Posts Tagged ‘painful intercourse’

Progesterone May Be a Cause of VD-Vaginal Dryness!

April 4, 2013

Vaginal dryness is troublesome condition with many causes.  Vaginal dryness can lead to itching, burning and even painful intercourse.  However, one of the most common causes of vaginal dryness is the use of progesterone in either oral or vaginal suppositories.

Progesterone is a naturally occurring hormone that regulates ovulation and menstruation in women. Progesterone can also be used to regulate the menstrual cycle in women who have too little progesterone to cycle on their own. As with any medication, progesterone vaginal suppositories have the risk of side effects.

Other side effects of progesterone include mild nausea, vomiting, bloating, abdominal cramps, diarrhea, constipation, dizziness, drowsiness and fatigue. Other more bothersome side effects may include pain in the vaginal or rectal area or pain during sex. Some women may experience a reduction in libido. Some women will experience pain, swelling or tenderness in the breasts. Other discomforts can include joint or muscle pain and an increase in urination at night. The suppository itself can cause mild vaginal itching, burning or discharge, according to

In additional to vaginal dryness possible serious side effects include a sudden headache accompanied by numbness or weakness that occurs on one or both sides of the body. These more serious effects paired with shortness of breath, vision problems, speech problems or loss of balance may indicate a stroke or other serious condition. Women should report chest pain, chest heaviness, pain or swelling in the legs, hands, feet or ankles to a doctor. Other serious effects include fever, chills, body aches, flu symptoms, breast lumps, depression, insomnia and mood changes. Some women may experience liver problems with the use of the medication. explains that the symptoms of this include jaundice, clay-colored stools, darkened urine, appetite reduction, low fever or abdominal pain paired with nausea.

ImageBottom Line: Vaginal dryness is an uncomfortable condition “down there”.  The problem may be related to progesterone or to your birth control pills if they contain progesterone.  For more information speak to your physician.

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Dr. Neil Baum is the co-author of What’s Going On Down There-Improve Your Pelvic Health available from

Female Sexual Dysfunction-Women, You Can Be Helped

January 20, 2013

It is of interest that women have just as many sexual problems as men. In the past 15 years, more attention has been given to male sexual problems, mostly erectile dysfunction, as medications have been available for treating this common condition. Now women with decreased desire, decreased lubrication, decrased aroiusal, and lack of orgasm can now be treated.

What Causes Sexual Dysfunction?

Sexual dysfunction in women can be a result of a physical and\or psychological problem.

Physical causes. Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart disease, neurological diseases, hormonal imbalances, menopause plus such chronic diseases as kidney disease or liver failure, and alcoholism or drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
Psychological causes. These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, or the effects of a past sexual trauma.

The most common problems related to sexual dysfunction in women include:

Inhibited sexual desire. This involves a lack of sexual desire or interest in sex. Many factors can contribute to a lack of desire, including hormonal changes associated with menopause, medical conditions and treatments (for example, cancer and chemotherapy), depression, pregnancy, stress, and fatigue. Boredom with regular sexual routines also may contribute to a lack of enthusiasm for sex, as can lifestyle factors, such as careers and the care of children.
Inability to become aroused. For women, the inability to become physically aroused during sexual activity often involves insufficient vaginal lubrication. This inability also may be related to anxiety or inadequate stimulation.
Lack of orgasm. An absence of orgasm can be caused by a woman’s sexual inhibition, inexperience, lack of knowledge, and psychological factors such as guilt, anxiety, or a past sexual trauma or abuse. Other factors contributing to an absent orgasm include insufficient stimulation, certain medications, and chronic diseases.
Painful intercourse. Pain during intercourse can be caused by pelvic organ prolapse, endometriosis, a pelvic mass, ovarian cysts, vaginitis, poor lubrication, the presence of scar tissue from surgery, or a sexually transmitted disease. A condition called vaginismus is a painful, involuntary spasm of the muscles that surround the vaginal entrance. It may occur in women who fear that penetration will be painful and also may stem from a sexual phobia or from a previous traumatic or painful experience.

The diagnosis of female sexual dysfunction begins with a physical exam and a thorough evaluation of symptoms. The doctor performs a pelvic exam to evaluate the health of the reproductive organs and a Pap smear to detect changes in the cells of the cervix (to check for cancer or a pre-cancerous condition).

An evaluation of your attitudes regarding sex, as well as other possible contributing factors (such as fear, anxiety, past sexual trauma/abuse, relationship problems, or alcohol or drug abuse) will help the doctor understand the underlying cause of the problem and make appropriate treatment recommendations.

Treatment of Female Sexual Dysfunction

Most types of sexual problems can be corrected by treating the underlying physical or psychological problems which include:

Providing education. Education about human anatomy, sexual function, and the normal changes associated with aging, as well as sexual behaviors and appropriate responses, may help a woman overcome her anxieties about sexual function and performance.
Enhancing stimulation. This may include the use of erotic materials (videos or books), masturbation, and changes in sexual routines.
Providing distraction techniques. Erotic or non-erotic fantasies; exercises with intercourse; music, videos, or television can be used to increase relaxation and eliminate anxiety.
Encouraging non-coital behaviors. Non-coital behaviors (physically stimulating activity that does not include intercourse), such as sensual massage, can be used to promote comfort and increase communication between partners.
Minimizing pain. Using sexual positions that allow the woman to control the depth of penetration may help relieve some pain. Vaginal lubricants can help reduce pain caused by friction, and a warm bath before intercourse can help increase relaxation.

The success of treatment for female sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a treatable or reversible physical condition. Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners.

Hormones play an important role in regulating sexual function in women. With the decrease in the female hormone estrogen that is related to aging and menopause, many women experience some changes in sexual function as they age, including poor vaginal lubrication and decreased genital sensation. Low levels of the male hormone testosterone also contribute to a decline in sexual arousal, genital sensation, and orgasm. Women can use a topical gel containing testosterone or receive a small pellet of testosterone, the size of a grain of rice, placed under the skin which can result in enhancement of their libido and sex drive.

Many women experience changes in sexual function after a hysterectomy (surgical removal of the uterus). These changes may include a loss of desire, and decreased vaginal lubrication and genital sensation. These problems may be associated with the hormonal changes that occur with the loss of the uterus. Furthermore, nerves and blood vessels critical to sexual function can be damaged during the surgery.

The loss of estrogen following menopause can lead to changes in a woman’s sexual functioning. Emotional changes that often accompany menopause can add to a woman’s loss of interest in sex and/or ability to become aroused. Hormone replacement therapy (HRT) or vaginal lubricants may improve certain conditions, such as loss of vaginal lubrication and genital sensation, which can create problems with sexual function in women.

I think it is important to mention that some postmenopausal women report an increase in sexual satisfaction. This may be due to decreased anxiety over getting pregnant. In addition, postmenopausal woman often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

Bottom Line: Many women experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the women and her partner, and can have a negative impact on their relationship. If you consistently experience these problems, see your doctor for evaluation and treatment.

For more information on women’s health, I suggest my new book, What’s Going On Down There-Everything You Need To KnowAbout Your Pelvic Health. the book is available from

New book on women's health

New book on women’s health

Vaginal Dryness-Another “VD” You Don’t Want To Have

July 2, 2011

For most women sex is fun and enjoyable.  However, if there isn’t enough lubrication and the vagina is dry like the desert, sexual intimacy can be excruciatingly painful with fun placed on the back burner.   It’s especially frustrating when the natural vaginal lubrication a woman is used to “dries up,” making it so much more difficult to enjoy what is one of life’s greatest pleasures— sex after 50!   In spite of the list of physical changes from aging, studies have shown that sexual satisfaction increases, rather than decreases, as women grow older. This article will provide suggestions to fix the problem and help restore vaginal lubrication to its former friction free status that makes intimacy something to look forward to rather than to avoid.

Why women experience vaginal dryness

Menopause is results in a loss of estrogens and this can create more than hot flashes.  This condition that affects every woman in her late forties and early fifties also results in less natural lubrication as the woman ages, resulting in vaginal dryness and dyspareunia, a medical term for post-menopausal thinning of your vaginal walls resulting in painful intercourse.  You are not alone as one in four post-menopausal women experiences pain, either before, during and after sexual intercourse. Unfortunately, many are embarrassed to discuss female dryness and intercourse pain, either with each other or with their gynecologist. It’s time to get over that fear. Every woman experiencing intercourse pain after 50 should seek a doctor who is skilled in vaginal examinations, and one who isn’t afraid to ask you everything you need to know to help you address this pain.

The solution isn’t always at the tip of a pen with a prescription written by your primary care doctor or your gynecologist.  There are several over the counter remedies that will put the slippery back into the bedroom activities.

Liquid Silk is topical cream used by many postmenopausal women for overcoming vaginal dryness.  Another is Carrageenan, which has no smell or taste.  A popular solution is Replens, which is a unique, estrogen-free vaginal moisturizer. It has the advantage of being long-lasting as one application can last three days and women can use it two or three times per week. As a result there is more spontaneity with sexual intimacy and the woman need not excuse herself to apply the cream when the opportunity presents itself. Astroglide’s name says it all as it does make things glide and slide.  Women find this topical gel a nice companion to their toys and accessories.  A little dab and a little water works just great.   OH! Is the name of a product which can fuel the fire down there in a gentle, sensual way.  And finally, don’t over look the ol’ standby, K-Y Jelly, mother of all vaginal lubricants.  It’s inexpensive, effective, and now comes with more exciting names such as Silk-E and His and Hers. For those women who are reticient about requesting these products at the local drug store, you can buy them online at:,, or

Getting started.  Suppose you may have purchased vaginal lubrication, or you may tried several out and found one that fits your fancy, how do you present this option to your partner.  Two suggestions: First, invite your partner to apply the lubricant. Seeing how it works will probably turn him on, too, and encourage him to make it part of your sex play.  Second is to try using some of the cream or ointment on him during foreplay. The way your hands will slide should make a believer out of him. If he is still resistant and I doubt he will be, try putting some lube on your inner lips of your vagina when you are planning to have sexual intimacy.

First line therapy consists of the vaginal lubricants just described.  However, if lubrication isn’t enough, there are other options usually consisting of vaginal estrogen therapy, which I will discuss in greater detail in a following blog.

Bottom line:  While female dryness which develops at the time of menopause can result in painful intercourse, the good news is that effective treatments exist for vaginal dryness and dyspareunia.