Hi Dr,
I am a 27 year old woman in a steady relationship. I am experiencing a lot of pain during intercourse and this has begun to affect me in terms of confidence and also reluctance to have sex. Lately, I am so tense during the act and I think this is also contributing to the pain as well. the funny thing is that, when my partner and I have non-penetrative sex, I have a wonderful time. The problem comes when we attempt penetration. Fortunately, my partner has been very understanding and patient, but I am now worried it will have disasterous impact on other areas of our relationship.
After doing some research on the web, I came across a condition called vulvodynia and I read about it as it described exactly what I have been experiencing. However, I have not been able to find anything about how it can be treated. And also, I would like to find out if it is a psychological problem or physiological one.
Dr Eve Answers
You describe a situation that is common to many women: painful intercourse, or as it is clinically called "sexual pain disorder". I suggest you get a proper clinical examination done so you know exactly what pain disorder you have. This is a new area of work for clinicians and we are learning more about this disorder all the time. There are overlapping symptoms which can add confusion to the diagnosis. For example, in your case, you may have vulvodynia but you have also developed secondary vaginismus with it.
This means that your pubococcygeus muscles surrounding the vagina go into spasm when you anticipate penetration making entry difficult and increasing your pain. Now you wonder where exactly the pain is coming from - the vulva or the vagina or both?? Then you become more confused as you experience no pain with non- penetrative sexual play.
Vulvodynia is a disorder caused by enervation of the nerves in the vulvar vestibules. This is caused most times by a long history of thrush, possible untreated STI’s, and reasons unknown. It is physical, most times cannot be seen by a clinician even though it may feel for you as if you have raw skin, itching, pain. The treatment depends on the diagnosis. However there are always psychological overlays which is why therapy is essential with treatment.
I recommend you call SASHA HELPLINE and ask for a referral to a medical sexual health specialist.
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