6/8/11
Dear Dr. Kate: Intercourse and Tampons Both Hurt Me

photo by mistress_f

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions here every two weeks. To ask her your own question, click here.

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

Dear S.S.,

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
Gynotalk
dr_kate_100

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.



2 Comments

  1. Um, is your hymen still intact? If so, that could be the problem. Although I’m active and had been using tampons for years (with some minor discomfort upon insertion or removal), my hymen remained intact. When I’d go to the gynecologist, I felt like the speculum was ripping me apart. It wasn’t until the past few years, however, that I saw a new doctor and she mentioned that I had an unusually thick/strong hymen, which was why pap smears were so uncomfortable. She also explained that my hymen would make intercourse very painful for the first few times unless I opted to use the dilators OR to have a simple surgery to cut my hymen. I didn’t do either; I went ahead and had intercourse. It was pretty painful initially, which is why looking back, I think the surgery might have been a good idea. You might want to ask your doctor if the problem could be your hymen and if that surgery is an option. Good luck!

  2. Er, not to contradict a gynecologist who probably knows much better what she’s talking about, I’d like to point out that despite I’ve a healthy sex life now, my first experiences with tampons and penetration in general were not happy. Purely due to psychological reasons, in my case.
    I started using tampons at about 15 and I didn’t understand how to put them in painlessly until when I was 17, I think, only because I expected pain, so I couldn’t relax, so of course it hurt: nice vicious circle. Then I found out I could put them in while lying, which was less painful and only after doing that 2 or 3 times could I put in a tampon while standing up/sitting down in a toilet.
    As far as sex is concerned, it took some time for penetration to appear erotic and enjoyable to me rather than a bit scary, so it’s not before that change of mind took place that I started liking it.
    So if you think an uneasy mind might be part of the equation here, just take your time, I’d say. If your boyfriend loves you he’ll be able to wait. I’m adding this sentence because ShutShop’s age can’t be told from her e-mail.
    And then if it’s a purely medical problem, scratch all I said and listen to the doctor!

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