His and Her Health

I am 25 years old and have had this problem for about 3 years. I get a throbbing pain when I am aroused--it's not in my vagina, it's actually hard to describe where it is...almost like it isn't coming from any female organ, but the pain can sometimes radiate to the vaginal area and occasionally after a strong episode I can actually feel soreness in the right buttock. The throbbing pain starts on the lower, right side of the vulvar area (I'm not really sure what to call the area it's in) and the best way I can describe the pain is that it feels like I have a rush of blood trying to get through a blocked vessel. It's a throbbing pain and can sometimes radiate to the vaginal opening, the radiating pain feels like I'm being ripped apart or stabbed with a knife (sorry to be graphic). My fiance has put his finger on the spot where the throbbing is and says he can actually feel it pulsating (I have too). I also have a problem with the vaginal opening shrinking which makes intercourse, exams, and tampons painful and each of those has caused tearing. Occasionally when we do manage intercourse it feels like I'm being rubbed with sandpaper inside my vagina, but my fiance has never noticed this feeling. All of these problems have caused tension during sex and lowered sex drive because I'm always so nervous about how bad it will hurt. I do not have to be attempting sex for the throbbing to occur...even if I'm just sitting on the couch and get aroused the throbbing will start. Does anyone else have this problem?? I have used testosterone creame to try and increase my sex drive and most recently my doctor prescribed an estrogen creame to help with the shrinking/tearing...the testosterone did not help at all, but the estrogen actually helped with my sex drive...unfortunately, the pain causes so much tension that sex is almost impossible. I don't know what to do or where to start, my ob/gyn said that anatomically everything is fine and he doesn't know what the throbbing could be...is there a gland or series of blood vessels that could be causing this?? We are getting married next year and I just can't see spending the rest of my life only having sex a couple of times a year.

You are not alone. There are quite a few threads on this topic in the "sexual pain" forum, although nobody seems to have reached a solution yet. I'm sorry that your doctor is unable to help you. If it is a gland or a blocked duct, I would think that something could be done surgically about it, but I would also expect that your doctor would be able to identify that problem.

I am actually shocked to hear that your doctor gave you hormones to try to improve your sex drive. I see no evidence from what you've said that your low sex drive is caused by anything other than fear of pain - certainly not low hormone levels!

I think you should see a different doctor. It sounds like something physiological. Actually, it sounds more like vaginismus - a muscular spasm. You can search here on this forum for information about that.

He only prescribed the testosterone for the lack of sex drive, but that was before the shrinking occured and before I realized that the pain was only occuring during arousal...the estrogen was not prescribed for lack of sex drive, it was prescribed to help increase my production of natural lubrication and to help with the shrinkage...somehow it did manage to help my sex drive though!

At 25 you're way too young for HRT. Really, fear of pain alone is enough to explain your reduced sex drive. If you had a broken leg, you'd probably develop an aversion to taking long hikes. You need to fix the source of the problem, not the symptoms.

Try astroglide for lubrication. It's great stuff, and much safer than messing with your hormones.

If you can get aroused just sitting on the couch, there's nothing wrong with your sex drive.

Sanda2007, you may have a pudendal nerve issue.
The pudendal nerve controls all sexual sensation, as well as the anal sphincter and what nerve endings you do have in your vagina and vulvar area. When it is inflamed, it can cause pain or numbness in the rear or buttocks, oversenstivity of the vulva, painful spasms in the vagina, heightened or painful arousal, etc. It sounds like this may be affecting you on one side of your body only, which can happen.

You should avoid caffeine in your diet and also avoid any sexual activity for the time being (including masturbation), to see if this starts to calm the nerve down. You should also try basic pelvic floor relaxation exercises, because when the nerve is acting up, it makes the muscles of your pelvic floor tense, and that just irritates the nerve even more. You may in fact have a chronic habit of tensing your pelvic floor muscles and that only aggravates the condition.

You can also tell your doctor and he may be able to prescribe something that will calm the nerve down (although these drugs tend to also kill your sex drive as long as you take them, unfortunately). If you have experienced this for three years it may take time for it to go away.

Hi, I have the very same problem. I must have pinched the nerve while using a vibrator and I have had problems since. After orgasm I have a dull ache that doesn't resolve for a week. I have stinging, tingling upon arousal. Sex is something I have a problem with. Please let me know what you have done to fix it. Right now I am using ice.

Perhaps you may want to seek assistance from a physical therapist. I know there was one that posted here before. Do a search for 'physical therapy or therapist' on this board and see what comes up.

I'm reading this book by a physical therapist and find the amount of information that she has about muscles, joints, nerves, ligaments , etc. to be fascinating. She seems to be more helpful than traditional doctors on certain health conditions. A regular doctor may typically just prescribe drugs, whereas the PT will help you strenghten the whatever part(s) of the body that are weak or compressed in order to aleviate pain. The book I have is called The Core Program by Peggy Brill PT. She has some exercises in her book especially for the pelvic floor called Dead Bugs. Maybe that could help.

Laura where are you? You had given great advice on the balance of PH. Give me a shout out here, or e mail me at ********. I would like to discuss your method further.


On another note. I had recently also gotten advice from this forum to contact the NVA for my vulvodynia problems. I was looking for a doctor who could help me and apparently the NVA was the place to go. Unfortunately I could not pay for a "membership" to the NVA so they wouldn't help me. I tried to apply for a membership on financial distress reasons but was denied that as well. Great organization right??? I have nothing good to say about them.
I have gotten more help from the people right here.
******
Moderator's Note
Sorry we do not allow email addresses to be posted on the bulletin boards. You may put your address in your profile for others to contact you.

<small>[ 01-15-2008, 03:16 PM: Message edited by: Moderator ]</small>

Sanda2007,

It sounds like you have some muscle spasming after intercourse and it sounds like you have trigger points. the trigger points may be the reason for the referred pain and they are probably in your pelvic floor as well as externally (butock, low back or thighs).

I have seen women your age receieving estrogen cream for the tearing and thin tissue, so I am not surprised even to your age.

I highly suggest seeing a doctor who works with pelvic floor dysfunction and perhaps PT.
An above reply mentione the Core Program book: that book is very nice, in fact I just read it too, but if you have spasming in the pelvic floor muscles, I suggest not doing abdominal exercise right now. Things will get more complicated if you continue to tighten muscles that are unable to be relaxed on their own.

Hope this helps
Niva

<small>[ 01-16-2008, 04:32 PM: Message edited by: Moderator ]</small>

Sanda2007, did you ever get a cure for the pain you were having? Reason I'm asking is that I have the same exact thing. I've been with this pain since 2002. My doctor's have run all tests on me and found nothing. I even had surgery for adhesions, but the pain was back within two days. I'm thinking of having my left ovary removed due to the pain. Anyone with any ideas, please feel free. This pain feels like something is going to explode inside of me. I actually had a female gyn tell me that maybe I just didn't want to have sex with my husband and that was the cause of the pain. What a moron.

Thank you

Hello wonderful women,
I just came across this site and signed up in order to bring up Myofascial Release in case nobody else has. MFR is often highly effective in treating women experiencing vulvodynia, painful intercourse, or other pelvic floor pain and dysfunction. MFR most often is offered by physical therapy clinics. Look for PT's with extensive training in and years of experience practicing Myofascial Release for the pelvic area. MFR can also help to relieve other kinds of pain and dysfunction. Many PT's have told me that they get excellent results using Myofascial Release.

hi, i had this problem too. it went away when i started taking spironolactone for cystic acne (150 mg). my theory as to why this worked for me is that the medicine reduces male hormones... i had the horrible throbbing pain during arousal that i could feel actually throbbing. i kept waiting for it to go away, but it only got worse. i also started getting cystic acne & was gaining weight that i could not lose all around the same time, but didn't really connect them together. i was tested for and then diagnosed with insulin resistance.

unfortunately, i did not have my hormones checked before i started taking spironolactone, so i can't confirm whether this is what fixed me. i would guess that my testosterone levels were probably in the "normal range" by doctor standards, but probably still too high for me personally.

anyway, the spironolactone has improved my skin, i lost all the weight i gained (turns out it was water retention), and i no longer have the throbbing pain during arousal. it could be coincidence since i wasn't prescribed the meds. for that problem, but it could also be worth looking into.

From your symptoms it does not sound like you have vulvadynia but rather PSAS which stands for persistent sexual arousal syndrome or disorder. The reasons this happens can be multiple including medication induced, trauma, an arterio-venous malformation in the pelvic vessels, pelvic vein congestion and idiopathic. Pudendal nerve syndrome or entrapment or scar tissue around it can also cause similar symptoms. You need to be evaluated by someone with experience in pelvic pain as well as PSAS. Pelvic floor spasm can also cause similar symptoms and may happen in isolation or in conjuction with PSAS. I would be happy to try to give you the names of experts in your area.

Hi,
I wrote in about a month ago about pain with orgasm. Today I went on a Pudendal Nerve website and read many posts. I would very much like to know of experts in my area (SF Bay Area) who have experience with pelvic pain, PNE, etc. I don't have pain on a daily basis, but if I have an orgasm, watch out...it's awful! I have been lifting weights/working out on weight machines for about 6-8 months, and several posts on the PNE website cited weightlifting as a factor, if you are already predisposed to the condition. My orgasm pain is new (last 6 months) and before that I had enjoyed almost 50 years of pleasurable orgasms. I thought I could do it 'til I'm a truly old lady, but now I'm truly sad, scared and depressed about it!!

Thank you anyone who can help!!
marigold7