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Jun 14

Ask Dr R: Glamour reader asks -What to do when Sex Hurts!

I recently read an article you were featured in for Glamour magazine and sparked me to find out more about your practice.  I am a 25 y/o female in a committed, sexual active relationship.  With past partners I have experienced vaginal pain during intercourse and this partner is no exception.  No matter how much foreplay, lubrication, positions, etc we try, I still experience pain.  I want to be able to enjoy sex with my boyfriend, but it’s hard to do when it is physically painful every time.  Help!

 Dear Glamour reader,

Your symptoms can be treated – the trick is to figure out how many issues are contributing, and how best to formulate your personal recipe for successful resolution of your sexual pain. For instance, if stiff levator (Kegel) muscles are part of the problem, it is important to figure out if the muscles are the cause of your symptoms, or if the muscles are stiff and sore because of another source of pain in or around the vagina that also hurts, with the muscles reacting to the pain and then themselves becoming a secondary source of pain. Confused yet?

You may have vestibulitis, you may have vaginismus, you may have a urethral diverticulum, you may have yet another urogynecologic condition contributing to your pain. The key to successful treatment is evaluation and management by the right team, which may include a gynecologist who specializes in vestibulitis, a urogynecologist, a pain management anesthesiologist, and a pelvic floor physical therapist.

If you’re in a large metropolitan area, this mix of clinicians will be easy to find, time consuming, but easy. If you are in an area without a lot of specialists, you may need to travel to get the care that you need to put your pelvic life on a normal track.

Most importantly, it is NOT in your head. (It’s in your vagina) Be tenacious. Screen the offices over the phone with questions like “Does Dr. XYZ take care of patients with sexual pain, vestibulitis, levator hypertonus and vaginismus?” If the answer is yes, GO THERE.

Thanks for sharing your story.  Please keep us posted.

Dr R

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