Vestibulodynia

In 2007 I was diagnosed with vestibulodynia. I had had pain during penetration since I first started having sex at the age of 16 and a year later even inserting and removing tampons was painful and sex had become temporarily impossible so I saw a gynaecologist who, after ruling out thrush and sexually transmitted infections and had biopsied the skin to check for another suspected condition, diagnosed me with vestibulodynia.

Vestibulodynia is a condition causing pain during the touching and pressure of skin where the vulva (the external part of the female genitalia) meets the vagina (the internal cavity). It's an area of high sensitivity anyway, so the increased sensitivity of vestibulodynia can cause a lot of pain. Sufferers can have pain just from light touch of the area and walking and sitting can become uncomfortable. 

The condition is usually caused by a nerve problem - nerves may be overly sensitive or register pressure as pain by mistake. For myself, vestibulodynia is likely caused by the chronic joint pain condition I suffer as a result of faulty connective tissue which makes the skin sensitive as well as damaging the nerves.

Treatment for vestibulodynia varies from patient to patient and from doctor to doctor so I thought I'd summarise what works for me both physically and mentally - because losing the ability to have sex can be quite traumatic!

• Pelvic floor muscle or kegal muscle exercises - if the pain is persistant these exercises goes some way to preventing the natural response of the muscles to the pain - tensing. This tensing increases the pain experienced during penetration and can be avoided using a simple routine of exercising the muscles twice daily.These exercises teach the muscles how to relax again. To do this, clench your pelvic floor muscles (those you use to stop pee mid flow) really tightly and hold for ten seconds, then release and relax for ten seconds. Repeat this ten times twice a day preferably in a calm and relaxed situation and laying down. 

• Vaginal dilators - these can be used to get the vaginal entrance used to being stretched and touched. In England you can get dilators given to you by your gynaecologist. These are a set of three or four hard plastic tubes in varying sizes from teeny to quite large. These should be used daily with a little lubricant (such as this slick and good value lube from Durex which you can get in many shops that sell condoms etc. or online).

• Soap - skin sensitivity can only exacerbate the problems caused by vestibulodynia so using only warm water to clean your bits is advisable however if you really must use soap - go for the Simple brand which you can get almost anywhere (I recommend Home Bargains for cheapness!) and is very gentle on the skin. If you bathe rather than showering avoid using detergents on your bath (or rinse really, really well) and avoid bubble bath. Using Simple baby wipes to freshen up rather than washing excessively is a good idea as excessive washing can be very drying.

• Long foreplay and regular "stretching" using small toys and fingers before sex - this one's pretty self explanatory. Take your time. Build up to the "main event" slowly and increase your tolerance. Testing the water with a small sex toy can give the added benefit of seeing how the pain is on that particular occasion rather than only discovering it's a "bad day" half way through him entering you.

• Condoms - if your partner is on the large size and you're using another form of contraception, using a condom that's slightly too small can make him more streamlined - but you must only do this if you're using another form of contraception and are safe from STIs as the risk of the condom breaking is increased if the size is wrong.

• Foreplay as the main event - whilst we're talking main events, penetrative sex isn't the be all and end all! You will do yourself a huge favour if you get your head round the idea that sex isn't just about penetration - it's also about oral and intimacy, touching and enjoying each others body's! If you can't get his penis inside your vagina it's not the end of the world as long as you're both having a bloody good time! Just enjoy yourself and don't stress yourself with unnecessary pressure. And talk to your partner - chances are your partner is more than happy with a good oral session!

• Relax, relax, relax - easier said than done, but absolutely crucial to a happy sex life.

•  Don't always orgasm - take the pressure off! You don't have to orgasm if you don't want to. If it's painful it'll be the last thing on your mind so focus on getting some enjoyment from every session and the orgasm being a bonus!

• Slow sex - it's so important to take your time during the initial penetration, ease the penis inside slowly and pause anytime you need to. Once he's inside, make him stay still and do a few kegal exercises around him to remind your muscles to relax then proceed slowly - chances are, if you get this right, the pain will improve and you can speed up again soon after.

Other treatments available include local anaesthetic creams to be applied prior to sex and the referral to a sexual therapists in cases where the condition persists for a long time and is impacting on the sexual relationship. Tricyclic antidepressants can also be prescribed which work as pain modifiers in low doses.

It is important that if you are in a relationship or having sex during a period of vestibulogynia that your sexual partner is aware and understanding of the condition and that you work together to take sex at the right pace for you to allow enjoyment. Whilst it may be tempting to stop sex all together, whilst penetration is possible with modifications it is sensible to try and continue and try not to feel to scared (which can make the problems worse) however it is also important to recognise when a sex break is required and take good care of your sexual health by listening to your body.

For many sufferers of this painful condition, the symptoms improve with time and normal sex can resume but some patients suffer for a long time and must work with their partner and doctor to find a regime that suits them best making sex possible and enjoyable again.

 

If you think you may have vestibulodynia, see your doctor about a referral to a gynaecologist! Having seen countless gynaecologists over the past few years I can assure you it's rarely as bad as you think it will be, they've seen it all before and know how to keep you calm. There are many causes of pain during sex and many are very treatable. The cause needs to be identified to rule out risky STIs or other nasties which can cause major complications if left unchecked so get to your GP with any pain during sex!

Happy sexing!

Alicia <3

P.s. I've written this with a heterosexual relationship in mind but all the rules apply to other relationships too (well gay male relationships won't have vestibulodynia problems ;) but you know what I mean). Just substitute penis for dildo or strap-on and you're away.

P.p.s I'm seeing a gynaecologist soon to work out why my pain has increased lately (possibly medication relation) so if I have anymore tips from the appointment I will update this post!