Vulvodynia and Painful Sex

We have had a lot of questions lately about different causes of painful sex and what causes ongoing pain around the vagina and mons pubis area. This is a difficult condition to deal with and can be just as debilitating as endometriosis and chronic dysmenorrhea.

Vulvodynia is chronic pain in the area around the opening of your vagina for which there is no identifiable cause. The pain, burning or irritation associated with vulvodynia may make you so uncomfortable that sitting for long periods or having sex becomes unthinkable. The condition can go on for months or years, but it can vanish as suddenly as it started. Vulvodynia can have a huge impact on a woman's life. It can impair her ability to have sex, exercise, socialize or work.

The pain you experience may be constant or intermittent. You may feel the pain in your entire vulvar area (generalized), or it may be localized to a certain area, such as the opening of your vagina (vestibule). A similar condition, vulvar vestibulitis, may cause pain only when pressure is applied to the area surrounding the entrance to your vagina.

Many women with vulvodynia have a history of treatment for recurrent vaginitis or vaginal yeast infections. Some women with the condition have a history of sexual abuse. But most women with vulvodynia have no known contributing factors. Vulvodynia isn't sexually transmitted or a sign of cancer.

Vulvodynia treatments focus on relieving symptoms. No one treatment works for every woman, and you may find that a combination of treatments works best for you. It may take weeks or even months for treatment to improve your symptoms noticeably.

So what causes it in the first place? Where does it come from and how does it start? Doctors and researchers have found an association in women that have had:

• Previous nerve injury or irritation.
• Abnormal response of vulvar cells to an infection or trauma
• Genetic factors that make the vulva respond poorly to chronic inflammation
• Hypersensitivity to yeast infections
• Muscle spasms
• Allergies or irritation to chemicals or other substances
• Hormonal changes
• History of sexual abuse
• Frequent antibiotic use

Some of the most common symptoms of vulvodynia are:

• Burning, stinging or rawness
• Aching, soreness or throbbing
• Painful intercourse (dysparunea)
• Itching

There are some things you can do to help yourself get through flare ups, and some things you definitely want to avoid. I've listed a few here for you.

• Always wear 100% cotton panties during the day and no panties at night
• Avoid use of tight fitting clothing and pantyhose
• Use unscented toilet paper that’s soft and white, or unscented baby wipes
• Avoid getting shampoo on the vulvar area.
• Avoid perfumed creams or soaps, pads or tampons, and contraceptive creams or spermicides
• Avoid foods that make urine more irritating; this may include foods such as greens, beans, berries, chocolate or nuts
• Cleanse with natural emollients like olive, grape seed, or almond oil and plain water
• Avoid douching
• Use natural lubricants during intercourse and avoid products with propylene glycol
• Cleanse or dab the vulva with cold water after urinating
• Apply ice or gel packs to area prior to or after having intercourse
• Topical anesthetics that contain lidocaine or capsaicin applied 30 minutes prior to sex or any activity that could trigger vulvar pain will numb the affected area (avoid cortisone topical steroids); this can be used instead of ice.
• Avoid activities that put direct pressure on the vulva; this includes bicycling and horseback riding
• Use a donut pillow when sitting for long periods of time
• Avoid hot tubs and pools that are chlorinated
• Soak in lukewarm or cool baths
• Topical heat applied with a heating pad can reduce pain for some women
• Some antidepressant and anti-seizure medications are known to have pain-reducing qualities
• Trigger-point injections of steroids or Botox
• Patients who see a physical therapist who is experienced in treating women with vulvodynia can see marked improvement in symptoms after a series of sessions; the therapist works on stabilizing muscle tone to improve contraction strength and structure of pelvic floor muscles, which can be a potential trigger for pain
• Relaxation techniques
• Biofeedback, cognitive and behavioral therapies (CBT) and supportive talk psychotherapy can help patients develop self-regulation strategies to cope with the pain and psychosocial distress that can accompany Vulvodynia
• And, as a last resort, surgical procedures (perineoplasty or vestibulectomy) remove tissue that is causing the pain

I hope this helps all of you who suffer with this. Don't forget, because WaterWorks is an FDA-cleared, all natural product that uses no chemicals, it is a wonderful way to ensure excellent feminine hygiene. WaterWorks uses plain water and can be used externally and internally for cleansing. You will love it and not want to travel without it.

Read more...

What Is Causing My Pain ‘Down There’?

Imagine vaginal burning and pain so severe you can’t sit comfortably, wear tight clothing or have sex. That’s the reality women with vulvodynia face, and although many of us would like to have a push-button answer to the problem, the human body does not function this way.

Why so many women suffer from pelvic pain during their cycles, during sex and some almost every day has puzzled many researchers and clinicians for years. There are a wide variety of reasons women can experience pain and problems.

Vulvodynia is a debilitating, difficult to treat, often incurable problem that causes extreme sensitivity of the vulva and vaginal labia. Possible contributors include injury to nerves in the vulva, hypersensitivity to candida (yeast) or other fungal and bacterial infections At times, the pelvic floor muscles spasm, causing throbbing and sensitivity to the slightest touch or pressure.

Some partially successful treatments have included the use of tricyclic antidepressants (to block pain receptors in the vulva), topical estrogen or lidocaine gel, and even surgery. Surgery is an extremely radical approach and requires removal of vulvar tissue in hopes the grafted tissue will cure the pain Capsaicin cream is a newer treatment that has to be specially compounded (and which contains the active ingredient in chili peppers), but has been shown to dramatically reduce symptoms.

If a woman’s condition is flared by a candida (yeast) hypersensitivity -- to which even a slight imbalance can cause itching and burning -- weekly doses of an oral antifungal medication over several weeks or months can help alleviate symptoms.

Some treatments for painful sex in women do not require medical intervention and can be treated safely at home - by using personal lubricants with intercourse, allowing injuries & surgical incisions to heal completely after surgery or childbirth, and simple patience and rest. Sometimes with vaginal pain due to menopause, excessive dryness after childbirth, or infections like yeast or bacteria, it may require a prescription from your physician. And, there are actually physical therapists that specialize in pelvic floor muscles that can help to alleviate the pain of pelvic organ prolapse.

Another condition, vaginitis, is caused from a disruption in the natural balance of bacteria that live in every healthy vagina. Vaginitis usually refers to bacterial vaginosis and yeast infections that can cause unbearable itching, burning, pain and/or odor for many women. It can re-occur several times per year.

There is no single cause for vaginitis, and it is not considered sexually transmitted. Common causes may include hormonal changes due to birth control, menopause or pregnancy, as well as chronic medical conditions, such as HIV and diabetes, which weaken the immune system. Frequent sex can also be a big cause of recurrent vaginitis, due to the sugary, alkaline solution surrounding the sperm which disrupts the acidic environment of the vagina. This creates a perfect environment for bacteria and yeast to flourish. Recurrent infections can cause chronic pain in women. Treatment is painless and easy - most women simply insert a prescribed cream at night or take a prescription oral antifungal or antibacterial.

Atrophic vaginitis is thought to be a problem of menopause. The term describes the dryness, vaginal wall thinning and shrinkage, and paleness of tissue due to lack of estrogen. Urinary incontinence can go hand in hand with this. Many of you have experienced this with childbirth and breastfeeding, due to the hormone changes which are similar to menopause. This condition can feel like an infection, with burning, itching, and pain, but no active fungus or bacteria is found. Treatments such as estrogen creams or oral estrogen therapy can help.

Some women suffer from another condition called lichen dermatoses, which is a condition that can lighten and stiffen the tissue in the vulva and can cause severe itching and scar formation. A mix of topical steroids with a tiny dab of estrogen can help heal the damage to the vulvar tissue and decrease symptoms.

Vaginismus is a rare condition (affecting fewer than 2% of women in the United States) in which the muscles surrounding the vagina involuntarily spasm so tightly that you can’t have sexual intercourse or even insert a tampon. The specific cause of vaginismus is unknown, but, as with vulvodynia, physical therapy can be a successful treatment.

Physical therapists who specialize in pelvic floor disorders can correct structural abnormalities and design a manual therapy and exercise program that will retrain pelvic muscles that are too tight or too weak, depending on the condition. Their efforts can dramatically reduce symptoms without the side effects of medication. They also teach women the proper way to perform techniques at home, with dilators and their own fingers, to gently stretch and massage the muscles. If a woman’s symptoms persist despite physical therapy, a doctor can inject Botox to paralyze muscles and prevent the spasms for up to six months. Other (older) treatments that have been successful for vaginismus include sex therapy medications such as Valium and hypnotherapy.

Fibroids affect about 77% of women, but most don’t realize they have them. In some cases, there are no symptoms, but some women can develop cramping, excessive bleeding during menstruation, and painful intercourse. The growth and development of these uterine tumors are rarely cancerous, in fact less than 0.01% of the time. Fibroids may shrink naturally after menopause. Treatment options vary and usually have a lot to do with a woman's age and desire for future childbearing.

Hysterectomy is one option, but if you have a desire for future fertility, it is possible to have only the fibroids removed, leaving the uterus and ovaries intact. There is also a procedure called uterine artery embolization, which cuts off the blood supply and forces the fibroid to shrink, however this may compromise future ability to have children, as it compromises blood flow to the uterus.

Genital Herpes is a disease caused by the herpes simplex virus (HSV), of which there are two types. Type 1 (HSV-1) usually causes oral herpes, an infection of the lips and mouth. Symptoms are commonly known as cold sores or fever blisters. In the past, HSV-1 was not known to cause genital lesions, but that is changing, and we now know oral herpes can be passed to the genital area via oral sex. Genital herpes is caused by the second type of herpes virus (HSV-2) and reoccurs more often - causing more distress to the person who has it. Chronic herpes infections can be a cause of persistent pelvic pain and painful intercourse.

Read more...