His and Her Health

I am currently 26 years old. Ever since my husband and I started having intercourse a few years ago I have experienced a terrible burning pain during intercourse. I sometimes say that it feels like someone is taking a sharp object and scraping the inside of my vagina when we are having sex. I also experience a lack of sex drive which also causes problems in our sex life. Additionally, I seem to get yeast infections more often than most people I know (4 to 5 per year) and I have problems with vaginal dryness. My doctor did blood tests and we came to the conclusion that I have a low Estrogen level. She put me on an anti-depresant (can't remember which one at the moment), but it kept me awake at night and didn't help the problem. Does anyone have any suggestions of steps, medications, or procedures that I can take to help cure my problem?? <BR>Thanks for your help and time. <BR>

Er...wait a minute. She found out you had low estrogen, so put you on an anti-depressant? That really isn't addressing the issue, is it? And, to top it off, anti-depressants are well known as causes for lower libido.<P>My suggestion would be to first, get a second opinion. Anti-depressants physically change the brain, and if you're not chemically depressed, this isn't necessarily a good thing. Also, treating your low estrogen may very well clear up any residual depression you do have, as it's actually sometimes the cause of depression.<P>You could treat your low estrogen with Hormone Replacement Therapy, which you doctor can talk to you more about. Or, you can do what I am doing ot increase my estrogen because it seems I am perimenopausal at age 31--eat a lot of phytoestrogens. Increase your soy intake, or take soy isoflavin capsules. It will take a while (several weeks) to see results, but if you can increase your estrogen level you'll likely see an improvement in vaginal wetness at the very least. This may help with the burning sensation, as well. Another way to do this could be the new patch birth control method (not oral--the patch doesn't have a risk of further lowering your libido).<P>You should also consider finding an FSD specialist. The pain you experience during intercourse could be vulvadyna, and there are treatments available. You'll need to find a specialist, however, because most Gyn's aren't trained to know what it is or how to treat it. For more information on specialists in your area, there is another forum to visit. If you post this in the Women's Sexual Health portion of this website: ( http://www.newshe.com/cgi-bin/ubb_newsh ... tion=intro ), <BR>you'll likely get a response from Distressed who can direct you to the other board (direct talk of providers isn't allowed on this board, but it is on the other board). Or, you can just click on his profile and get the link there. <P>It could also be that you're never really getting rid of the yeast infection, which can happen, and would make sex uncomfortable or painful. There are some women on the other board who've had that issue, and may be of some assistance.

Dona1,<BR>It sounds like she might have vulvodynia.<BR>There is no cure for vulvodynia, however, there are treatments that work for some women. These include taking certain antidepressants (those that raise the brain's dopamine levels, interfering with the transmission of pain). Antidepressants are not prescribed for vulvodynia because of depression, but because of how they affect neurotransmission. The dosage is often a lower dose than the therapeutic level to treat depression. She may have had a doctor who knew what (s)he was doing.<BR>

Musicgirl,<BR>You might want to try posting a message on the message board reviewed by Andrew Goldstein, MD. Apparently it is for discussion of pain issues.<P><A HREF="www.newshe.com/cgi-bin/ubb_newshe/forumd...amp;LastLogin=" TARGET=_blank>www.newshe.com/cgi-bin/ubb_newshe/forumd...lt;/A><P>If you do have vulvodynia, some other treatments include anti-convulsant medications (for pain), biofeedback, diet monitoring/modification, among others.<P>

From your description, you might have a condition called vulvar vestibulitis syndrome ( a subset of vulvodynia) which causes severe pain upon vaginal penetration (with a penis, tampon, etc). This condition is caused by a proliferation of pain nerve fibers at the opening of the vagina (the vestibule). A diganosis of this condition is made by a vulvar specialist performing a test called a Q-tip test. <P>There are excellent treatments for this syndrome so I urge you to find a specialist to get a diagnosis.<P>Dr. Andrew Goldstein <BR><p>[This message has been edited by Dr. Andrew Goldstein (edited 26 September 2003).]

Owner, I am sorry if you got the impression that my post was saying she shouldn't take anti-depressants for vulvodynia. I was responding to the fact that the poster said she'd been diagnosed with *low estrogen* for her problems, which just sounded weird to me given her symptoms. She didn't say she had been diagnosed with vulvodynia, but rather that she'd been diagnosed with low estrogen. My point was that usually antidpressants aren't the best way to treat low estrogen, if that's what the issue really was. If she'd been diagnosed with vulvodynia, my reply would've been different. If you note in my post I did say she should consult a specialist, or at least get a second opinion, because her symptoms presented as possible vulvodynia.

As Dr. Goldstein says, I think you suffer from Vulvar Vestibulitis Syndrome. I suffer from it too and was on antidepressants. There are several things you can do to have it under control, but the first thing you have to do is go and see a specialist.

I have been having many of the same difficulties as musicgirl7 since about seven months ago, including burning during intercourse, re-occuring yeast infections, and overall frustration with having sex to the point where I haven't for the past month and a half. I do not have a problem of dryness, however, and I also have a clear discharge that is abnormal for me. My burning also remains constantly present during the day and week, sometimes without intercourse. Intercourse just makes it exponentially worse. <P>My obgyn has diagnosised me with Bacterial Vaginosis (BV) twice in three months (with a yeast infection diagnosis in between), and she gave me MetroGel both times (for the BV). This past time, I followed the MetroGel up immediately with a precautionary yeast treatment; still the discharge and some level of internal and vulvular burning has been constant and consistent. I don't feel that the medications are helping or even altering the symptoms. Which is frustrating me economically on top of emotionally, as my insurance will not cover the charges of diagnosis or treatment related to this. <P>My burning and stinging are very rarely if at all itchy, and I have no severe pain upon any type of penetration (sexual or medical applicators - I don't use tampons). Could this still be vulvar vestibulitis syndrome or a form of vulvodynia, perhaps associated with BV? <P>Also, from what I understand of some medical opinions, yeast infections and BV can be caused or related to high pH levels of the vagina. With this in mind, could simple dietary changes help me? I've tried both increasing and decreasing my yogurt intake with no noticeable results - is there anything else I can try? <P>As an offshoot of that, I also just today started to use an over-the-coutner product called RepHresh. The product is marketed as a substitution for douching and as a gel to help with vaginal odor (which I suprisingly don't have much of if any at all). I don't know yet whether or not it will be effective.<P>Other facts about me that may or may not be related: I am currently on Ortho-Tricyclen, and my boyfriend and are monogomous (sp?) and very happy on an emotoinal level. I'm 23, have been tested for STDs, and don't have any. I also think that I might have a small cyst on my left ovary due to a very focused and specified ache that I've had during this same seven month time period. Problems with bowels, etc, have been ruled out as causes of the pain. I just haven't wanted to pay for a sonogram, especially since I don't see the cyst as anything really that abnormal - just a bit uncomfortable. <P>I found a lot of condolence in reading musicgirl7's post because I felt like there was someone else out there like me. Thank you musicgirl. <P>Likewise, I welcome any thoughts or comments on these symptoms - medical or empathetic. <P>Thanks, <BR>Catherine07