Dr. Kate is an OB/GYN at one of the largest teaching hospitals in Boston and she answers your medical questions here once a week. To ask her your own question, click here.

Dear Dr. Kate,

I’m a girl who likes it rough. Not a little bum-smack here, a little hair-pull there, but slap-me-across-the-face, black-bruises-for-two-weeks rough. The thing is, this predilection presents a rather annoying problem that I haven’t been able to find an answer for just yet. What do you do to relieve the pain caused by torn or scratched inner labia? I tried epsom salt baths, which work okay, but is there a product out there that I can rub on the affected area, like during the workday? So many things that you’d think might be appropriate are “for topical use only”, so other than Astroglide, I haven’t been able to find anything to soothe the affected area. Oh, and just in case you were wondering: yes, I use safewords with my partners – most of the time I’m really enjoying myself when the injury occurs; yes, I practice safe sex; and yes, I give myself a long resting period after stuff like this happens so that it can fully heal before I engage again.

— Hurts So Good

Dear HSG,

You’re right, there are very few products that are designed for internal use — the vulva and vaginal canal are very sensitive to chemicals, and most over the counter products haven’t been tested internally. You can ask your gyno for a prescription for topical estrogen cream, which not only may be soothing but will actually promote healing.

But I wonder if sex play that leads to actual injury is really healthy for you, physically or emotionally. All injuries that break the skin put you at increased risk of infection, even if you’re always using condoms. (And I’m not just talking about sexually transmitted infections [STDs], but infections of any laceration from your native bacteria — believe me, an abscess on your vulva is no fun to experience or have treated.) You say “most of the time” you’re really enjoying yourself…I think a realistic and healthy goal for the bedroom is to enjoy yourself 100% of the time, especially when you’re playing with fire like you are.

— Dr. Kate
Gynotalk

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.