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Vulvodynia Treatment: Causes, Symptoms & Care
Are you looking for a vulvodynia treatment that works? For years, you've tried everything to reduce the burning and stinging associated with vulvodynia, but haven't been able to find relief. You're not alone. Eight percent of all women afflicted with vulvodynia never find a cure for that pelvic pain. While 8% may not seem like a large number at first, it translates into over 13 million women in the United States having to bear the vulvar pain of vulvodynia. (1) Vulvodynia places a significant hardship on emotional wellbeing, society, the health care system, and significant others. In this article, we'll discuss vulvodynia treatment, causes, symptoms, and care to relieve pain for the millions of women suffering in silence. What is vulvodynia? According to the National Vulvodynia Association, vulvodynia is chronic pelvic pain in the vulva with no known etiology for three months or longer. (2) Women with vulvodynia report varying levels of chronic pain in different places in the vulva. In some cases, women experience pain solely in one area of the vulvar tissue, referred to as localized vulvodynia. The specific pain points may include the external genitals like the clitoris or the vestibule (vaginal opening). Generalized vulvodynia is when the pain occurs on the entire vulva. The severity and constancy of the pain varies, too. It can be chronic, during certain activities such as sexual intercourse or when applying pressure while inserting a tampon. Also, the pain can be present with or without touch. When discussing the pain with their health care professionals, women often don't report it as pain, but rather as stabbing, rawness, burning, itching, and tearing. How is vulvodynia treated? The American College of Obstetricians says vulvodynia treatment should be individualized and can be treated by one or more of the followings ways: (3) pelvic floor physical therapy with vaginal dilation medications including oral, topical, and injectable biofeedback training dietary changes sexual counseling cognitive behavioral therapy surgery Relieving pain with vaginal dilation The American Family of Physicians states that physical therapy may help relax and strengthen pelvic muscles. (4) Vaginal Dilator Therapy is a type of physical therapy that uses vaginal dilators to treat and cure vulvodynia. In a clinical trial by the Physician Care Clinical Research, 80% of all women reported less pelvic pain using VuVa™ magnetic vaginal dilators. VuVa™ magnetic vaginal dilators help stretch and lengthen the vagina naturally. Each dilator has Neodymium magnets that help pull fresh oxygenated blood to pelvic floor muscles and surrounding nerves. It creates a positive energy field that draws out any acidity in the pelvic floor. The nourishing energy rejuvenates the nerve endings to promote faster healing while soothing pain. Over 30,000 women around the world, suffering from vulvodynia and other pelvic pain conditions, have found relief with VuVatech vaginal dilators. The pelvic floor physical therapy happens in the privacy of your home without a physical therapist, at a pace that works for you. What are the causes of vulvodynia? The exact cause of vulvodynia is unknown. It isn't caused by an underlying condition, such as a sexually transmitted disease, skin disease, or cancer. Each woman is different, but the following factors increase the risk of vulvodynia. It's also essential to remember that one or more of these factors may be working together. (5) Inflammation and tenderness in the vulva Damaging and weakening of the vulva nerves Genetic predisposition Environmental allergic reactions to certain foods or chemicals Long-term exposure to infection or trauma Hormonal changes due to menopause or birth control Debilitation of the pelvic floor muscles Provoked vestibulodynia may occur from having sexual activity, a pelvic exam, and prolonged sitting. Horseback riding and wearing tight clothing may also "provoke" the pain. Other risk factors include undergoing pelvic radiation therapy. Pelvic radiation therapy is a treatment for women with certain types of cancers, including the breast and cervix. The process can cause painful scarring and shortening of the vagina. When this happens, the vaginal tissue becomes thin, dry, and tight. What are the symptoms of vulvodynia? Vulvodynia symptoms vary from person to person, but characteristics include an itching, irritating, burning, or stinging sensation. The vulvar tissue may give the appearance of being inflamed or may look normal. It’s thought that vulvodynia is a neuropathic pain, which means the surrounding nerve fibers in the vulvar send irregular messages. Hypersensitive nerve endings are a result. While vulvodynia isn't life-threatening, it can prevent women from engaging in ordinary or everyday activities. In some cases, it can lead to depression. How to care for vulvodynia? Women with vulvar pain do have options for care. Using vaginal dilators to stretch the vagina is a safe and effective way to treat the pain syndrome associated with vulvodynia. Women can also help ease and prevent symptoms by making dietary and lifestyle choices. Clothing choices: Try to wear 100% cotton underwear, avoid tight underpants and pants, and forgo wearing underwear at night. Personal care choices: Avoid products (shampoos, perfumes, detergents, deodorants) with fragrances, dyes, and chemicals that may irritate the skin and vulva. Bathing considerations: Don't clean the vulva with anything but water and after bathing dry thoroughly. You can also apply petroleum jelly or preservative-free oil to help preserve skin moisture and nourish the skin. Sexual activities: You can use lubricants during sexual intercourse, but don't use flavored oils or ones with a cooling or warming sensation. Also, add more foreplay into your sexual routine to help with penetration. Other care tips: After going to the bathroom, rinse and dry the vulva. Also, avoid douching or applying anything inside the vagina that might irritate. Switch sanitary pads to 100% cotton pads to prevent irritation. Another way to soothe vulvodynia symptoms is to apply cool gel packs to the vulva. How is vulvodynia diagnosed? Scheduling an appointment with your doctor or gynecologist is the best way to diagnose vulvodynia. During the first meeting, your physician will ask you personal questions regarding your health and pain symptoms. It's essential to gain a full picture of your particular situation. In most cases, the doctor will use a cotton swab to test for pain points in the vulvar. Your doctor wants to determine how mild or how severe the vulvar pain is for you. The swab test can be the most stressful part of the exam. Your doctor may order additional tests to rule out a yeast infection or sexually transmitted disease by taking a sample of vaginal discharge. If you're suffering from vulvodynia, it's time to find a cure that works for you. Using vaginal dilators daily can help provide long-lasting relief. When you’re ready, we can help you. Other VuVa Helpful Links: 7 Reasons for a Tight Vagina and How to Loosen How to use Vaginal Dilators How to Relax Vaginal Muscles, Vaginismus & Sex Vaginal Stretching - Keeping in Shape with Dilators Do Dilators Really Work? Yes, and They can Improve Your Sex Life! Shop for VuVa Vaginal Dilators https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014358/ https://www.nva.org/what-is-vulvodynia/ https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Persistent-Vulvar-Pain https://www.aafp.org/afp/1999/0315/p1561.html https://www.medicalnewstoday.com/articles/189076.php#treatment
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Vulvodynia Diagnosis: What is the Q-TIP test?
Any woman who has suffered from vulvodynia pain will confirm that it is absolutely debilitating and profoundly impacts many aspects of life. Women with vulvodynia must also suffer the loss of pleasure from sex, difficulty exercising, walking or sitting, and the fear of unexpected flare-ups with no discernable cause. Needless to say, social life and working life can become difficult to manage. Do you have vulvodynia? The answer may not be clear, but we are here to help with a Q&A on vulvodynia. This article aims to answer the most pertinent questions about vulvodynia, focusing mainly on vulvodynia diagnosis methods such as the Q-tip test. We will also cover the causes of vulvodynia and the most telling vulvodynia symptoms… What is the Q-tip test? The Q-tip test, also known as the cotton swab test, is one of the go-to vulvodynia tests performed by women’s health clinicians. They consider Q-tip testing to be one of the most accurate and necessary tools in the assessment of sexual pain; in particular, pain caused by vulvodynia and provoked vestibulodynia. Q-tip testing involves a cotton swab or Q-tip to apply pressure to various (carefully mapped-out) areas within the vulvar and vestibular regions. This is done randomly, rather than in a specific order, so that the specialist can determine pain and sensitization levels. How do I know if I have vulvodynia? You may come to assume that your problem is vulvodynia through the symptoms alone, although they can vary a lot. Some women experience chronic and constant pain, while others can experience a range of symptoms, sporadically or intermittently. Some of the main vulvodynia symptoms are: Stinging pain Itching Burning pain Throbbing sensations Pulsating sensations Inflammation Muscle spasms Vulvodynia pain can start or stop suddenly, making it unpredictable and thus difficult to manage. It could be that you go for months with no pain, and then symptoms reappear without warning and become chronic. There is often no real pattern to it. It is important to remember that vulvar pain can have many origins, and many conditions share similar symptoms to vulvodynia. Furthermore, vulvodynia is a complex condition with no definitive underlying cause, and various possibilities (we’ll get into that later in the article). For this reason, it is important to get a proper vulvodynia diagnosis, which will likely involve the Q-tip test. How is vulvodynia diagnosed? To find out if you have vulvodynia, two checks are usually required. The first is an interview with a mental health professional. This interview is essentially a psychological assessment to gather information on what might be causing your pain, the affect it has on you, how long you have experienced it and what prompted you to seek treatment for it. They will endeavor to find out whether any comorbid disorders are present, what you have tried in terms of pain management and what the results were. The next is a biological assessment with an appropriately trained health care professional; perhaps a pelvic floor physical therapist or gynecologist. Sometimes this professional will also do the psychological assessment. There are two types of vulvodynia, so they will be trying to determine which you have so that it can be treated accordingly. Generalized vulvodynia Generalized vulvodynia refers to the kind of chronic pelvic pain that affects the whole vulvar area. It can come and go, or be constant, and is easily aggravated by activities and behaviors such as: Wearing tight clothes Sitting for extended periods of time Riding a horse Pressure on the area (e.g. from a bike saddle or hard chair) Some describe it as a burning pain – the sensation of the vulva being on fire. Localized vulvodynia Localized vulvodynia differs in that the pain is usually only felt in one or two specific areas in the vulva, with the pain also presenting as burning or stinging. It can sometimes feel as if a muscle is torn, or that the vagina is stretched. Pressure on one of these painful spots brings on, or exacerbates the pain. How is the Q-tip test done? Once the psychological interview is complete, your health care professional will begin the physical examination by doing a Q-tip test. Here’s what that may look like: You are placed in the lithotomy position with your legs in stirrups You will be encouraged to relax your muscles, if you can You will be informed of each step in advance so there aren’t any surprises A gauze pad will hold the labia minora in place so your vulval vestibule can be accessed The vestibule is divided into sections according to a clock face (don’t worry, this is not a physical division, but a mental map for your practitioner) A cotton swab (or Q-tip) is used to apply pressure to each section at random and you will be asked to rate the pain level on a scale of 1-10 Your pain levels will be documented in order to confirm a diagnosis This is a typical assessment for vulvodynia, but practitioners may use slight variations of this process according to their preferred methodology. How reliable is the Q-tip test? The Q-tip test is considered clinically reliable, although it is possible for some extent of human error to occur, given that the Q-tip test requires the pressure on each section to be consistent. It is possible that a practitioner might use what is known as a vulvalgesiometer instead of a cotton swab or Q-tip test. A vulvalgesiometer is a device that exerts a set level of pressure on each section of the vulva. What is the cause of vulvodynia? Although it is not definitively proven, experts think that vulvodynia could be a form of neuropathic pain. This means that the vulval nerve fibers respond as if they were pain fibers, interpreting even very delicate touch as pain. Burning and stinging sensations often characterize neuropathic pain, which lends credibility to this theory. There are three types of neuropathic pain that may cause vulvodynia: Allodynia: Pain sensations in areas that don’t normally hurt when pressure is applied Hyperalgesia: Excessive pain response to pressure that might usually cause a smaller degree of pain Dysesthesia: unusual levels of discomfort when the pressure is minimal Although you might experience all three, experts usually consider vulvodynia to fall under the category of allodynia. Other possible causes of vulvodynia are: Inflammation of the vulva Damage or irritation of the nerves of the vulva A response to long-term infection Food sensitivities Muscle dysfunction in the pelvic floor Genetic disorders Conditions impacting muscles or bones close to the pain site Autoimmune diseases like fibromyalgia and systemic lupus erythematosus. What can trigger vulvodynia pain? If you already have vulvodynia, you might experience a flare-up because of any of the following: Nerve injury or irritation Abnormal vulvar cell reaction to trauma, infection or chronic inflammation Pelvic floor muscle spasms Hormonal fluctuations or changes Pressure on the bowel or bladder (when full) Hypersensitivity to vaginal yeast infections (candida) Excessive antibiotic use (also causes yeast infection) Sexual trauma or abuse Allergic reactions (e.g. irritants in personal care products and laundry detergents) Stress If you are searching for further information, this article gives some insight into the possible reasons for vulvodynia flare-ups, and some tips for managing vulvar pain. We often hear the question, “Will my vulvodynia pain go away?” and we are always pleased to answer with something positive: yes, it can and with persistence probably will, but not on its own. So it is necessary to seek treatment from an expert. Many experts recommend using vaginal dilators for vulvodynia – in particular magnetic dilators, which increase blood flow to the area to soothe nerves – and many of our customers and clinic trial participants report great results with them. Resources Sandiegosexualmedicine.com/female-diagnostic-tests/cotton-swab-test Vuvatech.com/blogs/care/is-vulvodynia-a-chronic-illness Vuvatech.com/blogs/care/foods-to-avoid-with-vulvodynia Vuvatech.com/blogs/care/vulvodynia-exercises-besides-dilators Do you need to order vaginal dilators so you can start your pelvic floor therapy process? Made in the USA. Visit www.vuvatech.com VuVa Helpful Links: How do Neodymium Vaginal Dilators work? 7 Reasons for a Tight Vagina and How to Loosen How to use Vaginal Dilators How to Relax Vaginal Muscles, Vaginismus & Sex Vaginal Stretching - Keeping in Shape with Dilators Do Dilators Really Work? Yes, and They can Improve Your Sex Life! Shop for VuVa Vaginal Dilators Tara Langdale Schmidt is the inventor of the VuVa Dilator Company. She has pelvic floor dysfunction herself and wanted to create a dilator set that is made in America that women can trust. VuVatech has been in business since 2014 and has helped over 50,000 women all over the globe. She patented the Neodymium Vaginal Dilator, that is clinically proven to help with blood flow and nerve pain. Podcast Episode 22: Tara Langdale-Schmidt What’s on Your Vagenda? Click here
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Vaginal Dilators: Important facts you need to know
When it comes to vaginal dilators, they have two main purposes - one is they help the vagina get used to having something inside of it, and the other is they help erase the muscle memory that keeps your pelvic floor in a protection mode. Even if the size of your vagina is normal, you need to know that painful sex starts a pain cycle, which can cause a fear of penetration that results in contracting the vagina when trying to have intercourse. The dilators are a safe option to help eliminate the initial cause of pain, but bear in mind to use the smaller one and then increase up slowly. You want to end up using a dilator close to the penis size of your partner if you are sexually active. The vaginal tissues and the pelvic floor muscles start learning to hold something inside without leading to the surplus pain responses. It is a great way to make your deeper pelvic muscles relax as well, and when you have sex with an actual person, your pelvic muscles will relax as well. A vaginal dilator is also a way you can use to gently and gradually stretch tissues that are tighter and not elastic enough - it is often the case when a woman has vaginal dryness and thinning due to hormonal changes (post menopause or chemotherapy). This can arise due to skin conditions or when a vagina tissues have been affected by radiation or surgery as well. The reduction in size of the vaginal opening can always reversible, and an essential advantage of using a dilator is that you will know if you are prepared for intercourse. 10 ways VuVa Magnetic Dilators can help: When used appropriately, potential benefits of VuVa Magnetic Vaginal Dilator therapy can include: Improved physical comfort with sexual intercourse after pelvic floor surgery with scarring and narrowing and/or shortening of the vagina. Allowing pain free sexual penetration by training pelvic floor muscle relaxation. Reducing pelvic floor muscle tension or spasm with vaginismus Overcoming fear of vaginal penetration buy using dilators on a regular basis. Prevention of adhesions/fibrosis from forming during and after pelvic radiotherapy Allowing for easier use of tampons. Facilitating ease of gynecological examination. Creating natural energy to the painful area for nerve pain reduction. Helping with natural lubrication and vaginal dryness by creating blood flow to the area. Relaxing muscles immediately before intercourse to allow easy penetration by your partner. Vaginismus And Depression: The Real Deal When you notice the symptoms of vaginal muscle tightening, penetration restrictions, or vaginismus, it may leave you a little bit confused regarding your body. It can make you question yourself why it is so hard for you, and it can maker you worry and feel uncomfortable when people talk about sex around you. Doubt - When it is certain that there is something wrong - due to the patterns of being unable to have continued sex, they start doubting themselves. It is not just in the context of their physical health, but it also greatly impacts their overall mental health. Fear - In the case of vaginismus, fear is multi-pronged, and while it all starts with the fear of intercourse, the other fear also arises for failure. It further leads to the fear of relationships going down the drain and being unable to do anything about the pain - the fear only compounds with time while making the problem even more complex. Guide - The prospect of not being a "sexually adequate partner" consumes many women when they have vaginismus, especially when it is happening continuously. As a result, women start to take responsibility for everything going wrong in their relationships, and inside their minds, they start thinking that maybe it is due to the lack of sex that is causing relationship issues. When sex hurts, you can find a way out. We know that many of our readers benefit from using vaginal dilators, since they can help you to work with physical causes and prepare you for sex when the cause is psychological. Our site has so much information designed to help you, but you should also feel free to contact us if you think we can help with anything. This article was posted by VuVatech. VuVatech has their own line of Magnetic and Vaginal Dilators for Pelvic Pain. Learn more here: Vuvatech.com/pages/how-vuva-vaginal-dilators-work Do you need to order vaginal dilators so you can start your pelvic floor therapy process? Made in the USA. Visit www.vuvatech.com VuVa Helpful Links: How do Neodymium Vaginal Dilators work? 7 Reasons for a Tight Vagina and How to Loosen How to use Vaginal Dilators How to Relax Vaginal Muscles, Vaginismus & Sex Vaginal Stretching - Keeping in Shape with Dilators Do Dilators Really Work? Yes, and They can Improve Your Sex Life! Shop for VuVa Vaginal Dilators Tara Langdale Schmidt is the inventor of the VuVa Dilator Company. She has pelvic floor dysfunction herself and wanted to create a dilator set that is made in America that women can trust. VuVatech has been in business since 2014 and has helped over 50,000 women all over the globe. She patented the Neodymium Vaginal Dilator, that is clinically proven to help with blood flow and nerve pain. Podcast Episode 22: Tara Langdale-Schmidt What’s on Your Vagenda? Click here
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Vaginal Dilators are Essential, Doc Says.
Written by Dr. Elizabeth Prusak Dilators are “Essential” Vaginal dilators are an essential and beneficial medical treatment for patients who experience pelvic pain and anxiety in response to vaginal penetration. Vaginal dilators, also known as vaginal trainers or spacers are designed to gently and gradually restore and expand the tissue and muscles of the vaginal opening. Combined with the use of pelvic floor physical therapy, behavioral health therapy, correction of underlying medical issues, and some dedication and persistence on the patient’s and provider’s part, this simple tool can increase a patient's quality of life in the area of sexual intercourse and during the routine gynecological office speculum exam. Vaginal dilators are also part of the postoperative care of male to female transgender patients after their surgery to maintain a neovagina. What is a Dilator? Vaginal dilators are non sterile cylindrical medical devices that sequentially increase in diameter and/or length. They are placed inside the vagina in a gentle manner by a trained medical professional and then, after some training, by the patient to help expand the vaginal tissues that may be contracted and tight. Dilators are prescribed to patients by a wide array of medical professionals including OB/GYN physicians, physical therapists, counselors, and pain specialists. They have been in use for over 75 years in the medical field and have a long track record of success if used properly. Vaginal dilators are very unique in that they have the ability to treat the patient both psychologically and physically. How Do They Help? Dedicated usage reconditions and facilitates an adaptive body/brain connection to stop anticipatory anxiety and pelvic discomfort and pain that is often experienced by patients from a psychological standpoint. Dilator introduction and progression also treats the physical vulvar region and retrains pelvic floor muscles. Over time the muscles are stretched gently by the dilators. What Conditions Can Dilators Treat? Patients who suffer from several categories of medical conditions greatly benefit from the use of vaginal dilators. Three categories of patients encompass the clinical scenarios where vaginal dilator usage would be valuable. It is important to address underlying medical issues and be sure they are being treated first before attempting vaginal dilator usage. 1. Change in Pelvic Floor Anatomy The first category encompasses patients with conditions that have created a change in the normal pelvic anatomy. This includes postoperative patients after a hysterectomy, gender reassignment surgery, or a prolapse repair. Another type would be an alteration due to a cancer therapy, such as radiation. Also included in this group are genetic conditions where either no vagina or a rudimentary vagina is present at birth such as Mullerian agenesis or Mayer Rokitansky Kuster Hauser (MRKH) Syndrome. This group is amongst the more straightforward to treat, because the cause of the vaginal penetration is usually a purely anatomical issue, with less of an emphasis on the psychological area. 2. Problems with Penetration The second category are patients who have never been able to insert anything into the vagina- a tampon, a speculum, nor any sexual activity with penetration. These patients can have the desire to allow penetration, but even after multiple attempts they cannot. These also can include patients with a strong negative psychological history associated with vaginal penetration, such as those who have been raped or abused in the past. This condition is known as vaginismus and is best treated with vaginal dilators combined with regular behavioral health sessions. This group of patients is very difficult to treat and usually requires a longer time period of dilator usage and training before they achieve success. Frequent behavioral therapy sessions are key to treating these patients. 3. Pelvic Pain Conditions The third category of patients are ones who have a medical condition that causes painful or restricted vaginal penetration. This encompasses vaginal atrophy during menopause, vulvodynia, vulvar vestibulitis, interstitial cystitis, painful bladder syndrome, endometriosis, pelvic pain after childbirth from episiotomy or perineal tears, lichen sclerosus, chronic vaginal infections, and tumors that create a mass effect such as ovarian cysts, colon tumors and bladder cysts. Ensuring that these patient’s medical conditions are optimized and treated is very beneficial in the success for these patients. How to Talk About Dilator Use Approaching the topic of starting to use vaginal dilators with a patient is never easy, but it is usually up to the provider to initiate this discussion, because typically a patient's fear or embarrassment about the subject of unsuccessful vaginal penetration or pain is heightened even more during the office visit. 1. Creating a comfortable environment Reassuring the patient that their problem is very common and trying to put them at ease is the first step. Patients will encounter a wide array of emotions during this visit and it might take a few visits before even attempting to use dilators in the office. Showing patients the dilators and how to use them in the office is a key step, followed by co management with a pelvic floor physical therapist, behavioral health therapy, and treatment of any underlying medical conditions. 2. Longer appointment times and frequency Ensuring that the visit is allotted proper time for this type of patient is very important, so neither the provider nor the patient feels rushed. Many healthcare providers do not address vaginal dilator use at the office visit and barriers such as lack of knowledge, reimbursement issues, physician and patient embarrassment, poor communication, and lack of time are ranked as the top reasons for such problems going unaddressed. Even with a motivated patient and provider, vaginal dilator compliance remains low, so making subsequent visits at close time intervals is helpful and education is key. 3. Seek out a NAMS certified Physical Therapist Typically providers receive special training and have a special interest in treating patients with vaginal penetration issues and training with vaginal dilators, and these would be the providers most sought out by and recommended to patients with these issues. The North American Menopause Society (NAMS) offers a certification for providers with this special interest, and their website has a list of certified providers. This is a good starting point for patients to look for a provider, although choosing a provider for this type of treatment is a very personal decision, and many patients have to see multiple providers before committing to one for treatment. How Do Medical Vaginal Dilator Sessions Work? A first session with vaginal dilators would entail an education session with the patient: explaining the uses of dilators and how they can help with the patient's medical condition and issues of vaginal penetration. Showing them the various sizes of dilators and explaining with simple easily understood words and language that the patient can understand should be done. Instructing the patient that they will be in a lying down position and using the dilators with lubricant or lidocaine ointment for any pain relief is the first step. Once the patient feels comfortable and wants to start and is properly positioned, the physician first inserts in the smallest dilator into the vaginal opening and allows the patient to relax around the dilator if possible, and leaves the dilator inside the vagina for 15-30 seconds before repeating and moving onto the next dilator size up. This is done in the office until the patient feels even the smallest discomfort with the largest size of dilator. The patient is instructed that different companies sell dilators and the provider recommends a set for him/her to obtain before leaving the office. For home use, the recommendation is three times a week for fifteen minutes per day being a typical goal for patients to strive to use their dilators. Then moving up from there. Patients should be instructed to write down their progress and which dilator number they are able to achieve on a weekly basis. Activities such as deep breathing and relaxation techniques can be used during dilator therapy. Scheduling and attending cognitive behavioral therapy along with this is very helpful. A follow up phone call to the patient within a week giving words of encouragement is beneficial to maintaining continuance of usage. The next follow up appointment should be within a month’s time. A good “bonus plan” for the patient also can be to recommend dilator usage prior to coitus to help relax the patient after he/she becomes more comfortable with the use of dilators. Patients should be reassured that this is a long term solution to their issue of vaginal penetration and that fast results are not going to happen, and that this is normal to achieve success slowly. It is also important to tell patients that use of vaginal dilators will need to be continued even after the patient achieves initial success, although a more infrequent basis is prudent after this. Final Word on Dilators Vaginal dilator therapy is an important part of treatment for sexual pain and vaginal penetration issues. Education and reassurance of both physicians and patients is key to a successful journey to treat this issue. Vaginal dilator therapy requires long term patience and goal setting, but it is a safe and effective therapy and is very much underutilized in the medical community. Seeking out providers who have a special interest and education in treating these issues is key for the patient to have a successful treatment. Dr. Elizabeth Prusak is a board certified OB/Gyn physician and sexual health specialist, ABOG board instructor, and medical writer who has devoted herself to helping and empowering women and transgender patients. She has spoken at several national conferences, educating other physicians on how to better approach patients with the difficult topics of menopause and sexual health. She takes a holistic approach to gynecology and emphasizes the value of a total mind and body approach to care. She has over 15 years experience with the use of vaginal dilators and pelvic floor physical therapy helping patients.
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How to Overcome Fear of Physical Intimacy
Fear of physical intimacy can cause havoc in a woman’s life. It has a detrimental impact on her self-esteem and her romantic relationships, and if not dealt with, it can become a serious problem that hampers the quality of her life. Fear of sex (genophobia) is actually quite a common thing, but it can be overcome. Overcoming fear of physical intimacy may require more than one form of treatment, and this could be psychological or physical in nature depending on the root of the issue. Our recent article on the root causes of fear of sex and physical intimacy addresses some of the most common reasons for this issue. This article will take a look at what you can do to overcome fear of physical intimacy. How to overcome fear of physical intimacy Firstly it is necessary to determine whether your fear of intimacy stems from a physical or psychological issue. Fear of physical intimacy generally does have psychological origins, however for some women this results in a physical manifestation that can worsen the fears of intimacy. Let’s take a look at the most common causes of fear of intimacy and how to address them: Physical causes Physical conditions can lead to fear of sexual intimacy because of the pain or embarrassment they cause. For example, if you have vaginismus you are dealing with a physical issue, but the condition itself is likely to have psychological origins. In this case you may need a combination of counseling or sexual therapy and some form of physical therapy to help manage the physical symptoms. Lots of women have success with vaginal dilators, which allow them to practice penetration in the privacy of their home, in their own time. Eventually fear of penetration is likely to subside. Dilators can also help train your mind to release the anxiety you feel around intimacy. If you have vulvodynia, you’re going to experience painful sex (dyspareunia), which tends to lead to fear of physical intimacy because sex becomes associated with pain. Vulvodynia is unlikely to have psychological causes, and will need to be treated with the help of an experienced practitioner. Typical vulvodynia treatments include pelvic floor therapy, natural self-care techniques, medications and vaginal dilators. As is the case with vaginismus, vaginal dilators can help your vagina get used to the feeling of penetration. Psychological causes If your fear of physical intimacy stems from a history of sexual abuse, poor self image or performance anxiety, a professional counselor of some kind will be best equipped to help you overcome your negative associations with sex, or self esteem issues. Psychotherapy comes in many forms, and the treatment required is unique to each person, but long-term therapy is generally beneficial in managing fear of intimacy. The most common types of psychological therapy are: CBT (Cognitive Behavioral Therapy)EMDR (Eye Movement Desensitization and Reprocessing) Somatic Experiencing (SE) Other traditional psychotherapy for Post Traumatic Stress Disorder (PTSD) It may be necessary to have a consultation with more than one type of therapist to see if they are right for you. For example, a CBT therapist might introduce different ways of thinking or techniques to help you overcome triggers, whereas a sexual therapist might address your feelings and teach you strategies for reframing sexual activity. A counselor might be able to help you work through the underlying issues that caused your negative self-perception or performance anxiety. If you think you may have a vaginal pain condition or you get severe phobic reactions to sexual intimacy, a proper diagnosis is important. Your doctor should be able to provide you with some helpful resources and where necessary, give you a referral to the right type of therapists for your problems. Overcoming fear of physical intimacy can sometimes be a long road, but it is certainly worth the effort. Make the commitment and you will get there! VuVa Helpful Links: 7 Reasons for a Tight Vagina and How to Loosen How to use Vaginal Dilators How to Relax Vaginal Muscles, Vaginismus & Sex Vaginal Stretching - Keeping in Shape with Dilators Do Dilators Really Work? Yes, and They can Improve Your Sex Life! Shop for VuVa Vaginal Dilators
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How Do You Diagnose Vaginismus?
Why is it hard to diagnose vaginismus? Vaginismus is generally summarized as the persistent or recurring difficulty a women experiences in allowing penetration of any kind, whether that is a finger, penis, tampon or gynecological examination tool. This difficulty occurs regardless of a woman’s desire to allow penetration, which may seem totally out of sync with her ability to do so. On paper, it may not sound too difficult to diagnose vaginismus, but it actually can be. It is still necessary to look into the issue in detail in case there are underlying or concurrent conditions that may also need to be overcome. Women with vaginismus are often immersed in a cycle of fear and avoidance around penetration, since their resistance to penetration usually leads to some degree of physical pain. The pain occurs because of involuntary contractions of the vaginal muscles, which vaginismus sufferers will have little to no control over. At best, they will experience fear and resistance, and at worst, pain too. The reason it is sometimes difficult to diagnose vaginismus is that some have what is called partial vaginismus. Total vaginismus is more obvious because women with this can’t tolerate any kind of penetration, at any time. With partial vaginismus, the fear and involuntary muscle spasms can be related to specific situations, people, or other variants, and these variants can be changeable. Women with partial vaginismus can sometimes tolerate penetration to some extent, albeit with difficulty. For some women the condition is lifelong (known as primary), and for others it can happen later in life (known as secondary). There may also be other elements involved, such as a hypertonic pelvic floor. Likewise, other conditions may overlap; for example, vestibulodynia or dyspareunia. For all of these reasons vaginismus is considered to be a clinical syndrome rather than a definitive diagnosis. How will your practitioner diagnose vaginismus? To diagnose vaginismus, your healthcare practitioner is likely to go over your entire psychosexual history. Your practitioner is also likely to ask personal questions about your medical history, your symptoms, your typical reactions to penetration, your anxiety levels and fears, and your current sexual relationship/partnership. It is likely that you will need a physical examination to properly diagnose vaginismus. Your practitioner will assess your levels of distress, anxiety, and mental or emotional resistance to penetration, which is actually considered to be more important in the diagnosis than physical spasms, muscle tone or the presence of pain. The physical examination of your genitals and pelvic area is necessary also for exclusion of other issues, dysfunctions, injuries or infections that could be presenting similar symptoms to vaginismus - or actually causing it. What to do when you have a vaginismus diagnosis Your practitioner will determine whether the cause is psychological, in which case you may be referred for psychological treatment for vaginismus. If the cause is determined to be physical, you may be referred to a pelvic floor physical therapist, a sex therapist or a gynecologist. It could be that the cause is multifaceted, so you may need to see more than one type of specialist. Finally, vaginal dilators are one of the most common methods of treating vaginismus, whether inside the treatment room or at home in your own time. We have heard more success stories with dilators than we could possibly recount, but we highly recommend them as a treatment if your Doctor does diagnose vaginismus. We hope you found this article informative, and don’t forget to check out our blog for more vaginismus articles. VuVa Helpful Links: 7 Reasons for a Tight Vagina and How to Loosen How to use Vaginal Dilators How to Relax Vaginal Muscles, Vaginismus & Sex Vaginal Stretching - Keeping in Shape with Dilators Do Dilators Really Work? Yes, and They can Improve Your Sex Life! Shop for VuVa Vaginal Dilators
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Erotophobia Causes, Treatments & Overcoming
Definition of Erotophobia The definition of erotophobia is the fear of any sexual intimacy. It encompasses a wide range of specific phobias that cause intense fear of sex and sexual dysfunction. Erotophobia is a complex issue that may cause sufferers to experience more than one kind of sexual anxiety. If left untreated, the negative emotions cause untold damage to relationships and mental health. The person may isolate themselves and avoid any intimate contact with possible love connections, close friends, and family. Types of Erotophobia Erotophobia varies in type and intensity. For some, it's a simple dislike, and for others, the negative associations cause extreme panic when sexual intimacy is attempted. Genophobia or coitophobia: It's the fear of sexual intercourse. The fear of sex is irrational and causes avoidance of intimate relationships. The person may be romantically involved but avoids sexual activities at any cost. Fear of intimacy: One phobia related to genophobia is the fear of intimacy. For those fearful of sexual intimacy, it may include any affection from holding hands to kissing. Even people even thinking about sexual images or the thought of sex brings up deep-rooted fear. Haphephobia: For those with this phobia, it involves the fear of touch. The sufferer doesn't like touch at all and recoils from any physical affection. For men, this may cause erectile dysfunction (ED). Gynophobia: It involves being afraid of being naked. The condition may cause deep body shame, fear of seeing others, and themselves naked. Causes of erotophobia The variance in the phobias connected to erotophobia makes it more difficult to pinpoint a purpose. In some circumstances, the reason for the intense fear or panic can't be identified. Past sexual abuse Sexual abuse can happen at any age. It's any sexual contact that isn't consensual. In the United States, roughly 1 in 10 girls are sexually abused before the age of 18. (1) Sexual abuse victims carry life-long issues that may cause intense sexual dysfunction. Most of the time, victims knew their sexual abusers before the abuse began, making the damage even harder to overcome. The negative impacts may include the following: A deep-seated fear of sexual intimacy Distrustful of people Addictions Depression Suicidal thoughts Fear and anxiety Angry outbursts Generalized anxiety disorder One condition that can cause erotophobia is a generalized anxiety disorder. This condition makes you worry about everything in your life, from waking up on time to your sexual performance in bed. Generalized anxiety causes irrational fears that are unrealistic. People can become extremely scared of sexual relationships and begin to isolate themselves. Bipolar disorder Bipolar disorder is also referred to as manic-depressive illness or manic depression. It's a mental health disorder that causes extreme shifts in energy, mood, and activity levels. At times, the individual is unable to concentrate and complete daily tasks. It can also cause a fear of sexual behavior and having intimacy with others. Learned negative response According to a study published in the Journal of Sex, erotophobia may be a learned behavior from growing up in a restrictive household that taught the fear of sex and any sexual exploration met with punishment. For example, men and women growing up in an extremely religious household that viewed anything related to sex as immoral. Over time these past experiences could cause fear or anxiety around sexual intimacy. (4) Pelvic pain conditions Fearing sex or sexual intimacy may come from having chronic pelvic pain. This issue is more prevalent than you believe, and for some reason, the reason for the daily pain and discomfort has no source. Below are common types of pelvic pain conditions. Vulvodynia Vulvodynia is when a woman has pain in the vulva region of the vagina. The vulvar is right at the opening of the vagina, and the pain can have a trigger, such as a touch or pressure, or be ongoing. Vaginismus If you have painful pelvic muscle spasms, you may have vaginismus. The cause of the involuntary contractions may have a source or unknown. Dyspareunia Dyspareunia is a health condition that causes pain during sexual intercourse. The reason may be psychological or medical. Treatments & Overcoming Erotophobia There are different treatments for overcoming erotophobia. The type of treatment ideal for you depends on the advice of your health professional and symptoms. It's important to remember that overcoming erotophobia may take time for the healing process to be complete. Cognitive-behavioral therapy Cognitive-behavioral therapy (CBT) is a type of treatment that helps you identify the cause and reasons for your issues or intense fear and see them differently. During CBT, you begin to understand your irrational beliefs and self-destructive tendencies. By facing these negative emotions, you can hopefully work through the specific phobia, such as erotophobia. (5) Vaginal dilators Vaginal dilators or vaginal trainers are tube-shaped devices recommended by doctors and physical therapists to help people overcome pelvic pain. Pelvic pain can have an emotional, psychological, or physical component. When you're experiencing uncomfortable or searing pelvic pain, you may start to have negative associations with sex. Or perhaps, past trauma has linked pain with sex. Thousands of women have turned to vaginal dilators as a non-invasive way to stretch and lengthen a tight vagina. As you work with the vaginal dilator, your pelvic muscles begin to expand and relax as you move freshly oxygenated blood into your vagina tissues. Vaginal dilators can help with many pelvic pain conditions, including: Vulvodynia (pain around vaginal entrance) Dyspareunia (pain during sexual intercourse) Vaginismus (uncontrollable muscle spasms) Shortened vagina from undergoing menopause or radiation treatment Vaginal atrophy (extreme dryness) Everyone deserves a healthy sex life. When you have erotophobia, you may avoid romantic relationships and affection of any kind. As social beings, we need love and friendship from significant others. Therapy and vaginal dilators can help you overcome erotophobia. https://www.journeytohealministries.org/sexual-trauma-facts https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311357/ https://www.nimh.nih.gov/health/topics/bipolar-disorder https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159165/ https://www.healthline.com/health/behavioral-therapy Other VuVa Helpful Links: 7 Reasons for a Tight Vagina and How to Loosen How to use Vaginal Dilators How to Relax Vaginal Muscles, Vaginismus & Sex Vaginal Stretching - Keeping in Shape with Dilators Do Dilators Really Work? Yes, and They can Improve Your Sex Life! Shop for VuVa Vaginal Dilators
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Genophobia - Overcoming the Fear of Sexual Intercourse
What is a Phobia? According to Harvard Health, a phobia is an intense fear that’s excessive without rationality. It’s a type of anxiety disorder directed at an object, person, situation, or activity. (1) In the case of genophobia, it’s the intense fear of sexual intimacy. It’s sometimes called erotophobia. Even the thought of engaging in sexual relations with someone brings out extreme anxiety, overwhelming fear, and intense shame. When you have genophobia, you may also be dealing with other types of sexual phobias related to intimacy. coitophobia: overwhelming fear of sex. gymnophobia: fear of nudity. haphephobia: fear of touching. coitophobia: fear of penetration heterophobia: fear of the opposite gender tocophobia: fear of becoming pregnant or giving birth People with genophobia look for ways to overcome the fear of sexual intercourse, and the good news is that there are solutions. Treatment of genophobia The specific treatment of genophobia depends on whether the fear connects to a physical condition, such as vaginismus. Or the anxiety comes from a psychological issue. Vaginal dilators Genophobic people who experience intense pain from sexual penetration, inserting a tampon, or undergoing a gynecological exam, may benefit from using vaginal dilators. Dilator therapy has helped thousands of women overcome genophobia. Vaginal dilators are safe and effective in assisting women in stretching and lengthening vaginal tissue slowly. In a clinical trial, 80% of participants reported reduced pain after using VuVa™ magnetic vaginal dilators. (2) The Memorial Sloan Kettering Cancer Center recommends vaginal dilators to ease painful discomfort from vaginal penetration. (3) When a woman has ongoing pain associated with sexual intercourse, it can lead to an intense fear of sex or genophobia. Psychotherapy Meeting with a licensed therapist may help ease the symptoms of genophobia. Once you've identified the physical concern, you can address the emotional aspect. While many types of psychotherapy are available, one standard method is cognitive behavior therapy (CBT). CBT involves helping the patient view the condition differently. As your therapist encourages alternative methods of thinking about the activity or phobia, you can examine physical responses to the cause of the problem. (4) You’ll learn about what triggers the reaction and how to overcome your response. Sometimes this may require you to expose yourself to sexual intimacy, to overcome the phobia. Exposure Therapy The American Psychological Association defines exposure therapy as a type of psychotherapy meant to engage the patient in the activity or trigger that causes the phobia or stress. Your goal is to confront your fears in a safe environment, in the hopes of overcoming them. (5) For example, if you have a fear of snakes, you may be asked to hold a snake. Or, if you're experiencing post-traumatic stress due to sexual abuse, you may be asked to imagine the traumatic event and reimagine it. Exposure therapy can help overcome the following conditions, including: Phobias (e.g. genophobia) Post-traumatic stress Generalized anxiety disorders Obsessive-compulsive disorders Social anxiety disorders If you’re experiencing genophobia, speak to your healthcare professional about vaginal dilator therapy and psychotherapy to determine which treatment is right for you. Symptoms of genophobia Every person experiences different genophobia symptoms. Genophobia has different triggers and has a profound effect on the person, making daily life unbearable at times. Symptoms may encompass one or more of the following: The thought of sexual intimacy may make you feel nauseous and overwhelmed when confronted with the possibility of intercourse. You have an immediate fear and panic that causes problems with sexual functioning. Logically you understand the fear is irrational, but sexual intimacy causes panic attacks, low self-esteem, and performance anxiety. The symptoms become worse the longer you're exposed to sexual triggers, and the only way to stop the fear is to stop the activity. You may begin to avoid the situation causing the fearful response. You may have trouble breathing, feel dizzy, become sweaty, or endure heart palpitations. Causes of genophobia Becoming fearful of sexual intercourse has different causes and triggers. In some situations, the exact cause may be hard to determine. Fearful of sexual performance: For some, being concerned about their performance in bed can cause erectile dysfunction or feelings of inadequacies when intimate. Body dysmorphic disorder: It's a mental health condition when a person can't stop thinking about perceived flaws in their appearance. You become ashamed and fearful of being seen in public, and this causes social anxiety and genophobia. (6) Vaginismus: It's the condition when pain and uncontrollable muscle spasms occur during sexual intercourse, tampon insertion, or a pelvic exam. The state may be primary or secondary. Primary is when the woman has never been able to have sex due to the pain and muscle spasms. Secondary is when pain happens after a woman has had sexual intercourse and then is unable to engage in sexual relations. Women suffering with vaginismus often find relief with vaginal dilators or sometimes called vaginal trainers to help ease vaginal tightening. Sexual abuse: When a man or woman experiences a childhood trauma such as child abuse by a primary or secondary caretaker, it may result in post-traumatic stress disorder (PTSD). The person may avoid or become fearful of sex and continue to relive the abuse. Experiencing sexual assault: When you've experienced sexual assault or rape, you may become fearful of intimacy or sexual intercourse. The event is traumatic and causes you to shut down and avoid any sexual intimacy. Sometimes it's hard to know the difference between healthy fear and a phobia. At times, you may become confused as to what's causing the genophobia. The best solution is to speak to a sex therapist or medical professional to help you overcome the fear of sexual intercourse. With proper treatment, such as vaginal dilators or psychotherapy, you can have a healthy sex life. The first step is always the most difficult, but living the life you deserve is possible. https://www.health.harvard.edu/a_to_z/phobia-a-to-z https://www.vuvatech.com/pages/clinical-trials https://www.mskcc.org/blog/strategies-women-cope-sexual-and-vaginal-health-concerns-related https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610 https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/symptoms-causes/syc-20353938 Other VuVa Helpful Links: 7 Reasons for a Tight Vagina and How to Loosen How to use Vaginal Dilators How to Relax Vaginal Muscles, Vaginismus & Sex Vaginal Stretching - Keeping in Shape with Dilators Do Dilators Really Work? Yes, and They can Improve Your Sex Life! Shop for VuVa Vaginal Dilators
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How Common is Vaginismus? (Don't Ignore the Pain)
Sexual intercourse can become uncomfortable for many reasons— physical and psychological— but for a lot of women, the cause is vaginismus. Vaginismus is the involuntary spasms of vaginal muscles during penetrative sex. It not only causes pain during sex but also when inserting a tampon or undergoing a pap smear. Unfortunately, vaginismus is a hidden problem that most women avoid discussing or seeking treatment to overcome. Women with vaginismus may experience deep shame, or talking about sex is taboo. The condition causes women to believe they are suffering alone when vaginismus is more common than they think. If you're experiencing painful vaginal muscle spasms, you shouldn’t ignore the pain. What are the different types and causes of vaginismus? The two main types of vaginismus are primary and secondary. Primary vaginismus Primary vaginismus is when vaginal pain has always been present throughout women's life. It causes women to freeze when sexually active or during a pelvic exam. Sometimes the woman stops breathing and becomes still during intercourse, and once the attempt at penetration stops, the sensation disappears. The involuntary contraction makes having a healthy sex life almost impossible and brings about extreme discomfort for the women and possibly hurting relationships. Secondary vaginismus Secondary vaginismus occurs after women have experienced a healthy sex life, but for different reasons, intercourse has now become painful. Some of these reasons (physical and emotional) include: Pelvic radiation therapy: When a woman has radiation therapy for breast cancer or cervical cancer treatment, it may cause the vagina to shorten. Menopause: Women experiencing menopause may have vaginal atrophy (dryness) and painful vaginal penetration due to the imbalance of hormones. Relationship issues: Problems within a relationship may make sex hurt. Traumatic event: When you experience a traumatic event such as sexual abuse or sexual violence it may cause sexual dysfunction. Pelvic surgery: It's a broad term to include any kind of operation in the vaginal area. Medication: Some medications for menopause, cancer, and other health concerns may cause vaginal dryness, shortening of the vagina, and more. What are the symptoms of vaginismus? Vaginismus doesn’t prevent women from being sexually aroused. Women with vaginismus usually don’t have issues with sexual desire, but rather experience some or more of the following: Dyspareunia or tightening and burning sensation during sexual intercourse Long-term vaginal pain without a known cause Extreme discomfort during a vaginal exam Closing of the vagina when trying to insert a tampon Breathing cessation during intercourse How is vaginismus diagnosed? The diagnosis of vaginismus begins by describing your symptoms to your healthcare practitioner. Your doctor may ask you when you started to experience pelvic pain and other questions related to your sexual health. You may need to undergo a gynecological exam to determine if any physical signs are causing the pain and discomfort. For some, this is the most stressful time during diagnosis. You can talk about ways to make the procedure more comfortable. At the end of the consultation and exam, the doctor can determine if it’s vaginismus. If there’s no scarring or signs of infection, it usually means you have vaginismus. What are the treatments for vaginismus? Vaginismus is a treatable condition. Treatment varies by person, but the most common ways are counseling and vaginal dilators. Physical floor therapy and counseling Sex therapy primarily involves education around the anatomy of your body and the process of becoming sexually aroused. You’ll learn about what causes vaginismus too. Choosing a sex therapist experienced with sexual desire disorders and treating vaginismus may be helpful. The ultimate goal is to help promote relaxation and to overcome vaginismus. Vaginal dilators Vaginal dilators naturally help stretch the vagina to promote relaxation and well-being, VuVa™ Dilators come in various sizes to help women undergo dilator therapy as comfortable as possible. Dilator therapy is the process of slowly inserting a cone-shaped device in the vagina. In the beginning, the dilator size is small, to make the pain and discomfort as gentle as possible. As you continue with the therapy, the dilator size slowly increases. Research shows that vaginal dilator therapy helps women improve sexual health. Why shouldn't you ignore vaginismus pain? Living with vaginismus causes emotional and physical trauma that causes severe problems in relationships. Finding solutions to sexual dysfunction can heal pain and save marriages. While it may be hard to talk about vaginismus and seek treatment, there are answers. Vaginal dilators have helped thousands of women have the life they deserve. Invest in your sexual health by exploring the healing power of vaginal dilators. It’s never too late to overcome vaginismus.
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