What happens when your vagina doesn’t work like you think it should? What happens when sex feels like daggers and the thought of putting anything in there, whether it be finger, tampon, toy, or penis, is simply out of the question?
Remember you’re reading an article and we can’t actually diagnose you, but we think it quite important to address sexual pain, an unfortunately overlooked and underdiagnosed that affects up to 25% of women. Painful sex can affect all aspects of life, and during times of stress, symptoms may surface or even worsen. In fact, we’ve seen much more of this condition during the Coronavirus pandemic than usual, and therefore we think it’s a good idea to give you a little information, just in case!
The most common cause for painful sex is called vaginismus. It is also known as pelvic floor dysfunction. This happens when the muscles surrounding the vagina sit at a higher resting tension. Over time, this can result in burning, irritation, and pain, especially pain when sitting or with sex.
What can cause painful sex?
There are multiple factors that go into painful sex, and one of the big ones is stress. It could be relationship stress, job stress, or general life stress (like a pandemic).
Your state of mind —Emotions such as fear, guilt, embarrassment, or awkwardness about having sex may make it hard to relax, especially during a pandemic! When you cannot relax, arousal may be difficult, and pain could result. Stress and fatigue can seriously affect your desire to have sex.
Relationship problems —Having to be in quarantine may cause friction between you and your significant other. This may interfere with your libido and ability to orgasm. A common relationship issue is a mismatch between partners in their level of desire for sex, where one may have a higher level of desire than the other.
Medications —Many medications especially antidepressants and some forms of birth control can reduce sexual desire. Many pain medications also may reduce sexual desire as well.
Medical and surgical conditions —Some medical conditions can indirectly affect sexual response. These conditions include diabetes, thyroid conditions, depression, endometriosis, and lupus.
Your partner —If your partner has a sexual problem, it can make you anxious about sex too. If your partner is taking a drug for erectile dysfunction, he may have delayed orgasm, which can lead to longer sessions of intercourse which eventually could become painful.
If you think you may be suffering from vaginismus, what can you do if you’re quarantined? I recommend a few things you can do at home, and then a few things you may need to teleconference with your doc:
First of all, ground and center yourself daily. This includes deep breathing and light meditation. Visualize all your muscles melting in relaxation for 10 minutes at a time.
Kegel muscle exercises more specifically. If you cannot figure out how to Kegel at home, do this: imagine to help relax the tight muscles
Physical therapy to loosen the muscles around your vagina. You can actually find some helpful Youtube videos on this.
Devices called "dilators" you place in your vagina – These can help you get used to having something in the vagina to allow the muscles to relax. A small dildo works too. You can use numbing medicine (prescribed by your doctor) when using the dilators to help with pain. One of my favorite devices is called a TheraWand, easily ordered from PelvicTherapies.com (I have no financial interest in them). It really helps to target tense vaginal muscles.
Vaginal estrogen – If you have dryness or thinning of the tissues near the vagina and you haven’t had a period in more than a year, the reason for painful sex could be menopause. Vaginal estrogen may be what you need if this is the case. It comes in creams, tablets, or a flexible ring. Of course, you’ll need a teleconference with your Gyno for this. If this isn’t possible, see the next one!
Vaginal lubricants -- Pile on the lube! If you are stressed with tense muscles because of the pandemic, you may experience vaginal dryness. If this is the case, get a good lubricant that will stick with you for a good amount of time. I like Slippery Stuff or Uberlube. For my patients in menopause, consider Replens. It is slightly more viscous and can stick with you up to 3 days.
Overall, keep in mind that you are NOT alone in this. In any given women’s lifetime, up to 40% will have some type of sexual complaint. Factor in the stress we are all experiencing from the pandemic, and know it’s completely understandable. Make sure to meditate, practice muscle relaxation, get lots of lube, and know that you too will get through!
Xoxo
Dr. W.