Re: Middlesex MD Blog

[Heather34]

Hi all. If you haven’t already, I would encourage you to subscribe to this excellent Blog. As written above, they discuss vaginismus and sexual pain but this is just one of the many interesting topics discussed.

I wanted to share one article concerning Assessing Sexual Pain

http://blog.middlesexmd.com/2012/02/16/assessing-sexual-pain/

Excerpts from the article include:

“Secondary and primary dyspareunia may be associated with a myriad of causative factors, including lack of estrogen in the vulvar tissues, vulvar dermatoses, scarring, fissures or adhesions, and psychogenic issues like past or current sexual abuse. One of the most common causes of pain is vulvar vestibulitis syndrome (VVS), also referred to as provoked vestibulodynia (PVD). This is characterized by localized redness, generalized rawness, itching, discomfort at the vaginal opening, and discomfort associated with a gentle cotton swab touch, upon exam, to the glands at the vaginal opening.
Healthcare for the woman with VVS/PVD begins with competent and early diagnosis. Up to half of women are misdiagnosed. Most women are told that their symptoms are psychological, and that they need to “relax” or that they have an ongoing yeast infection. A simple physical examination can usually provide the correct diagnosis. In the “touch test,” vulvar structures like the glands of the vulva are tested with a cotton swab; the woman with sexual pain will often find these touches painful. Touch testing should be performed as part of a thorough pelvic and vaginal examination, including cultures for species identification for yeast (and bacteria, if necessary).
Managing dyspareunia often begins with anti-irritant hygiene regimens: avoiding scents, allergans, and irritants from soaps and other products. Other treatments a healthcare provider may prescribe include topical hormone creams, antifungal therapy, pelvic muscle physical therapy, biofeedback, and/or surgery.
Alternative approaches include use of topical creams like Neogyn vulvar soothing cream, compounded creams containing capsaicin, amitriptyline, cromolyn, atropine, and other therapies such as acupuncture.
Women should be aware that symptoms are not “in their heads,” and that it may take months for pain to diminish. Patience is paramount. Maintaining a physical relationship (other than intercourse) with a partner is important, because “complete intimacy avoidance” can be common among women with sexual pain and can be detrimental to the couple’s relationship.
A relationship therapist can help women—and their partners—coping with sexual problems. Both patients and clinicians can learn more about the condition by visiting the National Vulvodynia Association website at http://www.nva.org”