An interview with a woman who saw an obstetrician about pain during sex and came away with not only solutions to her pain but a new relationship with desire as well.
This post is part 4 of the series: Improving Intimacy
Part 1: How to Agree on How Often to Have Sex
Part 2: Waiting for Sex Until Marriage- Can I Really Do It?
Part 3: A Therapist Answers Your Questions About Sex Part I
I’ve received FOUR emails now asking me to address pain during sex. I’m hearing you. I have a friend who experienced this, went through multiple treatments for it and finally got it all figured out. And she figured out how to enjoy sex in the process! Win win.
She has very nicely allowed me to interview her. The following are some question/answer snippets from our two hour conversation 🙂 This post is divided up into four sections: “My story,” “Pain During Sex,” “My Relationship With Desire” and “Advice.” -Celeste
Celeste: “Can you walk me through how you decided to go to a doctor?”I had been married four or five years. We had sex regularly, like 2-4 times a week, but I was never the high-desire partner. I didn’t really look forward to or enjoy sex. It was always a little painful, but I knew it was something that made our relationship stronger.Four or five years into marriage, I ended up needing to see my family doctor about a strange rash I had in my perineum area. My doctor couldn’t figure out where it came from.
Luckily, my husband and I know quite a bit about the medical system and how to navigate it, so I did my research and found an obstetrician (OB) in the area who specialized in dyspareunia (painful sex) and vulvadynia (pain in the vulva area).
So, this OB I saw really knew what he was talking about. The rash ended up being caused from complications with my birth control. It went down, but even then I still had more pain than usual with sex.
I went to him initially for my pain in the vulva area, but he ended up changing my relationship with sex entirely.
Pain During Sex
Celeste: “You mentioned sex was always a little painful for you? Did you ever think before your rash that pain during sex was a big enough problem to see a doctor about?”
You know, I didn’t. I thought it was bearable enough. I didn’t have any reason to think it was abnormal. We didn’t know it could be any different. But it can be!
Celeste: “Can you give us an overview of your treatment?”
So with painful sex there are lots of pieces to the puzzle.
- Some of it can be infection (which aren’t just from STDs – birth control, like my Nuva ring, can cause infections)
- Another piece is nerves over-firing. There are some medications to help tone that down (some creams, others were pills).
- Another piece was muscle tension. That’s where physical therapy, myofascial release, and using a vaginal dialator came into play.
- The last sort of piece of the puzzle is your anatomy. Turns out there are some glands around the opening of the vagina, and mine were chronically and super inflamed. We were able to get that inflammation down with all of the above treatment, eventually though I had to have a surgery to have them removed.
Celeste: “There are physical therapists who specialize in pain during sex?”
There are physical therapists who specialize in every type of muscle group! Mine, who my OB recommended, specializes in pelvic floor muscles, whether they’re too tight (like mine) or too loose (causing things like incontinence). It can be really helpful for women to know how to relax their pelvic floor muscles to make sex feel good. Though there can be mental issues that contribute to that too.
Celeste: “Wow, so you took pills, had creams, went through physical therapy and had a surgery?!? That’s a lot! Was it worth it?”
Yeah, way more then I was bargaining for, but yes it was worth it! We finally figured out how to make sex feel awesome for us and we grew a lot as a couple.
Also, it was very empowering to learn all about my body through this process. Before this, I had never even held a mirror to my nether-region. After this experience, I knew all about my anatomy- what it looked like, what it felt like, what it should feel like and how to use it to have wonderful sex. I also learned about my own body and how I climax (which is good to know!).
My Relationship with Desire
Celeste: “So, you went in to your OB with a rash and came out with a better sex life?? How did that happen?”
So I will say, the initial appointment was pretty embarrassing. We had a chat in his office with my husband there. I wasn’t used to talking about my sex life with someone other than my husband or close girlfriends. I’m from a fairly conservative culture when it comes to sex. He asked me:
- what my best sexual experience was (couldn’t really say – maybe my first time?)
- when I first had sex, (my wedding night at 21) – he looked a bit dubious when I said that
- on a scale of 1-10 what my pain level was with sex (before the rash always at least a 2 or 3)
- if I had ever had an orgasm (maybe I don’t know?) “That means you haven’t had one,” he said
He said that over the course of treatment my husband and I would need to figure out to get me to have orgasms. However, in the state of pain I was in, that wasn’t in the near future. He needed to help me get my pain under control.
Celeste: “Wow. How did you feel about your OB talking to you about orgasms? That probably wasn’t what you expected.”
Not. At. All. I was totally embarrassed.
Celeste: “Were you on board to try new things or pretty hesitant?”
Well, we had time because I was actually prescribed no sex for a period of time until we could get my pain levels under control. But I’m glad he brought it up at the first appointment. It gave me time to understand that how I had been experiencing sex could be much different. And more pleasurable for me.
It also opened up conversation between my husband and I. Since we’re very familiar with the medical field, we started reading journal articles in sexual health journals (yes those exist). And they were very eye-opening.
Celeste: What did you learn?
Just learning all the medical aspects of physical pleasure for women was instructive for me; and to be able to do that in an environment that felt “safe” (ie not pornographic or demeaning to women).
I learned that a woman getting to an orgasm is harder than for a man. And that many women need vibrators or other things to help get the stimulation they need. Also a woman’s emotional and mental state really plays a role as well. What I’m thinking about during sex will play a role on whether or not I can have one. The more I learned about it, the more I was like, “Huh. Sounds like sex could be way more awesome for me.”
I felt more empowered to embrace that side of myself.
Celeste: How did your husband feel after that first appointment?
He was relieved there was something to help me. We tried having sex once or twice during this intensely painful period. We had to stop because I was in tears it hurt so bad.
Also he felt sad that there had been such an imbalance in sexual pleasure in our relationship. We’d been married a few years! He really wanted me to be able to feel great during sex too.
His response surprised me since I hadn’t given my sexual pleasure all that much thought. Sex shouldn’t be just pain-free for me. It could be really pleasurable.
He was in my corner. We were going to figure out how to make that happen.
Celeste: “What would you say to girls who are in pain during sex?”
First off, see a doctor. Second off, see the right doctor. Find a specialist! This is SO commonly misdiagnosed. A quote from the National Association of Vulvodynia (NAV):
A recent Harvard study showed that as many as six million American women suffer from vulvodynia. Almost 60 percent of patients report visiting three or more health care providers to obtain a diagnosis and an astounding 40 percent remain undiagnosed. This study also reported that 40% of women with painful symptoms did not even seek medical care. Some women incorrectly assume that some level of discomfort or pain with intercourse is normal, while others may be hesitant to discuss painful symptoms with their health care providers for many reasons.
Those are huge percentages of women who either go undiagnosed after seeing a doctor or do not seek medical care at all! If you are not happy with your doctor’s answers, do your research and find someone who specializes in dyspareunia and vulvodynia. And lucky for you, the NAV has a list of doctors who specialize in this across the USA here.
Celeste: “How painful would you say it should be before you see a doctor about it?”
It shouldn’t be painful at all!! If you’ve been having sex for some length of time and it is still painful, there are so many specialists and doctors out there whose job is to help you! Find them and get help!
Celeste: “So, you mention that you never really saw a problem with your sex life for four or five years even though you never really enjoyed it. What would you say to women who similarly don’t really enjoy sex, but don’t really see a problem with that?”
Good question. I think this includes a lot of women. I would say, do some digging into why you don’t enjoy sex. Low libido? Too tired? Pain? Need more help around the house? Feeling pressured?
Try to address as many of those issues as possible. Then, I would say experiment a little. My own physical pleasure is not something I would have ever prioritized if I hadn’t seen that obstetrician, but I’m shocked at the positive impact it has had on me. You never know how a better sex life will improve your life and marriage until you prioritize it and try new things!