Posted 11 November 2010 by Dr. Burrows
I know it sounds strange, but it's more common than you might think! In fact, it is so common, that my practice is devoted only to treating women who have pain with sex. As you may have seen, Channel 19 recently did a story (which I was interviewed for) about women who are unable to have sex due to extreme pain.
(If you can't see the video, click here).
The fact is: many women experience a great deal of pain with sexual intercourse. For some women, they have had this pain their whole life, for others, they enjoyed a normal sex life and then developed the pain over time. Either way, pain with sex can be devastating for both the woman and her partner.
So, what can cause pain with sex? There is a condition called "vulvodynia." Vulvodynia means that you have pain in the vulva. It is a condition characterized by pain or hypersensitivity in the vulva and/or at the opening to the vagina. Pain located at the opening to the vagina is called vestibulodynia, which is a type of vulvodynia (all these words that start with "˜v' are confusing, I know!).
Sometimes the pain is constant and sometimes it is "provoked," meaning something has to trigger the pain. For some women, even a light touch can cause severe pain. Often times, the pain presents only when attempting sexual activity and many women are not able to have sexual intercourse due to the pain.
Up to 16% of women aged 18-64 suffer from vulvodynia — it is common! Sadly, 50% will suffer without seeking care and up to 60% will see three or more doctors and suffer on average more than 5 years of pain without receiving a definitive diagnosis. Frequently, women report being told that there is nothing wrong with them or they are made to feel that it is all in their head.
Here are some questions I'm frequently asked about vulvodynia:
What are the symptoms?
Women with vulvodynia often have severe burning, itching, stinging, aching, and a stabbing sensation. But again, some women are just fine, unless they try to use a tampon or have sex.
What causes this?
There is in increasing amount of research showing that there are several causes of this condition.
One cause of vestibulodynia is there are too many pain fibers in the skin at the opening to the vagina. Some women are born this way (congenital). Others develop this condition over time, possibly due to multiple yeast infections or even possibly as a reaction to various topical preparations that they may have applied to the vulva. Other causes that can cause vestibulodynia include spasm or over-contraction of the pelvic muscles, low hormone levels, some types of vaginal infections and vaginal discharge. There are probably other causes of vulvodynia and vestibulodynia and hopefully the causes and treatments will be identified in the future.
Also, anxiety and depression are commonly associated with vulvodynia. Some health professionals consider chronic pain to be a risk factor for developing psychological dysfunction yet others feel that psychological dysfunction contributes to the development of pain. It is not clear, which came first, the chicken or the egg?
What are options for treatment?
There are many treatments for generalized vulvodynia and vestibulodynia. These include oral and topical medications, topical local numbing medications, physical therapy, biofeedback, and psychotherapy.
The National Vulvodynia Association is actively involved in helping women with vulvodynia by supporting research and lobbying efforts. I will be starting some clinical trials here at Summa, so if you think you may have vulvodynia or know someone who does, don't suffer in silence, get help!
Learn more about me and my practice here. Summa's Center for Vaginal and Vulvar Health is located on the Summa Akron City Hospital Campus at 75 Arch Street, Suite 101. For more information, call (330) 762-0954.