Women's Therapy Center https://www.womentc.com Treatment For Vaginismus, Vulvodynia & Painful Sex Sat, 26 Dec 2020 16:37:10 +0000 en-US hourly 1 https://wordpress.org/?v=5.6 Painful Sexual Intercourse https://www.womentc.com/blog/painful-sexual-intercourse/ https://www.womentc.com/blog/painful-sexual-intercourse/#respond Sat, 26 Dec 2020 16:37:06 +0000 https://www.womentc.com/?p=5333 A question from a husband: My wife complains of searing vaginal pain upon intercourse and as a result she has been avoiding sex altogether. When I met my wife, she seemed to be so eager and interested in sex that I eventually married her… I am glad I did because we have a good life […]

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A question from a husband: My wife complains of searing vaginal pain upon intercourse and as a result she has been avoiding sex altogether. When I met my wife, she seemed to be so eager and interested in sex that I eventually married her… I am glad I did because we have a good life together – I just miss sex. Help!

Discussion and reply:

Has your wife consulted with her doctor to make sure there is no medical cause for her pain? Assuming she has and was cleared medically, read on.

Of course you miss sex and there is no need to end one’s sex life when intercourse is not possible, especially because sexual intimacy is the cementing force of any intimate relationship, the vehicle for entering that ‘special zone’ that is not shared by the closest of friendships.

A typical sexual menu will include two main entries:

  • Intercourse: a ‘penis in vagina’ act, lending to the definition of virginity = one who did not have intercourse (male or female);
  • Outercourse: any sexual act that does not involve intercourse: foreplay, oral sex, manual sex, masturbation, humping, rubbing, use of sexual toys on genitals, etc.

Men and women will mix and match intercourse and outercourse as per their sexual preferences and style. There may be other factors which will influence one’s choice, such as a physical limitation, hormonal influence, pregnancy and childbirth, aging, etc.

And then there is the difference between men (male) and women (female): Whereas a male is easily aroused through his senses (vision, smell, touch, imagery, etc.), the female will filter her sexual interest regardless of arousal level, thus being susceptible to ‘killing the mood‘ upon a fleeting negative thought. Example: “I am still mad at you for (whatever the reason may be) and you want to have sex????????” Or, “I am rushing to work and my mind is not on sex,” or “I am worried the kids are going to hear us,” etc.

From a psychophysical point of view, men need to be reminded that intercourse is about their penis entering the woman’s body — being the ‘do-er’ to her being ‘done to’ — and, therefore, they need to be invited and welcomed into her vagina when her body and mind are in sexual balance.

Naturally, when intercourse is painful, whether it is vaginismus or dyspareunia, the woman will want to avoid the act in self-protection. Furthermore, she will often decline outercourse too because she does not want to be reminded of the pain, of disappointing the partner, or because she is worried about his ‘surprise move’ into her vagina during outercourse.

This is when it would be very important for the couple to hold a candid discussion about the situation. The man will need to promise NOT to attempt any vaginal penetration (finger and/or penis) while the woman is being encouraged to enjoy herself as much as she can (remember the ‘filter’ that was mentioned above?) without pressure to orgasm — let it happen if/when it does. Make it fun, friendly, and stress-free!

Additionally, sexual counseling may be of great value in order to resolve underlying causes for this sexual breakdown, and to guide the couple onto a positive intimate journey.

The goal is to maintain an agreed-upon style of comfortable sexual intimacy and avoid slipping into asexual existence, or living like ‘brother and sister,’ which will put quite a bid of pressure on the relationship.

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IUD and Intercourse https://www.womentc.com/blog/iud-and-intercourse/ https://www.womentc.com/blog/iud-and-intercourse/#respond Mon, 21 Dec 2020 16:20:25 +0000 https://www.womentc.com/?p=5326 Is it possible for my IUD to become dislodged/displaced by a penis/fingers/sex toys, etc.? And do i have to be careful with previously mentioned now that I have an IUD?  As seen on MissMuslim. You can read it here.

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Is it possible for my IUD to become dislodged/displaced by a penis/fingers/sex toys, etc.? And do i have to be careful with previously mentioned now that I have an IUD? 

As seen on MissMuslim. You can read it here.

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Bleeding with sex (intercourse) https://www.womentc.com/blog/bleeding-with-sex-intercourse/ https://www.womentc.com/blog/bleeding-with-sex-intercourse/#respond Wed, 11 Nov 2020 19:25:01 +0000 https://www.womentc.com/?p=5317 Not all bleeding/spotting with intercourse suggest a medical crisis. Common, every day causes may include: Chafing irritation because of dryness/insufficient lubrication/prolonged thrusting. This would be a good reason to use vaginal lubrication! You have vaginismus or dyspareunia — your vagina is tight (nervous) and thus diminished in diameter because of clenching, thus causing chafing irritation; You just started having […]

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Not all bleeding/spotting with intercourse suggest a medical crisis. Common, every day causes may include:

  • Chafing irritation because of dryness/insufficient lubrication/prolonged thrusting. This would be a good reason to use vaginal lubrication!
  • You have vaginismus or dyspareunia — your vagina is tight (nervous) and thus diminished in diameter because of clenching, thus causing chafing irritation;
  • You just started having intercourse and are still breaking leftover hymenal tissue. The good news is that once totally broken, it does not grow back!
  • Your vagina is less elastic because of estrogen depletion such as in menopause or because of cancer treatment;
  • You just had your period and the tapping of the penis on the uterus shakes out leftover blood.

So,  before you panic and think of the inevitable (infection, cancer), explore the above.  Seek medical help if the bleeding/spotting persists.

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Suffering in silence with painful intercourse https://www.womentc.com/blog/suffering-in-silence-with-painful-intercourse/ https://www.womentc.com/blog/suffering-in-silence-with-painful-intercourse/#respond Tue, 27 Oct 2020 17:03:52 +0000 https://www.womentc.com/?p=5307 The body is built for intercourse and women should be able to handle it just fine.  Still, why do so many women suffer in silence during painful intercourse, instead of speaking up? Is this an inherent trait in women? Is the partner at fault? Is society to be blamed? Or culture? Religion? Excluding a justifiable […]

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The body is built for intercourse and women should be able to handle it just fine.  Still, why do so many women suffer in silence during painful intercourse, instead of speaking up?

  • Is this an inherent trait in women?
  • Is the partner at fault?
  • Is society to be blamed? Or culture? Religion?

Excluding a justifiable medical reason, the causes are deeply rooted in the woman’s psyche and include

  1. The sense of “I do not deserve any better…”
  2. The feeling of “I am the only one who is struggling so I may as well just keep quiet…”
  3. The inherent tendency of women to be pleasers, at their own expense;
  4. The fear of “Partner will leave me if I speak up… I do not want to be alone…”
  5. A statement like “In my culture women submit, quietly; speaking up will have negative repercussions…”
  6. Some religions where women are expected to be subservient to the husband’s sexual wants;
  7. The woman’s inability to say NO, to speak up her preferences!

Such suffering will typically lead to a deepening sense of victimization, resentment, avoidance, friction in the relations, and often to developing vaginismus.  After all, it is against human nature to be made helpless, hopeless, forced-upon.

Important: the vagina is a hostess to the penis! Its owner – the woman – determines if and when to invite the penis in, how long it can stay in, and when it is time to leave.  Have you ever thought of that in such terms? 

And, did you realize that the thrusting during intercourse is a rapid, powerful physical action inside the vagina, easily felt throughout the woman’s pelvis and body?  While normal for the woman to experience, it will turn traumatic under adverse conditions as noted above.

We encourage all women to speak up, to educate themselves, to have dialogue with their partner, to seek professional help so as to put a stop to their unnecessary pain and suffering.

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Vaginismus: is something (not) wrong with my vagina? https://www.womentc.com/blog/vaginismus-is-something-not-wrong-with-my-vagina/ https://www.womentc.com/blog/vaginismus-is-something-not-wrong-with-my-vagina/#respond Mon, 12 Oct 2020 18:43:38 +0000 https://www.womentc.com/?p=5303 Despite widespread online visibility in recent years, vaginismus continues to be an elusive condition.  Professionals are still not sure how to diagnose it, treatment is not standardized, misconceptions are abound, and the women who suffer often find themselves left alone in search for solutions. Why is vaginismus so confusing at our times, with advances in […]

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Despite widespread online visibility in recent years, vaginismus continues to be an elusive condition.  Professionals are still not sure how to diagnose it, treatment is not standardized, misconceptions are abound, and the women who suffer often find themselves left alone in search for solutions.

Why is vaginismus so confusing at our times, with advances in medicine and readily available information?

Answer #1: because vaginismus is NOT a disease/pathology/physical anomality but rather a stress response of the sympathetic nervous system, our guardian at time of fear, worry, or danger.  It is a psychosomatic condition, a fusion between medical and mental health that is not yet in the the professional mainstream.

Answer #2: because of the woman’s inability to ‘take a look at the vagina and see if anything is wrong’ because of its location inside the pelvis, unlike the male’s penis that is external and may be looked at anytime.  The only time she can see her vagina would be when a speculum is used, something that is typically done only during a gynecologic examination.  No wonder this invisibility is making the vagina quite mysterious and misunderstood to the point of believing that pain upon penetration – or complete inability to penetrate – must signal a physical problem with potential for further harm.

Answer #3: because the woman with vaginismus will have a difficult time believing that nothing is wrong with her vagina. She will often insist that there must be something physically wrong, especially because the connection between our stress response system and the genitals is still not widely recognized nor accepted.

By the time our vaginismus treatment process gets to demonstrating a gynecologic exam, we make sure to have each patient looks at her own vagina through the open speculum – some will even take a photo of it on their mobile phone – as proof that it is merely a simple canal that connects the outside world to the uterus… Yet a canal that is subjective to reactive clenching, which vaginismus is all about.

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Vaginismus and hymen https://www.womentc.com/blog/vaginismus-and-hymen/ https://www.womentc.com/blog/vaginismus-and-hymen/#respond Tue, 29 Sep 2020 16:14:08 +0000 https://www.womentc.com/?p=5292 Can a hymen cause vaginismus? Typically, NO, the presence of a hymen will not cause vaginismus or this condition would have been most common, which is not the case. Furthermore, the majority of vaginismus patients do not have an intact hymen in the first place despite not having had any vaginal penetration. Let’s take this […]

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Can a hymen cause vaginismus?

Typically, NO, the presence of a hymen will not cause vaginismus or this condition would have been most common, which is not the case. Furthermore, the majority of vaginismus patients do not have an intact hymen in the first place despite not having had any vaginal penetration.

Let’s take this opportunity to also correct a common fallacy: a hymen does not grow back!

The hymen is a thin, vascularized membrane, an embryonic remnant of the vaginal separation from the urogenital sinus = the tissue that forms the genitals. The hymen will usually perforate during embryonic development and will vary in thickness, size, and shape from one female to another. The hymen does not regenerate (grow back)!

There are 3 typical variations of hymeneal presence (excluding anomalies):

  1. An imperforate hymen, which means it did not perforate (did not develop an opening within it). An imperforate hymen is uncommon, and is typically diagnosed during onset of menstruation when the blood that cannot ‘come out’ of the body keeps accumulating on the inside. This is a painful and a potentially life-threatening situation that needs immediate medical attention.
  2. An intact hymen, which means that there is leftover hymeneal tissue present, typically between the 4 o’clock and the 8 o’clock, if we use that description. The opening within the hymen can be large enough to accommodate a tampon or a finger, or so small that even the pinky (smallest finger) will not pass through. A partially-intact hymen can be elastic and responsive to stretch (common), or fibrous and rigid (less common).
  3. Minimal or no hymen, even in the absence of vaginal penetration! Despite it being quite common, there is no explanation for it; bike riding or gymnastics are not the cause…

Imperforate and rigid hymens require a hymenectomy, a simple procedure during which the hymen is removed. When it comes to an intact hymen, of our thousands of patients treated, we encountered only 4 women that needed surgical intervention due to hymenal abnormality that restricted vaginal penetration.

An intact elastic hymen will respond to vaginal penetration, may it be a finger, tampon, gyno exam, or intercourse. There may be initial discomfort and/or bleeding, but not necessarily as not all hymens react the same. So, when it comes to intercourse, do not assume that the first-time will be painful or bloody!

Note: the presence of a hymen cannot be established just by looking at the vaginal opening. Clinicians who attempt a gynecologic exam inationon a woman with vaginismus will often interpret her tight (and anxious!) vaginal opening as an intact hymen and offer a hymenectomy as a solution… Remember: a digital (finger) exam is necessary to arrive at a definitive conclusion!

The presence of a hymen does not cause vaginismus. It may restrict or limit vaginal access, but the woman will typically be cool about her vagina and able to face vaginal management without distress.

So when may the presence of a hymen be associated with vaginismus? When there is an underlying stress/anxiety condition, either conscious or subconscious:

  • Anticipating pain upon first-time penetration (but maybe it won’t really hurt?)
  • Is anxious about ‘breaking’ the hymen (maybe there is no hymen?)
  • Cannot handle physical discomfort (maybe there will be none?)
  • Cannot handle the site of blood (maybe it won’t bleed?)
  • Stressed about an unknown; what will it be like to have something inside my vagina?
  • Forced into having intercourse/losing her virginity

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On a humorous note, check the following quote from a book by the name of Sex Revelations and The New Eugenics, published in 1936 by two physicians, Whitehead and Hertel:  “Regarding the hymen… It sometimes grows again in widows, or in women who have been a long time separated from their husbands…”

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Dilators and Lidocaine for treatment of vaginismus https://www.womentc.com/blog/dilators-and-lidocaine-for-treatment-of-vaginismus/ https://www.womentc.com/blog/dilators-and-lidocaine-for-treatment-of-vaginismus/#respond Wed, 09 Sep 2020 15:05:03 +0000 https://www.womentc.com/?p=5264 Vaginal dilators have been a vital component of vaginismus treatment. They may be used as a home kit for self-treatment, or by a clinician attending to the condition. When trying to self-treat with dilators, success is variable: some will be successful, some will continue to struggle, and some won’t be able to use even the […]

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Vaginal dilators have been a vital component of vaginismus treatment. They may be used as a home kit for self-treatment, or by a clinician attending to the condition.

When trying to self-treat with dilators, success is variable: some will be successful, some will continue to struggle, and some won’t be able to use even the smallest in the set as they are just too scared to insert anything into their vagina, or are terrified of the pain they anticipate. This is when you need to weigh the options of self-treatment vs. seeking professional help.

On another note, a common suggestion that is given for the penetrative ‘pain’ is to apply Lidocaine, a numbing preparation, to the tip of the dilator so as to neutralize the adverse sensation upon insertion. Often, women are also instructed to use this anesthetic when transitioning to vaginal intercourse, or even for ongoing intercourse.

A numbing cream sounds like a good, easy solution, right? Unfortunately, we do not believe so because it does not address the underlying stress response, which is THE source/cause of the vaginismus. And, there is a risk of becoming dependent on it, which does not lend to a normal use of the healthy – albeit nervous – vagina.

Choose your options wisely. There is no reason to live with vaginismus.

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Penis vs Bacterial Vaginosis https://www.womentc.com/blog/penis-vs-bacterial-vaginosis/ https://www.womentc.com/blog/penis-vs-bacterial-vaginosis/#respond Tue, 04 Aug 2020 18:24:41 +0000 https://www.womentc.com/?p=5244 Bacterial vaginosis (BV) is a common vaginal infection that is often recurring time and again, despite treatment, which is a cause of frustration to both the woman and her clinician. A recent article, The Microbiome Composition of a Man’s Penis Predicts Incident Bacterial Vaginosis in His Female Sex Partner With High Accuracy may open a […]

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Bacterial vaginosis (BV) is a common vaginal infection that is often recurring time and again, despite treatment, which is a cause of frustration to both the woman and her clinician.

A recent article, The Microbiome Composition of a Man’s Penis Predicts Incident Bacterial Vaginosis in His Female Sex Partner With High Accuracy may open a much-needed door to better diagnosis and intervention.

To quote their conclusion: “Baseline penile microbiota accurately predicted BV incidence in women who did not have BV at baseline, with more than half of incident infections observed at 6- to 12- months after penile microbiome assessment. These results suggest interventions to manipulate the penile microbiome may reduce BV incidence in sex partners, and that potential treatment (antibiotic or live biotherapeutic) will need to be effective in reducing or altering bacteria at both the glans/coronal sulcus and urethral sites (as represented by the meatus). The temporal association clarifies that concordance of penile microbiome with the vaginal microbiome of sex partners is not merely reflecting the vaginal microbiome, but can contribute to it.”

If you are one of those who suffers of recurrent BV, try using a condom for now, until further treatment is available.

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Vaginismus treatment – misconceptions https://www.womentc.com/blog/vaginismus-treatment-misconceptions/ https://www.womentc.com/blog/vaginismus-treatment-misconceptions/#respond Tue, 21 Jul 2020 16:34:27 +0000 https://www.womentc.com/?p=5238 Vaginismus continues to be an elusive condition that is often misdiagnosed and poorly managed due to limited understanding and resources by the medical community. Women, and partners, have embraced the Internet as it offers them a venue to research resources for vaginismus treatment without disclosing their own suffering in fear of shame or embarrassment. However, […]

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Vaginismus continues to be an elusive condition that is often misdiagnosed and poorly managed due to limited understanding and resources by the medical community.

Women, and partners, have embraced the Internet as it offers them a venue to research resources for vaginismus treatment without disclosing their own suffering in fear of shame or embarrassment.

However, like any other researched topic, one needs to decipher truth from false for accurate and reliable decision making. With vaginismus being an anxiety-based condition, and with posts that are rich with personal struggles, that may be a tall order.

Common misconceptions about vaginismus treatment include:

  • It will be painful
  • It will take many months to cure
  • It is impossible to predict how many treatment sessions are needed
  • You have to get aroused for it to work
  • Kegel exercises are a must
  • Need to keep the dilator in the vagina for (so many) minutes
  • Need to wiggle the dilator when inserted
  • Need to use a mirror for penetration
  • Need to look at my vaginal insertion
  • Need to get partner’s finger involved
  • Need to do relaxation breathing for penetration to happen
  • The dilator should go in slowly
  • Helps to image a pretty place while doing penetration/s
  • It is about sex
  • Doing sports/swimming/exercising is not advisable
  • Must walk slowly, always
  • Do not ever cross your legs
  • Taking a hot bath before/after treatment is helpful
  • Stop (dilation/treatment) if uncomfortable
  • You must have a hymen
  • Masturbation is important
  • Child pose (yoga) is helpful
  • The muscles need to be pulled back
  • Do dilation standing up
  • There is no cure… You have to learn to live with vaginismus…

The list is long and goes on. The confusion is deep. The damage to the woman’s body & mind is injurious and devastating. This is wrong!

Fact: vaginal use is a natural activity of the body; there is no reason to medicalize it. Vaginismus is not a broken vagina but rather a healthy vagina that is in-panic.

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We must stay strong. Positive. Optimistic. https://www.womentc.com/blog/we-must-stay-strong-positive-optimistic/ https://www.womentc.com/blog/we-must-stay-strong-positive-optimistic/#respond Thu, 07 May 2020 17:20:23 +0000 https://www.womentc.com/?p=5211 Yes, it sure seems like a very long time although, in reality, it has ‘only’ been several weeks since our lives got turned upside down. Are you coping alright? Have you taken these challenging times to reevaluate your life? Your goals? Your business? And most importantly, your relationships and health? Are you scared? Skeptical? Worried […]

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Yes, it sure seems like a very long time although, in reality, it has ‘only’ been several weeks since our lives got turned upside down.

Are you coping alright?

Have you taken these challenging times to reevaluate your life? Your goals? Your business? And most importantly, your relationships and health?

Are you scared? Skeptical? Worried about the future? After all, this novel virus is such an invisible, unknown enemy…

We must stay strong. Positive. Optimistic.

We must adhere to the basics that have proven right time and again: facemask, hand washing/sanitizing, and social distancing.

Medicine will understand this COVID-19 virus and will develop solutions: mainstream testing, vaccine, treatment, etc. But it will take time.

Staying patient is a must, albeit not an easy posture to assume.

Our office has been closed to in-person treatment since late March. For now, we offer telehealth services when applicable, but – as you know – it is impossible to touch the vagina virtually… We wish we could. Imagine the possibilities.

Also during this shut down period, we have been developing a protocol for the eventual reopening, and have been stocking up on PPE – a household term by now – that will be worn by our staff in protection of us, and you.

Do not hesitate to reach out to us. We continue to be available for support, guidance, and new inquiries.

Stay safe. Be smart. Act responsibly.

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