When sex hurts….

When sex hurts…. January 28, 2012
I was reading your article about the physical relationship for married couples in the LDS faith.  My wife and I are members and have been married for 5 years.  For our entire marriage, intimacy has been incredibly painful for her.  We have been to 5 different OB/GYNs with no real help.  Responses have ranged from “it will get better after you’ve had a baby” to “use lubrication” (which we always have) to trying to cauterize nerves (which was just excruciatingly painful and didn’t help).  She did go to a family therapist but she said she can’t deal with the physical pain.  Have you ever heard of this before, and do you have any recommendations of a type of doctor we could go to?  Thank you in advance for any help you can provide.

SEX SHOULD NOT HURT!

  1. Immediately stop doing anything that hurts.  For many couples this means taking a break from traditional intercourse.  Find other ways to be sexual that you can enjoy or agree on as a couple – such as self/mutual stimulation, oral sex, frictional embrace, etc.  
  2. Two books I would recommend would be When Sex Hurts by Goldsteins and Pukall and Healing Painful Sex by Coady and Fish.
  3. Getting a correct diagnosis is important – so finding knowledgeable specialists will be an important part of your journey.  Three mainly being an OB/GYN comfortable and knowledgeable treating sexual pain, a pelvic floor physical therapist (International Pelvic Pain Society) and a sex therapist (AASECT or ISSWSH).  Many communities will have “Pelvic Pain Centers” where you can find many of these specialists working under the same roof and in conjunction with one another. 
  4. Depending on the diagnosis, there are several treatments available such as prescription topical creams, prescription medications such as an antifungal or antibacterial, physical therapy, anti-anxiety treatments, anti-depression treatments, use of dilators, kegel exercises, yoga, injections, surgery, etc. 
  5. Having what we call “good genital wellness” is important to treatment as well.  This can include anything from getting good sleep, taking a multi-vitamin and having a fiber rich diet to making sure you are wearing breathable cotton underwear, and avoiding soaps, creams or other irritants.  Even gentle soaps can be irritating – and your vagina cleans itself naturally.  If you wear LDS garments make sure they are 100% cotton.  You may need to take a break from wearing the bottoms and see if that makes a difference.  And do not wear garments and underwear – we want less contact, not more.  Sleeping with no bottoms on can also give your body a break from contact with anything it may find irritating.  Stop wearing mini pads – instead change your underwear several times a day if needed.  Use tampons without chemicals if you can tolerate wearing a tampon.  If not, make sure your sanitary napkins are hypoallergenic and unscented.  You can apply a natural product, such as Aquaphor, olive oil, coconut oil, safflower oil or Walgreen’s Skin Oil with Vitamin E, to the vulvar area to prevent dryness and irritation from rubbing up to clothing.  
  6. I mentioned the use of dilators is often recommended as a way to desensitize vaginal muscles and prepare the vaginal cavity for intercourse.  I recommend Soul Source Dilators since they are made out of silicone and therefore are more pliable than plastic.  

It is important through the diagnostic and treatment periods to be patient with one another as loving partners.  Sexual pain has been one of the most misunderstood and misdiagnosed problems facing women.  Unfortunately this exacerbates feelings of frustration, anxiety, depression and hopelessness.  However, we are making headway with both research and treatment.  You have every reason to be hopeful for mutually satisfying sexual experiences throughout your marriage.  Getting away from myths such as “traditional intercourse and having an orgasm are the only ways to have sexual success” will be an important part of your journey.  There is much to explore and enjoy within the sexual realm that bring pleasure, bonding and intimacy.  I wish you the very best. 


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