Dear Dr. Kate,
After several unsuccessful attempts at having intercourse (due to pain), I talked to my doctor. My doctor told me to practice using tampons. I can’t even push a tampon all the way in! It hurts or feels uncomfortable. What’s wrong with me? I have a healthy sexual relationship with my partner, but I really want to experience vaginal intercourse. What do I do?
— Shut Shop
It sounds like you’re suffering from vulvodynia (pain in the vulva), or vaginismus (muscle spasms of the vagina), or even both. And having these conditions is not a reflection on your relationship. We don’t know what causes the vagina to interpret normal touching as pain, but the pain you’re feeling is definitely real. If the pain is from vulvodynia, a combination of topical medication and oral medication can help to relieve the pain. And dilator therapy has been used successfully in both conditions; by inserting a series of dilators into your vagina over several weeks (the smallest one is smaller than a tampon), you can help your vagina get used to the presence of something there without pain.
There are also physical therapists who specialize in sexual dysfunction. If your gynecologist is unable to help you figure out exactly what the problem is, you need to find someone with more experience — either get a recommendation of a great gyno from a friend, or consider joining the National Vulvodynia Association to get access to specialists in your area. But please don’t give up — many women with vulvar pain can find enough relief to have intercourse without pain, once they find the right help.
You can also check out the pain installment of my Female Sexual Dysfunction series for further reading.
— Dr. Kate
Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.