One of life’s greatest pleasures is intimacy with your partner. Nothing can put the ice on that relationship faster than when there is pain and discomfort for either a man or a woman associated with sexual intimacy. This article will review the most common causes of vaginal pain and what can be done to make the ouch go away.
The itching, burning, and pain associated with vaginitis results from a disruption in the natural balance of bacteria that live in every healthy vagina. There’s no single cause. Common culprits include hormonal changes due to birth control, menopause, or pregnancy as well as chronic medical conditions, such as HIV and diabetes, which weaken the immune system. Frequent sexual intercourse and sex with multiple partners can be to blame as well. Bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age. Women with BV may have a copious, thin grayish-white discharge. BV is easily treated with oral or vaginal antibiotics.
Yeast infections are caused by the overgrowth of one of several strains of Candida, a fungus that lives normally in the vagina. Women may notice a thick white discharge with a slight odor. However, many women complain of genital itching, soreness, or irritation. Treatment consists of a vaginal cream or an oral antifungal medication, Diflucan.
Treatment is painless and easy; most women simply insert at bedtime a prescribed cream or an ovule (a soft suppository) — generally soothing but messy — or they can take a prescription oral antifungal such as Diflucan. You’ll avoid the mess, but relief might take a few days longer.
Atrophic vaginitis is a result of a decrease in estrogen levels and the lining of the vagina becomes thin and easily irritated. Treatments such as estrogen creams or a vaginal estrogen ring can help.
Trichomoniasis, a sexually transmitted infection, can cause a greenish-yellow frothy discharge, with some itching and burning. This infection is easily treated with oral or vaginal antibiotics.
Vulvodynia is a condition where the pain so severe you can’t sit comfortably let alone have intercourse. The cause is unknown, but possible contributors include injury to nerves in the vulva, hypersensitivity to Candida, and pelvic floor muscle spasms. Treatment options include estrogens, oral antifungal medication, topical steroid creams, and physical therapy to loosen the muscles causing the spasms.
This is a rare condition that fewer than 2% of women, which causes the muscles surrounding the vagina to contract so tightly that a woman can’t have sexual intercourse or even insert a tampon. The cause is unknown, but like vulvodynia, vaginismus responds to physical therapy. Now doctors are using Botox to relax the muscles and prevent spasms for up to six months.
Stress incontinence occurs when there’s increased pressure or stress on the bladder or lower abdomen, such as when sneezing, when coughing, or during intercourse. This is a source of great embarrassment to a woman who loses urine during sexual intimacy. The cause is usually due to multiple vaginal childbirths, estrogen deficiency, obesity, and chronic constipation with the chronic straining to have a BM.
The easiest solution is for a woman to use the bathroom prior to sexual intimacy in order to empty her bladder. Kegel exercises can help build up the pelvic muscles that support the bladder and the urethra. Now there are minimally invasive surgical procedures that can help restore continence that can be done on an outpatient basis with immediate results.
Bottom Line: If you think you have any of these, see your doctor. Over-the-counter creams will often make the problem worse. The diagnosis is easily made in the doctor’s office and treatment can begin immediately and you will put the icing back on your sexual cake.