Is painful sex limiting your love life?
Vagina, vagina, vagina.
Say it with me. “Vagina, vagina, vagina.”
Feel better?
Or embarrassed?
Labelling the female genitalia such words as “birdie,” “fanny,” “vajayjay” etc. has been shown to create a dissociation.
Paediatricians and child psychologists have always encouraged kids to use the proper terminology. If parents are uncomfortable or embarrassed about discussing body parts with their children, the children will pick up on the tension, which could lead down a path to shame and secrecy.
✌🏾 Haven’t we had enough of this, ladies?
Our bodies are amazing – we can create a human life inside us which I personally think is freakin’ awesome architecture!
Stop feeling ashamed about it; ditch the bitch (the attitude).
20% of all women are having pain with sex. From having experienced it myself to working with women on a daily basis who complain of penetration disorders, I would assert that this statistic is much higher.
Data on the subject of pain in the vulvar region, or with intercourse is hard to gather, as many women are not reporting this accurately to their doctors.
According to the 2018 Jean Hailes’ Women’s Health Week Survey, 1/5 younger women (aged 18-35) have discussed or need to discuss with their doctor pain when having sex.
¼ have discussed or need to discuss a lack of interest in sex. 1/5 women younger than 66 reported that they have not but need to discuss with their doctor a lack of interest in sex; this is higher than any other topic that women identified as an issue.
Somehow this doesn’t fit with on screen steamy sex scenes where most women seem to be at peak arousal within minutes. And that perfect, dive in lubrication?
Full arousal, on average, is achieved in 30 – 45 minutes; that would take too long to show on screen!
Get a diagnosis
How do you know if your vulva (fleshy lips), pelvic floor muscles (around the openings) and vagina are healthy?
What is normal?
What colour is your anatomy meant to be?
How much lubrication and discharge should you have?
The answer is, it’s individual. Your doctor, pelvic floor physiotherapist or gynaecologist can assess you to give you a better understanding of what is “normal.”
Pain with sex, at any age, is not.
Pelvic floor physio helps
My foray and fascination with becoming a pelvic floor physiotherapist started from my own personal sufferings.
By the age of 19, I had been a gymnast, sprinter, weight lifter, and BodyAttack fanatic (R.I.P pelvic floor). I was also that person running out of gym classes to avoid running and star jumps due to urine leakage. The mums at the gym who had also run off to the bathroom to avoid running and jumping questioned me “Why are you here? You haven’t had babies!” I didn’t have an answer, as 10 years ago I didn’t know that an over-active pelvic floor could lead to urine leakage and pain with intercourse.
Click here to find out what pelvic floor physiotherapists do.
Your pelvic floor physiotherapy treatment program may include strengthening (or in some cases, downtraining) your pelvic floor, advice on reducing strains, nutrition, stress busting techniques, and detailed guidance on how to use some of the equipment listed below.
Get to know your body
Can’t tell your vagina from your vestibule?
You’re not alone. 44% of women and over 50% of men cannot identify where the vagina is on a picture, (The Eve Appeal, 2016)!
Knowing your anatomy and better education about our body parts is the first step.
How long does it take you to reach peak arousal? When are you at maximum lubrication, with lengthening of the vagina and erection of the labia?
That depends on your anatomy, stress levels, hormones, mode of arousal, nutrition, and so much more.
Using your clitoris.
Vaginal dryness can result from ageing of the vaginal tissue, menopause, breastfeeding, medications, diabetes, IBS, Crohn’s disease, and the side effects of chemotherapy.
To comprehend the link between female arousal and vaginal lubrication, the crucial role of the clitoris must be explored. Stimulation of the clitoris sends nerve signals up the sacral nerves (in your tailbone), which brings more blood flow to the vulva, vagina and clitoris, causing them to swell. This increased pressure on the capillaries (tiny blood vessels) pushes fluid from the vaginal walls into the vagina, or what we know as lubrication or being “wet.”
More clitoral stimulation actually causes the deeper muscles of the pelvic floor (levator ani) to contract, in turn causing the upper end of the vagina to open up to 7cm, while the lower end of the vagina narrows as the superficial pelvic floor muscles (near the opening) contract faster.
These pelvic floor muscle spasms or convulsions occur around 5 – 15 times every 0.8 seconds, while the vaginal length increases to an average of 10cm.
While the increased natural secretions and vaginal dimension changes are more accommodating to a penis or toy – here’s a little known fact – it can take 30 – 45 minutes to achieve this state of full arousal!
In summary – don’t skip the foreplay!
Mindfulness/ down training Pelvic Floor
Is your pelvic floor switched on as a defence mechanism?
The pelvic floor reacts to watching “threatening,” “sexually threatening,” “neutral” & “erotic” film scenes.
A 2001 study examined pelvic floor muscle activity using electromyographic (EMG) sensors in the pelvic floor muscles. Women responded with increased pelvic floor muscle activity to the threatening and sexually-threatening film excerpt, while the neutral & erotic scenes did little to the pelvic floor activity. The authors concluded that when the body perceived a threat, a defence reaction happened causing the pelvic floor to tighten.
This can be problematic for women who already have overactivity of the pelvic floor.
One of the first strategies to down train the pelvic floor is diaphragmatic breathing. Belly breathing, or 3D breathing encourages more downwards movement of the diaphragm (sitting below the lungs). This, in turn, works with the pelvic floor like a reciprocating piston. When the diaphragm moves down, so too does the pelvic floor, allowing it to lengthen and relax.
Dilators
Dilators are cylindrical shaped trainers that can gently release and stretch the muscles around the vaginal opening.
The smallest size can be the width of your little finger, ranging all the way up to 4cm in pre packaged kits. These can be made of plastic, glass or flexible silicon, and I encourage my clients to assess what size they require based on personal preference and /or male sexual partner’s size.
Lubricant
65% of women use lubricant.
Natural lubrication in the vagina is caused by fluid/ secretions oozing from the vaginal walls from adequate blood flow and pressure.
Causes of less lubrication in the vagina include:
– Low oestrogen: changes in hormone levels can occur during the luteal phase of your period, breastfeeding, menopause, and use of the contraceptive pill
– Douching/ washing: inside the vagina cleans itself, pretty nifty hey? Chemicals inside the vagina can change the pH and strip the natural secretions of the vagina! No need to use body wash, soaps, detergents, scrubbers, wipes, or douches. Mother Nature got the design right.
Medications
Just think that anti depressants, anti histamines and antibiotics = anti – lubrication!
Anti histamines cause vasoconstriction (constrict the tiny blood vessels) in the vaginal membrane.
➡️ less blood flow to the vaginal walls.
➡️ less secretions/ lubrication.
Anxiety studies show there is less blood flow to the vaginal walls when a woman is scared or anxious.
Too much alcohol and coffee, could your vagina be dehydrated?
More tips on naturally increasing lubrication & what lube to use can be found in the blog: The Lowdown on Lubricant.
The Oh nut
If the depth of penetration is an issue, the Oh Nut can limit how deep a penis can enter during intercourse.
Worn externally at the base of a penetrating partner (e.g. on their shaft or on a toy), the Oh nut compresses down to act as a soft buffer during sex. Each set comes with 4 linking rings that allow you to make simple adjustments, so you and your partner can discover what depths feel comfortable for both.
CBD oil
Hear me out.
If you’re looking to buy CBD oil in Australia, you cannot buy it online or over the counter. CBD is considered a Schedule 4 Controlled Drug by the Office of Drug Control. This means that a doctor must apply to the TGA (Therapeutic Goods Administration) for an approval to be able to prescribe products containing CBD.
The effects of topical CBD as a dermatological and anti anxiety treatment have long been studied, however its use with painful intercourse is unclear. A study in 2010 Fitoterapia) asserted that topical CBD has an anti-inflammatory effect, which could theoretically make sex more comfortable. However, there aren’t any studies specific on CBD and lubrication.
So there you have it. Try one, try them all. Theres no reason to not enjoy having sex anymore.
Managing pain with intercourse requires a team which may include your doctor, gastroenterologist, pelvic floor physiotherapist, nutritionist and sexual psychotherapist.
Book in for an assessment today. Pelvic floor physiotherapists are trained to assess and treat over activity of the pelvic floor, scar tissue management, faecal urgency, straining and dyssyneric defecation, pelvic organ prolapse (POP), fascial release work for endometriosis and more.
Performance Plus Women’s Physiotherapy provides the Women’s Health Service at Waverley Private Hospital.
Consulting nearby at 40 Lemana Crescent Mount Waverley for outpatients means that all your Women’s Health Services are covered.
It’s convenient location means that it services the suburbs of Glen Waverley, Burwood, Chadstone, Oakleigh and Clayton as well as suburbs along the south eastern corridor such as Wheelers Hill, Mulgrave, Dandenong and Springvale.
Phone 03 9815 2555 (Glenferrie Sports and Spinal)
