Pain During Sex

I’m Susan Bratton here with Dr. Jessica Drummond of the Integrative Women’s Health Institute and we are talking about pain during sex and we’re gonna help you with it. So, Dr. Drummond can you just tell us what the major causes of painful sex are?

One of the most common causes is endometriosis which is a complex disease process. Secondly, there is a common condition called vulvodynia or similarly, vestibulodynia, which is pain at the entrance of the vaginal canal and the vulvar vestibule which is a little space between the vulva and the vagina. Women who have general tension and tightness in the muscles of the pelvic floor, which include both the tiny pelvic muscles and the deeper hammock of pelvic floor muscles, also suffer from vaginal pain. Another most common cause the painful sex is low estrogen which is common postpartum or in the perimenopausal or menopausal timeframe, which is anytime over age 35 when estrogen levels can drop.

If you think that some part of your painful sex might be hormonal imbalance, Dr. Drummond has a good webinar called the Three Steps to Natural Hormone Balance that I want you to check out.

It seems to me like there are two pain sources at the entrance or the introitus, the entrance to your vaginal canal. We’re talking about the time of penetration of intercourse and vulvodynia sounds like a muscular issue, dryness and irritation, a lack of resiliency of the actual tissue at the entrance to the vagina from a hormonal imbalance, or a lack of estrogen that could also be skin pain than actual muscle pain.

It’s a bit of all. “Dynia” means pain, and the term vulvodynia is descriptive of where the pain is. It could be at the entrance of the vaginal canal at the vulva or it could be the entire vulva, the circular area, or just posteriorly. It’s often the skin and the muscles, especially if it’s on the bottom of the vaginal canal. There’s usually a muscular component to it where the pelvic floor muscles are tight or have difficulty relaxing. When muscles are tight, there is a lack of blood flow that can contribute to low lubrication as well, and if you layer low estrogen on top of that and/or low testosterone, you set up a perfect storm where you’ve got a combination of things contributing to pain in that particular region.

Another common contributor to vulvar pain or pain with penetration or the diagnosis of vulvodynia, is an autoimmune component. We also have to optimize our digestive and immune health to be able to optimize tissue integrity and resilience so that it’s not inflamed, red, and fragile. Anytime you have any kind of candida overgrowth or dysbiosis, or any acid reflux or tummy issues, it will affect your vaginal system the say way it affects your stomach, your gut, your throat, your mouth because the entire alimentary system from your mouth to your vagina is one tube.

If a woman has pain during sex, what can she do?

She can get her hormones checked, she can take your webinar and learn about hormones, she can watch my videos on which hormone tests to get and how to test your hormones, she can learn how to massage her own vulvar area to release tight muscles and bring blood flow in.

We also have a video on vagina massage in this series with Dr. Drummond that you can watch.

What are some other things beyond what we have spoken about that can help a woman isolate and fix or reverse her vaginal pain?

If self vaginal massage or alone or with your partner in a relaxed way isn’t enough to completely relieve the tension and pain, I definitely recommend a skilled assessment by a pelvic floor specialist physical therapist.

I’m a nutritionist but I’m also a pelvic floor specialist physical therapist. We exist all over the world and our skilled assessment can help you define the key contributors to your pain. Is it more of a gut overlap? Are there complicated problems because sometimes there’s a bladder pain condition and/or endometriosis and/or vulvodynia. Many times these coexist together and often have similar root causes. Relaxing the muscles is almost always a piece of the equation, but we also want to optimize your gut health and make sure you’re doing simple things like drinking enough water so that your bladder is healthy or ensure that you have the right kind of bacteria in your vaginal canal and around your urethra so you’re not dealing with chronic UTIs, yeast infections or bacterial vaginosis.

I’ll put a link to Dr. Drummond’s website below this video as well as a link to her webinar, and I’ll also put a link to my Women’s Sexual Empowerment email newsletter because if you were here because you have painful sex and you want to solve it, there are many things I cover with regard to moving into pleasure around intercourse and other areas of sexuality.

I recently video-blogged 22 episodes of a vaginal rejuvenation series. I did a vaginal rejuvenation stack. I had no pelvic floor issues; I had hormones completely in balance, all in a really nice topped-up bioidentical hormone replacement, and I still had pain at the entrance to my vagina all the way around and I just couldn’t solve it so I decided to try the Femi-lift laser inside the vaginal canal. I also had the Revive by Viora which is on the outer labia. It plumps up the vulvar tissue and gets collagen back in it. I also had two Orgasm shots which are a procedure where platelet-rich plasma, PRP, is injected from your own body back into your clitoris. It took five Femi lifts with the vaginal resurfacing, the laser resurfacing, of my vaginal tissue to bring strength back to it. I had also done a lot of laser resurfacing of my skin because I get a lot of age spots. So I thought if it worked on my body and the skin on my face, it’ll work in my vaginal tissue. It really did. It took a couple of Femi lifts procedures and ultimately I ended up doing five to get the tissue back, to be robust enough to not have pain with intercourse, and it was finally fixed for me.

I’ll be 57 this year, and I feel like those particular stacks of procedures turned back the clock on my vulva to feel I was 30 or 35 again. It shaved off 20 years. I didn’t realize how much I had aged. I’d lost sensation, even though I feel the incredible sensation. I have an incredible orgasmic capacity. I engorge very easily because I’ve had so much vaginal massage from my husband. We’ve been having an Expanded Orgasm practice for 14 years.

I really want to encourage you to figure out what you’ve got to do to fix it because I want you to have sex for the rest of your life. It is healthy for you. People like Dr. Drummond and myself are the vanguard of women’s sexual pleasure and health. Take a look at the links below and ask us questions. We will reply because we are here for you. It’s our passion.

I was at a conference last week and there’s new evidence that PRP shots are starting to be looked at in common medical research and we’re finding good results. So stay alert that it hopefully will be more widespread and available soon.

So you take good care of that vulva, girlfriend, and we are here for you if you need us. I’m Susan Bratton and I’m here with Dr. Jessica Drummond. We’ll see you on the other side.

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