Does Sex Hurt?

This page talks about Vulvar Vestibulitis, one possible cause of painful sex in women.

At some point in their lives, most women will experience some discomfort or pain with intercourse/vaginal penetration. Often, using a lubricant, finding a more comfortable position, or treating an infection can ease this discomfort.

However, if you are still experiencing pain in the entrance of your vagina, you may have vulvar vestibulitis. If you would like to learn more about vulvar vestibulitis or other causes of painful sex, please speak to one of our counsellors or doctors.

Vulvar Vestibulitis Treatment

There is currently no standard treatment for VV. However, there are many different treatment approaches with varying degrees of success. The following are some treatment options that your VV specialist may discuss with you:

• Applying topical anesthetic (numbing) creams several minutes before intercourse can temporarily relieve pain during intercourse but is not a long-term solution. Women are also advised to use non-irritating, water-based lubricants during intercourse.

• Long-term anti-candida (yeast) treatments used in conjunction with vaginal dilators to desensitize the vestibular areas have shown promising results.

• Some doctors prescribe low dosages of anti-depressant medications to block pain receptors involved in dyspareunia.

• Other doctors prescribe topical estrogen creams, based on the theory that the vestibule may have atrophied due to lack of estrogen (sometimes thought to be caused by low-dose birth control pills).

• Another treatment approach that has shown a high degree of success is biofeedback. Some researchers believe that in patients with VV, the muscles of the pelvic floor (the muscles that hold the pelvic organs in place) aren’t functioning properly. Biofeedback works on rehabilitating these muscles.

• Acupuncture, homeopathy, and other alternative methods of relieving pain may be of benefit.

• As a last resort, some doctors have suggested surgery for their patients to remove some or all of the vestibular area. However, in many cases, relief after surgery is short-lived and the pain that returns is often more severe than before the surgery.

• Finally, it is advised that all patients also receive counselling and/or sex therapy as VV can severely impact on a woman’s feelings of self-worth, their emotional comfort around sex and sexuality, and their intimate relationships with partners.

None of the above mentioned treatments are “cures” but most of them have had at least some amount of success. Some women who found penetration impossible prior to treatment are now able to have intercourse with minimal or no pain. The treatment course that is right for each woman should be decided between herself and her VV specialist.

The following is a list of things women can do themselves to help reduce vaginal irritation:

Allow your vagina to “breathe” by:

• Wearing white, unbleached cotton underwear

• Using 100 per cent cotton menstrual pads or tampons (usually found in health food stores)

• Not wearing pantyhose or stockings

• Wearing loose-fitting pants

• Removing wet bathing suits as soon as possible

• Not wearing underwear to bed

Avoid chemical irritations to the vagina by:

• Not using harsh or perfumed soaps in the vaginal area (Cetaphil, Pears, and unscented Dove are good alternatives)

• Avoiding feminine hygiene sprays, bubble baths, and hot tubs

• Using dye and perfume free detergents when washing underwear

• Rinsing your vaginal area with lukewarm water after washing, making sure there is no soap residue left

• Also avoid exercises that may irritate the vaginal area such as bicycle riding, horseback riding etc.