

Women should be reassured tightness in the pelvic floor is an involuntary, protective response they can learn to overcome, with help.

A multidisciplinary approach of management has been shown to be most effective, this includes:

  • education about vaginismus, the pelvic floor and sex
  • medical management of any underlying physical conditions
  • psychological management of any underlying worries
  • pelvic floor physiotherapy can help women learn how to relax, generally and in the pelvic floor
  • learning about what is pleasurable, as unaroused sex is a common cause of painful sex.

Woman should also be empowered to feel free to choose if, when and how to be sexual. Many women are either coerced into sex or are compliant for the sake of their partner’s needs.

They need to be supported to recognise and express their own needs and wishes. Although women can continue to be sexual in any way they wish, it’s vital to stop doing anything that hurts, such as continuing to try to have penetrative sex, while vaginismus is being treated.

Complete Article ↪HERE↩!

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Why some women ignore sexual discomfort and settle for bad sex

Women aren’t just more likely to experience consensual sex that’s bad and painful; they are also socialised to prioritise men’s pleasure over their own.

By Kellie Scott

Amelia*, 38, recently told her long-term boyfriend she experiences pain during sex.

He asked, “Why didn’t you tell me before?”

“I did tell him the times it was unbearable … but there were times where the pain wasn’t ‘that bad’ so I endured it,” Amelia says.

“His question made me question myself as to why I hadn’t said anything.”

Amelia says she realised she felt a “looming threat” to keep him satisfied.

“Luckily my boyfriend is amazing, and he was very understanding. It’s such a shame that as women we grow up with and deal with this garbage.”

Women aren’t just more likely to experience consensual sex that’s bad, painful and unsatisfying, they are also socialised to prioritise men’s pleasure over their own, explains sex and relationship therapist Lisa Torney.

And those messages begin as early as childhood.

“My mother, when she would serve food, would always serve more food to men. Right from the start there is almost this ‘Your needs are greater than mine’.

“It’s this subtle social messaging throughout our lives that then turns into sexual messaging.”

Women ignoring discomfort and not prioritising their own pleasure is at the heart of many sexual issues.

So how can we unpack these issues to have healthier, more meaningful relationships and better sex?

Bad sex for women vs bad sex for men

Bad sex can look like a lot of different things for women.

Pain, discomfort and fear of being hurt are some, says Ms Torney, referring to 2010 research.

The study, led by feminist psychologist Sara McClelland from the University of Michigan, found men and women imagined a very different “low-end” of a sexual satisfaction scale.

“Female participants described the low end of the scale in extremely negative terms, using terms like ‘depressed’, ’emotionally sad’, ‘pain’, and ‘degradation’. No male participants used terms with this degree of negative affect,” Professor McClelland writes.

Ms Torney says basically for women it’s about protection and pain, whereas for men it’s about “getting it at all” and orgasm.

We also know straight women are much less likely to orgasm through partnered sex than men.

Why women are more likely to experience bad sex

More likely to experience sexual pain

Australian data shows 20.3 per cent of women have experienced painful sex, compared to 2.4 per cent of men.

Jane Ussher is a professor of women’s health psychology at Western Sydney University.

She says sexual pain is more common in the context of penis-vagina penetrative sex, and can arise in the context of lack of lubrication or vaginismus.

Because of a gender inequity in healthcare, helping men have better sex has been a higher priority than for women.

For example, journalist Lili Loofbourow found medical journal PubMed has five times as many clinical trials on male sexual pleasure than it has on female sexual pain.

It’s why so many women with conditions like endometriosis (which can cause painful sex) go undiagnosed.

‘Part of the contract’

Professor Ussher says many women feel having sex is just “part of the contract” in heterosexual relationships.

“A lot of women have sex without desire. A lot of women fake orgasms to pretend to enjoy it,” she says.

Women are also socialised to not hurt men’s feelings, says Ms Torney.

Ella*, 29, says she used to find speaking up in the bedroom difficult.

“I would occasionally mention [what I liked or didn’t like] to past partners but wasn’t firm about it so sometimes would just drop it.

“We’re told not to speak up and keep things to ourselves, especially for our partner’s sake.”

In cases of sexual violence, women may also not feel safe to say no to sex.

“Men are less likely to be subjected to that kind of violence,” Professor Ussher says.

Lack of education and shame

Not only are we not taught about pleasure as part of our sex education growing up, women are often told their first time will hurt.

“This is often how vaginismus starts for some people,” says Ms Torney.

“That’s heavy social messaging right there that can lead to a condition as debilitating and painful.”

She says women need to learn about their bodies and what feels good.

“There is lots [of information] about male genitalia and their health, less so about women.”

Ella says she was never taught her own pleasure mattered, or encouraged to explore her own body — two things that held her back during those early sexual experiences.

“Female sexuality and pleasure has been swept under the rug for centuries, so having any type of sexual urge or desire is often met with guilt, shame or a dirty feeling.”

Sex as a performance

Professor Ussher says there is an expectation for women to be sexy for men.

This “sex is a performance” messaging is reinforced through pornography, for example.

“The idea of your own desire within you, what you want, is really quite absent.”

She says men are also harmed by these representations; for example, the idea that sex should last a long time can lead to performance anxiety and erectile dysfunction.

Learning to prioritise our own pleasure

There are several things women can do to learn how to prioritise their own pleasure.

Masturbate

When Ella began to masturbate, she learnt more about what turned her on.

“So I wasn’t willing to just let things slide and accept that is how sex is like.

“It felt great, I felt more confident and I realised what I had been missing and never wanted to go back to that.”

Professor Ussher says learning about your own body and what feels good is important.

Widening your definition of sex can also help.

Professor Ussher works with patients who have been impacted by cancer and says when penetrative sex is off the table it leads to other enjoyable experiences.

“Massaging each other, mutual masturbation — they often say sex is better than ever.”

Janelle*, 27, says after years of feeling pressured to have sex with her ex-boyfriend, which was painful for her, she reframed her understanding of intimacy.

“It doesn’t always mean that it has to be sex. There are many, many other ways of showing this between two people.”

Talk to your partner

While it’s not easy, Ms Torney says talking to your sexual partner is important.

“Talk about what you find pleasurable and what you don’t — have an open conversation about the real nitty gritty.”

Ella is married now and says she really enjoys her sex life.

“I learned that communication is vital, and you need to be upfront with your partner, no matter what.

“Tell them — or even better, show them — what you like so there’s no disappointment or resentment.

“A good partner will always listen and want to make sure you’re satisfied.”

Outsource some help

Ms Torney also recommends seeking professional support, whether it’s therapy or from your GP. You can also chat to your peers.

“Ask friends how they talk about things. Talking about it is what will make it easier.

“Because we build this stuff up as awkward and embarrassing, then not talking about it just makes it worse.”

Prioritising your pleasure is worth it, she says, because everyone will benefit from women having better sex.

“Everyone can benefit when sex lives are improved, which includes people of all gender expressions.

“We need to be mindful of our partners’ sexual needs and enjoyment and ensure we check in with them during sexual encounters to make sure things feel OK.”

*Names changed for privacy.

Complete Article ↪HERE↩!

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Why painful sex can plague women at any age

By Erin Blakemore

Your brain may be ready for sex. But what if your body refuses to cooperate? Women desiring intimacy with their partner sometimes experience pain instead of pleasure. Painful intercourse can happen even without other health issues — and it’s more common than you might think.

In a nationally representative 2013 survey, 1 in 5 women reported vulvar pain or discomfort during sex in the previous 30 days, and about 30 percent of women in a similar 2012 survey reported pain during their most recent sexual contact. Sometimes the pain is brief. But in others, it’s persistent.

Painful sex, known medically as dyspareunia, can have a variety of causes. Most affect women of all ages, although some women experience its onset during or after menopause. A variety of conditions, including endometriosis and a thinning of the vaginal wall, can be to blame — and sometimes, the pain has no discernible cause.

The pain can range from the discomfort of vaginal dryness to painful pelvic contractions or burning vulvar pain during penetration. Physical causes range. A lack of arousal or low estrogen can cause vaginal dryness and soreness. Infections or inflammation can lead to painful contractions of the pelvic muscles or burning pain during penetration. Birth control pills have also been linked with vulvar pain and uncomfortable intercourse.

Endometriosis, which is thought to affect up to 11 percent of American women of reproductive age, can be the culprit. In a nationally representative 2012 survey, 29.5 percent of women with endometriosis reported dyspareunia, too. The condition, which causes the cells that line the inside of the uterus to grow in other parts of the body, can cause bleeding, stabbing pain or cramping that can last for days after sex.

Other women experience vulvodynia: genital pain that burns, stings or throbs and makes sex uncomfortable or impossible. Although it’s correlated with past vaginal infections and pelvic floor weakness, the disease is still not well understood and there is no known cause. Treatments range from psychological interventions to pelvic floor therapy and vestibulectomy, a surgery that removes painful tissue along the vestibule, which surrounds the openings of the vagina and urethra.

A history of sexual trauma is also linked to painful intercourse, including genito-pelvic pain or penetration disorder. Previously known as vaginismus, the condition can involve painful vaginal spasms when something enters the vagina and is thought to be caused by a fear of penetration.

For many women, painful sex begins with menopause. During menopause, the ovaries produce less estrogen, the hormone that helps ensure vaginal lubrication and keep the lining of the vagina flexible and thick. Decreased estrogen can cause painful dryness, thin the vaginal walls and even shrink vaginal tissue. Those changes are known as vaginal atrophy. Vaginal estrogen therapy can help; so can vaginal moisturizers and the use of silicone-based lubricants during sex.

Azmia Magane, a 34-year-old social worker from Orlando, experienced painful intercourse early in her marriage. A variety of symptoms made sex challenging and, often, impossible. During and after sex, pain would shoot through her abdomen or radiate from her bladder. Sometimes, uterine polyps led to painful bloating after sex. And vaginal dryness made seemingly pleasurable acts feel more like torture.

In Magane’s case, endometriosis, polyps and other chronic health challenges were to blame. Vaginal dryness was one of the biggest obstacles between her and physical intimacy with her new husband, she says. “It just feels like shards of glass,” Magane says. “It’s very, very uncomfortable.”

Painful intercourse can affect self-esteem, body image and relationships. But despite its prevalence and importance, says Leah Millheiser, its highly personal nature means it can go unspoken and untreated. Millheiser, a clinical assistant professor at Stanford University and director of the female sexual medicine program there, says social taboos can get in the way of diagnosis and treatment.

“Some people are just uncomfortable talking about that area,” she says.

No matter the cause, self-esteem and relationships can start to hurt along with sexual intercourse. In a 2014 survey, 58 percent of postmenopausal women with vaginal discomfort said they avoid intimacy; 78 percent of their male partners agreed. Thirty percent of women surveyed said vaginal pain caused them to stop having sex entirely.

“It has caused some strain on my relationship,” Magane says. “It can really destroy your self-confidence.”

Silence in the doctor’s office can make matters worse, delaying treatment or causing women to seek out unproven treatments on their own.

“[Doctors] need to learn to step outside of our comfort zone and really address the issue of sexual function with our patients,” Millheiser says.

The conditions that can make sex painful are common — vulvovaginal atrophy, for example, affects up to 50 percent of postmenopausal women. Yet only 7 percent of women receive treatment for the condition.

Women who experience uncomfortable sex may also feel uncomfortable bringing up their complaints during a routine appointment. Doctors can share that discomfort, or not think to ask about sexual health, Millheiser says.

They can also minimize or ignore symptoms of sexual pain. It can take years for patients to receive a diagnosis of conditions that affect sexual health; with endometriosis, for example, patients wait an average of 6.7 years.

That’s what happened to Magane, who experienced excruciating pain, unsympathetic providers, and a botched laparoscopy before she was diagnosed with endometriosis. She recommends that women look for sympathetic providers — and that they insist on answers.

“I know my body,” she says. “I am an expert in my body. [Doctors] may have a medical degree, but I’ve lived in my body for 34 years and I know what’s normal and what is not. Painful intercourse absolutely is not normal — sex shouldn’t hurt.”

Millheiser says women shouldn’t suffer in silence. Patients may not think painful sex is worth bringing up, or worry that they’ll offend their health-care provider by discussing sex.

These days, Magane supplements her treatment with meditation and yoga. She has found some relief through pelvic floor therapy, too. It’s a form of physical therapy that can reduce pelvic pain and make physical intimacy more pleasurable.

“I actually had my husband come to one of my appointments,” she says. “It kind of gave him a visual of what I was going through.”

Although her ordeal has been painful, she says it has reminded her that “intimacy is about more than intercourse. Continuing to nourish the other intimate aspects of your life is important.”

Nonetheless, she says, women should experience everything their bodies are capable of. “Sex is a really important part of the human experience,” she says.

Millheiser agrees. “Sexual health is as important as any other part of your health. It’s about relationships. It’s about self-esteem.”

And luckily, she says, “there are effective treatments out there.”

Complete Article ↪HERE↩!

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Can Your Vagina Be Too Tight For Sex?

Not exactly, but there are reasons it might *feel* that way.

By

It’s a logical conclusion: If it hurts when a partner tries to put their penis or a toy inside of you, or if they can’t get all the way inside, then it must be a problem of tightness, right? Ehhh, not exactly.

There are several reasons for why you might feel like you’re too tight for vaginal penetration, and it’s actually a pretty common problem that gynecologists hear about. But it’s a misconception that feeling a sensation of tightness means you actually have less elasticity down there—and thinking this may prevent you from finding a real (and, in many cases, easy!) solution.

The truth is, vaginas are ridiculously stretchy, says ob-gyn Susan Khalil, MD, director of sexual health for the Mount Sinai Health System. Think about it: Lots of people push babies out of that tiny hole, so it’s gotta give.

So if it’s not a problem of stretch, what’s the issue? Well, there are a variety of factors that might be at play. For instance, “Certain medical conditions can mimic the feeling of tightness,” Dr. Khalil says.

Here are a few common reasons why it may feel as if your vagina is too tight for sex, plus how to find relief.

You went through a hormonal shift.

During menopause, your body experiences a drop in estrogen, which can lead to dryness and the thinning of vaginal tissues, the Mayo Clinic explains. As a result, you may feel a sensation of tightness or irritation during sex. This is something you should bring up with your doctor, who can recommend an over-the-counter vaginal lubricant, or possibly a prescription estrogen cream or hormone replacement therapy.

For some people, menopause messes with more than just lubrication. Sometimes a postmenopausal vagina also atrophies a little bit, Dr. Khalil says, meaning it literally gets more narrow. “And if they don’t have intercourse at all, it can become very uncomfortable,” she says.

Her recommendation? Masturbation. This way, you’re in total control and can gradually help stretch your vagina and make penetration feel more comfortable for you. If a larger toy is uncomfortable at first, you can practice with a series of vaginal dilators that will help your vagina stretch slowly over time.

Birth control, too, can sometimes cause a bit of hormonal upheaval for some people and cause dryness (and, in turn, painful sex). If you just switched your BC and noticed feeling dry or “tight,” or if you have this issue at a particular time during the month, talk to your doctor about it so they can help you determine whether your birth control might be to blame.

You recently had a baby.

Pregnancy and childbirth also involve hormonal changes that can lead to vaginal dryness and issues with painful sex. This is especially the case if you are breastfeeding, according to the American College of Obstetrics and Gynecologists (ACOG).

Or, if you’re seriously convinced your vagina is tighter after childbirth, it may not be in your head. Though this isn’t super common, Dr. Khalil says that some women who tear during childbirth get stitched up too tightly—meaning that in this one case, their vagina truly is too tight for sex. “Sometimes sutures are done too tightly [and] they’ll need a surgical procedure to fix it,” Dr. Khalil notes.

The same thing can happen if you’ve had a surgery in your genital area (with or without a baby involved), Dr. Khalil notes. But once your doctor goes back in and loosens the stitch, you should be good to go.

Your vagina is too dry.

There’s a laundry list of of reasons for why your vagina may be producing less natural lubrication than it usually does: Maybe you’re going through menopause, you’re breastfeeding, your vagina is naturally dry, or you’re on medication (yup, like birth control) that messes with your lubrication.

Regardless of the reason, though, not having enough lubrication can make sex feel more painful and might make you think your vagina seems tighter, Dr. Khalil says. “I’ll have patients come in and they’ll say it really hurts to have sex,” she says.

Luckily, the immediate solution is pretty easy most of the time: Use a lubricant. Tbh, lubricant makes sex feel better for most people, but it’s especially helpful for people who are dealing with vaginal dryness. Keep in mind, using lube doesn’t actually fix the underlying issue at hand (say, finding a birth control that vibes better with your body), so you should still *always* bring it up with your doc if dryness is a problem for you.

You have vaginismus.

Some people have a condition called vaginismus, which is when the muscles inside their vagina contract involuntarily. The muscle contraction makes it painful anytime something is inserted into the vagina; sometimes even tampon insertion is too much, according to the Merck Manuals.

Most of the time, someone who has vaginismus has it from the very first time they attempt to have penetrative sex. But in other cases it can develop later in life. For some, the cause behind vaginismus may be psychological or a result of an emotional trauma, the Merck Manual says.

While it may take some time to treat vaginismus, working with a pelvic floor physical therapist or gradually using larger and larger vaginal dilators can help, Dr. Khalil says. Working with a mental health professional may also help some individuals.

No matter what, Dr. Khalil encourages talking openly about *any* vaginal discomfort that you’re unsure about.

Whether you feel “tight” or something else, know that you deserve to feel pain-free down below during sex and everything else in life. So be your own health advocate and speak up—to both your partner(s) and your gynecologist.

“Your annual exam is more than a Pap smear,” Dr. Khalil says. “It’s also an opportunity to get to the bottom of any sexual health concerns.”

Complete Article ↪HERE↩!

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8 Things Doctors Wish You Knew About Dyspareunia, AKA Painful Sex

Yup, we mean the bad kind of pain.

[P]op culture’s depictions of sex typically focus on the romantic, the salacious, and (in some refreshing cases) the embarrassing.

But one thing that’s still rarely mentioned—both on screen and IRL—is pain during sex (also known as dyspareunia), or the shame, confusion, and stigma that often accompany it. (And we’re not talking about the good, consensual kind of pain during sex, FYI, we’re talking about sex that hurts when you don’t intend it to.)

While dyspareunia may be absent from many sexual-health discussions, it’s not rare, and it’s certainly nothing to be ashamed of. Here, doctors walk us through what they wish more people knew about painful sex:

1. Unfortunately, pain during intercourse isn’t that rare. In fact, it’s really common.

Nearly 75 percent of women will experience pain during sex at some point in their lives, according to the American College of Obstetrics and Gynecologists (ACOG). Sometimes, this pain will be a one-time thing. Other times, it will be more persistent.

2. The thing is, sex isn’t supposed to hurt unless you want it to.

Some people accept painful sex as the norm, but it shouldn’t be. “The most crucial thing for women to know is that pain during or after intercourse is never really OK,” Antonio Pizarro, M.D., a Louisiana-based gynecologist specializing in pelvic medicine and reconstructive surgery, tells SELF. There are, of course, some circumstances in which someone might seek out some level of pain during sex. But there’s a difference between a sexual kink and undesired, severe, or persistent pain in the vulva, vagina, or pelvis.

3. Minor soreness during or after sex and intense, chronic pain are not the same thing.

There are tons of reasons you might be sore after sex, Natasha Chinn, M.D., a New Jersey-based gynecologist, tells SELF. They include inadequate lubrication, penetration with a particularly large object or body part, and sex that was especially rough or fast.

If these are minor issues you only encounter every now and then, Dr. Chinn says you can usually pinpoint the cause of the problem and address it on your own (use more lube, seek out smaller sex toys, or have slower, more gentle sex). (Of course, you can go straight to seeing a doctor if you prefer.)

But what if your problem isn’t an every-now-and-then thing? If these issues are happening every time you have sex, happening more frequently than they used to, or if they’re not going away after you try to address them on your own, your painful-sex cause might be more complicated.

4. Unfortunately, there are a ton of health conditions—like endometriosis, cervicitis, and vaginismus—that can lead to painful sex.

Some of these include:

  • Contact dermatitis: a fancy medical name for an allergic reaction on the skin—and yes, that includes the skin on your vulva. This can happen if, say, the delicate skin around your vagina doesn’t react well to a soap, body wash, or detergent you’re using. Contact dermatitis can leave your skin cracked and uncomfortable, and chances are that any kind of sex you’re having while you’re experiencing this reaction is going to be pretty painful.
  • Cervicitis: a condition where the cervix, or lower end of the uterus connecting to the vagina, becomes inflamed, typically due to a sexually transmitted infection. While it often presents without symptoms, Dr. Pizarro cautions that it sometimes causes pain during urination or intercourse.
  • Endometriosis: a condition associated with pelvic pain, painful periods, and pain during or after sex. While the exact cause of endometriosis is not well understood, it seems to be the result of endometrial tissue (or similar tissue that’s able to create its own estrogen) growing outside of the uterus, which can cause pain, scarring, and inflammation. This can lead to pain that’s sometimes worse around your period, when going to the bathroom, and even during sex.
  • Ovarian cysts: fluid-filled sacs found in or on the ovaries. Sometimes they don’t cause any symptoms, but other times they rupture, causing pain and bleeding, including during sex.
  • Pelvic inflammatory disease (PID): this condition is typically caused when bacteria from a sexually transmitted infection spreads to the reproductive organs. PID can cause pain in the abdomen or pelvis, pain during urination, pain during intercourse, and even infertility if left untreated.
  • Uterine fibroids: noncancerous growths in or on the uterus. Fibroids often don’t cause symptoms, but they can make themselves known via heavy menstrual bleeding and pelvic pressure or pain, during sex or otherwise.
  • Vaginismus: a condition that causes the muscles of the vagina to spasm and contract. This can lead to pain during sex—or even make any form of vaginal penetration impossible, whether it’s sexual or just inserting a tampon.
  • Vaginitis: an umbrella term for disorders that inflame the vaginal area. Examples include bacterial vaginosis and yeast infections, both of which occur when the balance of microorganisms in the vagina gets thrown off, causing some kind of bacterial or fungal overgrowth. Other forms of vaginitis are sexually transmitted infections such as trichomoniasis (an STI caused by a parasite), chlamydia, and gonorrhea. All three of these infections are characterized by changes in vaginal discharge, vaginal irritation, and, in some cases, pain during intercourse.
  • Vulvodynia: a condition charactized by chronic pain at the opening of the vagina. Common symptoms include burning, soreness, stinging, rawness, itching, and pain during sex, Dr. Chinn says, and it can be devastating. According to the Mayo Clinic, vulvodynia consists of pain that lasts for at least three months that has no other identifiable cause.

Dr. Chinn says that women going through menopause might also experience pain during sex as a result of vaginal dryness that happens due to low estrogen levels.

People who recently gave birth may also grapple with discomfort during sex, Dr. Chinn says. It takes time for the vagina to heal after pushing out a baby, and scar tissue could develop and make sex painful.

5. There are so many other things that can mess with your sexual response, making sex uncomfortable or legitimately painful.

Any negative emotions—like shame, stress, guilt, fear, whatever—can make it harder to relax during sex, turning arousal and vaginal lubrication into obstacles, according to ACOG.

Of course, the source of these negative emotions varies from individual to individual, Dr. Pizarro says. For some, it’s a matter of mental health. Feeling uncomfortable in your body or having relationship issues might also contribute.

In an unfair twist, taking care of yourself in some ways, like by using antidepressant medication, blood pressure drugs, allergy medications, or some birth control pills, can also cause trouble with lubrication that translates into painful sex.

6. You shouldn’t use painkillers or a numbing agent to try to get through painful sex.

This might seem like the best way to handle your pain, but Dr. Pizarro cautions against it. Your body has pain receptors for a reason, and by numbing them, you could end up subjecting your body to trauma (think: tiny tears or irritation) without realizing it—which can just leave you in more pain.

7. If you’re not ready to see a doctor yet, there are a few things you can try at home, first.

According to ACOG, a few DIY methods might mitigate your symptoms:

  • Use lube, especially if you feel like your problem is caused by vaginal dryness.
  • Apply an ice pack wrapped in a towel to your vulva to dull a burning sensation when needed.
  • Have an honest conversation with your partner about what’s hurting and how you’re feeling. Let them know what hurts, what feels good, and what you need from them right now—whether that’s a break from certain sex acts, more time to warm up before you have sex, or something else.
  • Try sex acts that don’t involve penetration, like mutual masturbation and oral sex, which may help you avoid some of the pain you typically experience.

It’s totally OK to experiment with these things, Dr. Pizarro says, especially if they help you associate sex with something positive. But these tactics cannot and should not replace professional care.

8. If you’re regularly experiencing painful sex, you should talk to a doctor.

It’s really up to you to decide when to see a doctor about painful sex. “It’s like a cold,” Dr. Pizarro says. “If you’ve got a little cough, you might be all right. But if you have a cough and fever that haven’t gone away after a few days, you might want to see a doctor.” When in doubt, mention your concerns to your care provider, especially if any of these sound familiar:

  • Sex has always been painful for you
  • Sex has always been painful but seems to be getting worse
  • Sex is usually pain-free but has recently started to hurt
  • You’re not sure whether or not what you’re experiencing is normal, but you’re curious to learn more about painful sex

When you see your doctor, they’ll likely ask questions about your medical history and conduct a pelvic exam and/or ultrasound. “It’s important for doctors to ask the right questions and for patients to voice concerns about things,” Dr. Pizarro says.

From there, your doctor should take a holistic approach to treatment to address the possible physical, emotional, and situational concerns. “You really have to look at the total person,” Dr. Chinn says. Treatment options for painful sex vary wildly since there are so many potential causes, but the point is that you have options. “Many people think that it’s acceptable to experience pain during intercourse,” Dr. Pizarro says. “Use your judgment, of course, but it probably isn’t acceptable. And it can probably be made better.”

Complete Article ↪HERE↩!

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Vaginismus: a major psychological reason women experience pain during sex

If you have never heard of vaginismus, it’s time to get it on your radar.

Don’t suffer in silence

By

[A]ly Dilks, sexual health expert and clinical director at The Women’s Health Clinic, says: ‘It is the term used to describe recurrent or persistent involuntary tightening of muscles around the vagina whenever penetration is attempted,’

According to Vaginismus Awareness, the condition affects at least two in every 1,000 women at some point in their lifetime.

Approximately 10% of adult women have experienced painful intercourse in the past six months.

‘It’s not fully understood why the condition happens [but] factors can include thinking the vagina is too small, negative sexual thoughts – thinking sex will be painful and cause damage – and previous sexual abuse,’ says Ms Dilks.

She also lists damage to the vagina – common during childbirth or an episiotomy, a painful first sexual experience, relationship problems, and fear of pregnancy as other potential triggers.

Pain is not limited to sex.

Some women find inserting tampons or fingers painful; others find any type of penetration intolerable.

Unlike other causes of vaginal pain, such as an infection, vaginismus is a psychological problem that cannot be cured with a straightforward prescription.

There’s effective treatment

Help is available beyond search engine suggestions

This is not to say it can’t be treated: Vaginismus Awareness reports a 95% chance of treating this psychological condition effectively, and many women receive referrals to a sex therapist as a first port of call.

Colin Richards is a relationship and sex mentor and the founder of Intimacy Matters.

He says: ‘As a practitioner who works with both the psychological and physiological, about 20% of female clients that come to me for treatment around sexual performance come with some level of vaginismus.

‘The psycho-sensual treatment I offer involves talking through the psychological influences, followed by sensual massage that is given in controlled, professional space.

‘It allows the new emotional tools to emerge in an authentic, non-judgemental way.’

Both Ms Dilks and Mr Richards also suggest vaginal trainers: four, smooth, plastic penis-shaped objects in different sizes.

They can be used in the privacy of your own home, at your own pace. Ms Dilks says: ‘Once you feel comfortable inserting the smallest one, you can move on to the second size, and so on.’

‘It doesn’t matter how long it takes – whether it’s days, weeks, or months.’

Vaginismus is just one of many types of sexual frustrations and fears women face but, says Mr Richards, it is probably the most challenging for the sufferer.

That challenge is perpetuated by a lack of awareness and the taboo that still surrounds female sexuality, even when women talk to one another.

Yet it can have major implications on a woman’s sex life, self-esteem, body image and her relationships.

Hope for sufferers

Women can be reluctant to talk about their sex life, even with other women

If you have pain during sex, during your period, or if there’s anything that concerns you about your sexual health, don’t suffer in silence; women have been doing that for too long, and vaginismus is something for which there is a proven treatment.

Mr Richards says: ‘In my experience, if one can get to the root psychological cause of the anxiety or fear, then the vaginismus can be removed completely.

‘I have seen improvement over a period of three to six appointments.

‘As the mind learns that sexual penetration is not painful or wrong, and is, in fact, pleasurable, the body soon responds and lets go of the need to tense up.

‘[The woman] remains calm, and feels familiar with the situation, and so confident that everything should be fine.’

Complete Article ↪HERE↩!

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How to Rethink Intimacy When ‘Regular’ Sex Hurts

There’s no rule that says sex has to be penetrative.

By Breena Kerr

[W]hen sex hurts, women often feel alone—but they’re not. About 30 percent of women report pain during vaginal intercourse, according to a 2015 study in the Journal of Sexual Medicine which surveyed a subsample of 1,738 women and men ages 18 and older online.

Awareness of painful vaginal sex—sometimes lumped under the term Female Sexual Dysfunction (FSD)—has grown as more women talk about their experiences and more medical professionals start to listen.

Many conditions are associated with FSD, including vulvodynia (chronic vulva pain), vestibulodynia (chronic pain around the opening of the vagina), and vaginismus (cramping and tightness around the opening of the vagina). But they all have one thing in common: vaginal or vulval pain that can make penetrative sex anywhere from mildly uncomfortable to physically impossible. However, you can absolutely still have sex, which we’ll get to in a minute.

First and most important, if you are experiencing any type of genital pain, talk to your doctor.

There’s no reason to suffer in silence, even if it seems awkward or embarrassing or scary. Your gynecologist has heard it all and can help (or they can refer you to someone who can). The International Pelvic Pain Society has great resources for finding a licensed health care provider who specializes in genital pain.

“We don’t yet know why women get vestibulodynia or vulvodynia,” Kayna Cassard, M.A., M.F.T., a psychotherapist who specializes in vaginismus and other pelvic pain issues, tells SELF. “[There can be] many traumas, physical and psychological, that become internalized and add to vaginal pain. Women’s pain isn’t just ‘in their heads,’ ” Cassard says.

This kind of pain can affect anyone—regardless of sexual orientation or relationship status—but it can be particularly difficult for someone who mostly engages in penetrative sex with their partner. The important thing to remember is that you have options.

Sex does not have to revolve around penetration.

Hell, it doesn’t even need to include it. And for a lot of people, it doesn’t. Obviously, if P-in-V sex is what you and your partner are used to, it can be intimidating to consider redefining what sex means to you. But above all, sex should be pleasurable.

“The first thing to do is expand what ‘counts’ as sex,” sex educator and Girl Sex 101 author Allison Moon tells SELF. “Many people in heterosexual relationships consider only penis-in-vagina to count as sex, and everything else is some form of foreplay,” she says. But sex can include (or not include) whatever two consensual people decide on: oral sex, genital massage, mutual masturbation, whatever you’re into.

“If you only allow yourself one form of sex to count as the real deal, you may feel broken for enjoying, or preferring, other kinds of touch,” Moon says.

To minimize pain, give yourself time to prepare physically and mentally for sex.

That might sound like a lot of prep work, but it’s really about making sure you’re in the right mindset, that you’re relaxed, and that you’re giving your body time to warm up.

Heather S. Howard, Ph.D., a certified sexologist and founder of the Center for Sexual Health and Rehabilitation in San Francisco, publishes free guides that help women prepare physically and mentally for sex. She tells SELF that stretching and massaging, including massaging your vaginal muscles, is especially helpful for women with muscle tightness. (Too much stretching, though, is a bad idea for women with sensitive vaginal skin that’s prone to tearing.)

Starting with nonsexual touch is key, as Elizabeth Akincilar-Rummer, M.S.P.T., president and cofounder of the Pelvic Health and Rehabilitation Center in San Francisco, tells SELF. This puts the emphasis on relaxation so you don’t feel pressured to rush arousal.

Inserting a cool or warm stainless steel dilator (or a homemade version created with water and a popsicle mold) can also help reduce pain, Howard says. Women can tailor the size and shape to whatever is comfortable. If a wand or dilator is painful, however, a cool cloth or warm bath can feel soothing instead. Again, do what feels good to you and doesn’t cause pain.

Several studies have shown that arousal may increase your threshold for pain tolerance (not to mention it makes sex more enjoyable). So don’t skimp on whatever step is most arousing for you. That might mean some solo stimulation, playing sexy music, dressing up, reading an erotic story, watching porn, etc.

And of course, don’t forget lubrication. Lube is the first line of defense when sex hurts. Water-based lubricant is typically the safest for sensitive skin. It’s also the easiest to clean and won’t stain your clothes or sheets. Extra lubrication will make the vagina less prone to irritation, infections, and skin tears, according to Howard. But some people may also be irritated by the ingredients in lube, so if you need a recommendation, ask your gynecologist.

Now it’s time figure out what feels good.

Women with pain often know what feels bad. But Howard says it’s important for them to remember what feels good, too. “Lots of people aren’t asking, ‘What feels good?’ So I ask women to set what their pleasure scale is, along with their pain scale. I ask them to develop a tolerance for pleasure.”

To explore what feels good, partners can try an exercise where they rate touch. They set a timer for 5 or 10 minutes and ask their partner to touch them in different ways on different parts of their body. Sex partners can experiment with location, pressure, and touch type (using their fingertips, nails, breath, etc.) and change it up every 30 seconds. With every different touch, women should say a number from 0 to 10 that reflects how good the touch feels, with 10 being, “This feels amazing!” and 0 meaning, “I don’t like this particular kind of touch.” This allows women to feel a sense of ownership and control over the sensations, Howard says.

Another option is experimenting with different sensations. Think tickling, wax dripping, spanking, and flogging. Or if they prefer lighter touch, feathers, fingers, hair, or fabric on skin are good options. Some women with chronic pain may actually find it empowering to play with intense sensations (like hot wax) and eroticize them in a way that gives them control, according to Howard. But other women may need extremely light touch, she says, since chronic pain can lower some people’s general pain tolerance.

Masturbating together can also be an empowering way for you to show a partner how you like to be touched. And it can involve the entire body, not just genitals, Akincilar-Rummer says. It’s also a safe way for you to experience sexual play with a partner, when you aren’t quite ready to be touched by another person. For voyeurs and exhibitionists, it can be fun for one person to masturbate while the other person watches. Or, for a more intimate experience, partners can hold and kiss each other while they masturbate. It feels intimate while still allowing control over genital sensations.

If clitoral stimulation doesn’t hurt, feel free to just stick with that.

It’s worth noting that the majority of women need direct clitoral stimulation to reach orgasm, Maureen Whelihan, M.D., an ob/gyn in West Palm Beach, Florida, tells SELF. Stimulating the clit is often the most direct route to arousal and climax and requires no penetration.

Some women won’t be able to tolerate clitoral stimulation, especially if their pain is linked to the pudendal nerve, which can affect sensations in the clitoris, mons pubis, vulva, vagina, and labia, according to Howard and Akincilar-Rummer. For that reason, vibrators may be right for some women and wrong for others. “Many women with pelvic pain can irritate the pelvic nerve with vibrators,” says Akincilar-Rummer. “But if it’s their go-to, that’s usually fine. I just tell them to be cautious.”

For women with pain from a different source, like muscle tightness, vibrators may actually help them become less sensitive to pain. “Muscular pain can actually calm down with a vibrator,” Howard says. Sex and relationship coach Charlie Glickman, Ph.D., tells SELF that putting a vibrator in a pillow and straddling it may decrease the amount of direct vibration.

Above all else, remember that sexual play should be fun, pleasurable, and consensual—but it doesn’t need to be penetrative. There’s no need to do anything that makes you uncomfortable physically or emotionally or worsens your genital pain.

Complete Article HERE!

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Vaginismus: solutions to a painful sexual taboo

Many women use terms such as ‘failure’ or ‘freak’ to describe themselves

By Teresa Bergin

Vaginismus is often a problem from the start of a woman’s sexual life but for some it is a secondary problem, developing even though there may have been previous positive sexual experiences
Vaginismus is often a problem from the start of a woman’s sexual life but for some it is a secondary problem, developing even though there may have been previous positive sexual experiences

[V]aginismus is a very common but rarely discussed problem. Most women I see with this difficulty will not have discussed it with anyone else, not even female members of their own family or girlfriends. The silence that surrounds the issue and the sense of shame experienced sometimes serves to compound the difficulty itself. Many women with whom I have worked will use terms such as “failure” or “freak” to describe themselves, wishing they were “normal” just like every other woman.

Before seeking therapy, they will often have suffered this distress over a long period of time, not feeling able to embark on or enjoy sexual relationships. The thought that they may not be able to conceive through intercourse is frequently a huge anxiety for these women.

What is vaginismus?
Vaginismus occurs when the muscles around the entrance to the vagina involuntarily contract. It is an automatic, reflexive action; the woman is not intending or trying to tighten these muscles, in fact it is the very opposite of what she is hoping for. Often it is a problem right from the start of a woman’s sexual life but for some it is a secondary problem, developing even though there may have been previous positive sexual experiences. In most cases, the woman is unable to use tampons or have a smear test.

What are the symptoms?
The main symptom of vaginismus is difficulty achieving penetration during intercourse and the woman will experience varying degrees of pain or discomfort with attempts. Partners often describe it like “hitting a wall”. This is as a result of spasm within the very strong pelvic floor or pubococcygeus muscle group. Spasm or tightening may also occur in the lower back and thighs.

What are the causes?
Vaginismus is the result of the body and mind developing a conditioned response to the anticipation of pain. This is an unconscious action, akin to the reflexive action of blinking when something is about to hit our eye. This aspect of vaginismus is one of the most distressing for women as they really want their bodies to respond to arousal and yet find it impossible to manage penetrative sex. The more anxious they become, the less aroused they will feel and the entire problem becomes a vicious cycle.

Vaginismus can occur as a result of psychological or physical issues. Often it is a combination of both. Psychological issues centre around fear and anxiety; worries about sex, performance, negativity about sex from overly rigid family or school messages.

Inadequate sex education is often a feature in vaginismus, resulting in fears about the penis being able to fit or the risk of being hurt or torn. There can also be anxiety about the relationship, trust and commitment fears or a difficulty with being vulnerable or losing control.

Occasionally a woman may have experienced sexual assault, rape or sexual abuse and the trauma associated with these experiences may lead to huge fears around penetration. There are physical causes too – the discomfort caused by thrush, fissures, urinary tract infections, lichens sclerosis or eczema and the aftermath of a difficult vaginal delivery can all trigger the spasm in the PC muscles. Menopausal women can sometimes experience vaginismus as a result of hormonal-related vaginal dryness.

Treatment
Vaginismus is highly treatable. Because every woman is different, the duration of therapy will vary but, with commitment to the therapy process, improvement can be seen quite rapidly. Therapy is a combination of psychosexual education, slow and measured practice with finger insertion and/or vaginal trainers at home and pelvic floor exercises. Women with partners are encouraged to bring them along to sessions so that the therapist can work with them as a couple towards a successful attempt at intercourse.

Vaginismus can place huge stresses on a couple’s relationship as well as their sexual life; therapy can help the couple talk about and navigate these stresses. This is particularly important for a couple wishing to start a family.

What do I do if I think I have vaginismus?
Make an appointment with the GP. It will be helpful to have an examination to out rule any physical problem and have it treated if necessary. The GP is likely to refer you to a sex therapist, a psychotherapist who has specialised in sex and relationships through further training. They have specific expertise in working with this problem on a regular basis. You can also refer yourself to a sex therapist but, because of the very complex and sensitive nature of sex and sexuality, it is important to ensure that they are qualified and accredited. Sex therapists in Ireland may be found on www.cosrt.org.uk

GEMMA’S STORY
Robert was my first boyfriend. We waited six months to try sex, mostly because I was a virgin and very nervous. My mother had always warned me about not getting pregnant and I think I was too scared to try. When we did try, it didn’t work, it was disastrous. We tried again and again but he could not get in.

Every time we tried, I ended up in tears and over time I started to avoid sex. Robert was really patient but I know that it was very tough for him and I felt guilty. We thought it was a phase and it would improve with time. It didn’t stop us getting engaged because we knew we were right for each other.

Eventually I got the courage up to go to the doctor who diagnosed vaginismus – the relief of having a name to put on it was huge. She referred me to a sex therapist. I was embarrassed even talking about it, but quite honestly it was a relief to finally discuss it all. She explained everything about my problem and started me practising with vaginal trainers. I even got to start using tampons, something I never thought I would be able to do.

Robert also came to the sessions and that was a big help. We were given exercises to do at home together that helped me relax a lot. I made a lot of progress over a couple of months and, finally, last Christmas we got to try intercourse again. Success! Our sexual relationship is completely different now, no more worries and lots more fun.

I feel as if a huge worry has been lifted off my shoulders.

Complete Article HERE!