As a woman, when sex hurts, it's like a little slap in the face. After a string of pro-sexuality pop culture bits - Sex and the City (1998-2004), Girls (2012-2017), Broad City (2014-), Chewing Gum (2015-), and Offspring (2010-), to name a few - women seem finally able to express their sexual needs outside of the Madonna/whore complex prescribed to them by ~*THE PATRIARCHY*~.
(For more on the way that pop culture affects minority groups, please have a look at Miranda Fricker's brilliant work, Epistemic Injustice: Power and the Ethics of Knowing, 2007).
Here we are, women 'of the world', getting our flirt on, spending more time in bed (mine, his, hers, theirs), and more money on brightly-coloured toys that cost us an inexplicably high portion of our paycheck (how much is silicone anyway?). Then, bam! The pain hits. Oh the pain.
Burning. Itching. Leaking. Hot to the touch - and not in the good way. All this and more welcomes one in three women at some point in their sexual journey. It's not fair, is it? We're always told that inequality is a reliable marker of existence - to live is to live with unfairness.
But I've never once felt better for hearing that. What did help was knowing that I wasn't alone -that there was someone who was truly sorry for what I was going through, someone who possibly knew the same pain - and that I had options.
Because you do. You have options. They range from the more and the lesser complicated, but you have them nonetheless.
You don't have to hurt forever. One day, sooner than you might think, you can enjoy all the loveliness that great, healthy sex can provide. How? Well, take a look at the below list of possible causes for pain during sex (fancy name - dyspareunia), and then check out the available treatments and specialists.
Don't see any symptoms that match your pain? Scroll down for a list of useful questions to ask your gyne or GP next time you visit. Then you may also email me directly at firstname.lastname@example.org, and I'll be able to share more of my own experiences with dyspareunia. I'm always ready to talk about vaginas. K, you ready? Let's go.
Wait - one more thing. In this article, and on this blog in general - we use the proper name for our genitals. Vagina. Penis. Discharge. Cervix. Erection. They're all here. This is specifically because at toofufu, we encourage people - women especially - to know their bodies; undoing many years of shaming practices that have left us in danger of damage from manageable and treatable diseases. We say, 'No more!' And we hope you do, too. We realise it might be a while before you get used to speaking like this - either in your head or IRL - but we also acknowledge that it's VERY important to do so. K, ready for reals?
is this you?
The ouch: Latex allergy. Cause: A body's reaction to the milky liquid extracted from a rubber tree to make condoms and other protection items that make contact with it. Symptoms: Mild / Itching, redness of skin, rash or hives, Severe / coughing, wheezing, itchy and watering eyes, difficulty breathing, sneezing, runny nose, and itchy throat, Urgent / hives or swelling, difficulty breathing, nausea and vomiting, wheezing, drop in blood pressure, dizziness, loss of consciousness, confusion, rapid or weak pulse. All of these symptoms were listed and used here from the Mayo Clinic.
Treatment: Mild / Switch to non-latex condoms like these from Skyn, and these from Durex. If they're not available in your area, just keep an eye out for condom packaging that stipulates non-latex - it's an added benefit so companies do want to make this known. If you're using a female condom or dental dam, check with your local clinic (like Marie Stopes in South Africa) for non-latex options, or in the case of a dental dam, use a non-latex condom instead - here's how. For any severe or urgent symptoms, please get your fine ass to a doctor or emergency room as soon as possible.
To keep in mind: A latex allergy might not be the deepest root of your pain, but it may contribute to overall sensitivity, so err on the side of caution and grab some non-latex xondoms to try out for a test period.
The ouch: Vaginismus. Cause: Involuntary spasms in the vaginal muscles during penetration. Pain is brought on with penetration (with a penis, finger, dildo, vibrator - anything that you insert into your vagina), when the muscle tenses against insertion, and may or may not go with the withdrawal of the penetrating object or limb. Symptoms: Sharp pain during sex. The pain is often experienced as a tear or may feel like the inserted object is 'hitting a wall'. The causes of vaginismus are not well-known, but they are thought to be made up of physical as well as psychological components. This does not, I repeat, not mean that the pain is in your head. Rather, your psychological state may have real, physical consequences in your body. This Vaginismus Centre has an incredible website filled with more resources, if you'd like to read up on this.
Treatment: The same centre recommends a ten-step program for long-term sufferers (primary vaginismus), and a shorter one for those who have had pain-free sex in the past, but no longer do (secondary vaginismus). The steps are largely concerned with education, and practical treatments such as exercises and the use of dilators. Speak to your gynecologist for a treatment plan that will suit your specific needs. You might want to find a gynecologist in your area that has specifically dealt with vaginismus before, as it lends itself to be dismissed by medical professionals who don't have enough experience with it. Don't be afraid to email ahead and ask directly how much your gynecologist has seen of vaginismus, and whether there is someone they can recommend should you need a referral to doc more experience with your problems.
To keep in mind: Like other conditions that affect the genital and pelvic floor areas, vaginismus sometimes means having a team of specialists rather than one gynecologist or doctor. You may, for example, also be referred to a pelvic floor specialist, as well as a sex therapist to help heal the trauma that has built up over the time you have associated sex with pain. It takes a village. And a lot of money. Speak to your medical aid provider for payment options, and see if your treatment can span over longer periods to ease financial stresses.
The ouch: Irritation. Cause: Chafing and/or drying from tampons, underwear, bath products, shaving, and waxes. These items and behaviors can sometimes leave debris and dry out your vaginal cavity (as in the case of tampons), give you an infection by drawing bacteria from your anus to your vagina (thanks for nothing, g-strings), rub uncomfortably against your vagina's thin skin, leaving the area more sensitized (Tight undies, say 'bye'!), make your vagina a bacteria f*ckfest (No, but for real, 'bye-bye' tight underwear. And take sweaty underwear, and damp swimsuits with you.), strip your beautiful wobblies of good bacteria that keep them protected from stuff you'd prefer to keep out (chill out, bath bombs), or remove another of your vagina's best friends - hair. Symptoms: Itching, dryness, sensitivity, and urinary tract and/or yeast infections.
Treatment: There are thankfully a lot of alternatives to all that nasty. Blood collection / Instead of super-absorbent tampons that steal your vagina's juices along with the stuff you actually wanted it to take, use a gentler kind like that of Natracare. You could also try reusable pads (not ideal for the very sensitive), or a collection cup like this Mooncup babe on Faithful to Nature.
Thongs / Okay, so, no real alternative here besides reducing your time in your favourite g-string, and making sure it fits snug to squash out any rubbing (ouch!). Tight undies / We like to show off our butt as much as the next fourth-wave feminist blog, and we get that a pouchy nether region isn't the stuff of novels, but from now on, you're thinking for two. Yourself, and your vagina. Skip panties that sit too snug to avoid seams rubbing against your clitoris et al, potentially causing sensitivity. You could also switch to cotton fabrics that allow air to reach your vagina, keeping the area cool. A damp, sweaty climate just equals a higher risk of infection, and sex doesn't mix well with an infection, as you might well know.
Bath products / Harsh soaps and fragrances can mess with the pH balance of your vagina, causing irritation. Avoid using bathbombs, soaps, gels, and pretty much most other colourful and nice-smelling products where you can - or minimise the time you spend in the tub. Wash your vagina with water only. If you're used to washing rigorously with soap, this might seem strange. But don't worry, your vagina will still be clean, only minus the irritation. Yay!
Shaving and waxing / No matter how much you love or hate your pubic hair, the undeniable fact is that it's there to serve the purpose of protecting your precious cargo from infection. A lot of women experience issues with hair removal, and if you're one of them, you might want to consider going full bush over Brazilian. Even if it's just for a while to rule your waxes out of the pain equation. We're more 'top and sides' gals, ourselves, but that's just us.
To keep in mind: This list doesn't mean that your vagina has to live a life of boredom and restraint. Whether you do some or all of these, for a few months or a few years, they'll likely mean a healthier, happier vagina in the long-term.
And there is nothing boring or conservative about a women ready to rock out with pain-free sex. Also, there's a need here to note that your vagina is not irritated because you are 'dirty', have 'too many' sexual partners, or are otherwise out of whack from the very narrow prescriptions of old-timey gender norms that try to dictate a 'good' woman's behaviour. You've got irritation from things that easily irritate vaginas on a world-wide scale. These are just some simple ways to get you back to fun, safe, and consensual sex as soon as possible.
The ouch: Endometriosis. Cause: Endo is a condition that arises when uterine-lining grows outside of the uterus. The exact cause isn't known, but theories range from genetics, overload during heavy menstruation, and retrograde bleeding, through to immune system disorders. There are few risk factors that you might also want to look through. Symptoms: Very painful cramps during menstruation, painful sex (as penetration can push and pull against growths), heavy bleeding, painful bowel movements and/or urination, among others. Read more by visiting this entry by the Mayo Clinic.
Treatment: If you think you might have endometriosis, you need to see your gynecologist STAT. I don't want to you panic, but it is a pretty serious vibe, and it's best to get it checked out soon so you can manage your symptoms and get started on a treatment plan. Speaking of which, if your gynecologist confirms your diagnosis (with a pelvic exam, ultrasound, and/or a laparoscopy), there are a bunch of things you'll be able to. Pain medication, hormone therapy, and later on, perhaps surgery.
To keep in mind: There's a lot you can do about what you're going through. Don't get despondent. But don't take it from me, reach out to the Endometriosis Society of South Africa, or do a Google search for a similar group in your country.
The ouch: Vulvodynia. Cause: People aren't altogether sure what cause vulvodynia. The National Vulvodynia Associations says it might be nerve damage, an increase of nerve-fibers, pelvic floor weakness, and some other stuff. Symptoms: A raw, sensitive vestibule and vulvar area, UTI-like symptoms, with muscle tightness in the vaginal cavity, causing (among other things) pain during intercourse, pain when wearing tight pants, painful urination, painful tampon insertion, sensitivity to touch, an intolerance to synthetic materials (as in, where your underwear's concerned), increased frequency and urgency to urinate, urine leakage, bladder spasms, the association of sex with pain, and dryness.
Treatment: There are many ways to ease the symptoms of vulvodynia, but none to date do much more than help with pain management. This means that while you can almost definitely feel much, much better soon, it's unlikely that you will be 'cured' of vulvodynia. First off, you'll need to get rid of using any soap - at all - on your vagina. Wash yourself with lukewarm water instead. Avoid submerging yourself in chemically-treated water (swimming pools with loads of chlorine, for example), and don't dally about in the bath when using soap and other cleansing products for the rest of your body. Depending on your pain levels, you might want to forgo tampons for pads, but only use pads or liners during your period - you don't want to create a hotbed for bacteria. You might also want to rethink skinny jeans, or anything tight with a heavy seam running over your general vagina area.
If you're a gym bunny, consider buying tights with a gusset. You can buy an over-the-counter topical numbing cream like ones with this ingredient to use when experiencing intense pain, or after sex. An ice pack covered in a clean cloth will also help bring down inflammation after nookie. Wear nothing from the waist down to sleep, and walk around as much as you can without underwear - obviously easier to do if you live alone or with a close partner or friend. You'll also want to see a gynecologist as soon as possible so you can discuss other, maybe more specialised treatments. What helped me in the end was a daily dose of pain medication (80mg Trepiline), a vestibulectomy, and regular internal massage with a wand like this one from Therawand. Your journey will probably be a little to a lot different, so don't let that freak you out. The point is, find a doctor you can trust. Research healthcare professionals who have written papers on vulvodynia, and check to see if any are in your area. I found my doctor by literally googling 'vulvodynia research Cape Town'. A year and a bit later, he's one of my favourite people.
To keep in mind: I've had a lot of experience with this one. It took me seven years before I even found a diagnosis. There were times when I thought I'd never be able to watch a movie, have sex, go to a concert, travel, or even go to the bathroom pain-free. I'm happy to say I can do all of those things. Yes, there is still pain, but there's way, way less of it. You can do this babe. You're not alone. There are women all around the world experiencing the same thing, and I'm just an email away (email@example.com).
shit to ask your doctor
If you didn't see your brand of fucked-up in the list above, it doesn't mean that nothing is wrong, and you'll still want to chat to your GP or gynecologist as soon as you're able to, mkay?Before you go, make sure you know exactly what your symptoms are. Do you feel pain? If so, where? Does it come at a certain time, or coincide with other events like excersize, sex or menstruation? What kind of pain is it? Dry, raw, sharp, dull? Is there discharge? What colour is it? Does it have a smell? When last did you have your period, and how regular is your cycle? When you know the answers to these, young master, you will have the key to vaginal success, and find the path of vulvar enlightenment. Next up - the doctor. Here's some things you might to ask them:
1. I'm having pain in (body part), it's (description of pain), and it worsens when I (name of activity). What could be going on? 2. Can I be tested for STD's? (Don't get spooked - this is a normal thing to do as someone who is a responsible, health-conscious adult). 3. Is there a specialist I can talk to about this in more detail? 4. I'm not sure I'm comfortable with (type of treatment), is there an alternative? 5. What are the next steps in my treatment? 6. What are the next steps if this (type of treatment) fails? 7. Where can I get this (type of treatment or medication) at a better price?
By no means an exhaustive list, but you'll be off to a good start for sure. The super-important thing to keep in mind is that you need to do your own research, and that doctor's don't know your body better than you do. Practice, practice, practice describing your pain and its manifestations. Knowing that will drastically help to find a diagnosis. Okay, kids. I'm outie. Hope it was good for you.