By: Miranda Abild
Note: The following article is not intended as medical advice and use the content at your own risk. If you feel you might be experiencing any of the below, you may wish to speak to a medical professional.
Did you know that up to 25% of people born with vulva’s experience consistent pain in their genitals at some point in their lives? There’s no beating around the bush with this one (pun intended), it’s time to get frank and open about vulvar pain.
While this pain comes in many shapes and sizes - vulvodynia, provoked vestibulodynia, vaginismus – each has the potential to turn what is meant to feel good – genital touch – into one of discomfort and pain. Why does it happen? The reasons appear to be a mix of environment, genetics, psychology, and immune response to varying degrees. In the past, such conditions would be treated with hormone cream, anesthetic, and even surgical removal of the area. Thankfully, treatment has come a long way and while it may not be perfect, many experience at least some relief after exploring the following.
1. DIAGNOSIS
This can be one of the most challenging factors to treating vulvar pain. Shame and embarrassment can prevent people from seeking help or from talking frankly about their experience. Unfortunately, the longer these conditions go undiagnosed, the longer it can take to get support and relief. While getting diagnosed isn’t treatment of itself, it can mean getting better treatments (like with specialists like gynecologists or sex therapists) or getting treatment covered by insurance.
2. EDUCATION
Research has shown that learning about how our bodies work sexually – desire, arousal, orgasm – all positively influence our experiences. Additionally, education on how our pain systems work can help those with vulvas feel less responsible for the pain and more empowered to change it. Taking the time to learn can be one of the best investments in your sexual health. I highly recommend Better Sex Through Mindfulness by Dr. Lori Brotto as a starting place.
3. MINDFULNESS
You may have heard this term thrown around a lot lately and that’s not without good reason. Mindfulness practices have been shown to significantly improve the symptoms of depression, anxiety, and pain. For these reasons, mindfulness was used as a potential treatment of vulvar pain and was demonstrated, over time, to be more effective than any other form of treatment available when combined with education.
Whatever the shape of the practice – following a book, a podcast, app, a workshop at a local yoga studio – it’s time to start a mindfulness practice. Even if you don’t experience vulvar pain! Mindfulness allows us to take a step back from our thoughts as reality, choosing those we wish to give energy to and walking away from those that do not serve. You can find a time-tested list of resources here.
4. SOLO SEX
For those experiencing vulvar pain, the idea of touch itself can illicit pain. So start very slowly. In the beginning, remove any pressures of genital touch, penetration or orgasm. You may, for example, get naked, curl up under a soft blanket, and let your hands explore your body in ways that may be arousing without touching the genitals. The moment the experience becomes painful, stop. Go no further. Each time you do this, you might try to go a little further but that need not be the goal. Simply re-learning what can feel arousing in the body is an important first step but remember to stop at first sign of pain. This might feel like a slow and painstaking process but what you are doing here is trying to re-program the pathways of the brain toward arousal rather than going toward pain. And this takes time.
5. NON-SOLO SEX
The importance of communication with sexual partners cannot be overstated. By communicating frankly with potential sexual partners, we can better ensure boundaries for both parties are being upheld. You may consider, in the beginning, holding off on engaging with any type of sexual activity, instead focusing on activities that foster closeness – cuddling, kissing, looking into each other’s eyes. This removes the pressure of any social scripts we might have around sexual encounters (the other person(s) always have the option of engaging in their own solo sex). No longer is penetrative sex or orgasm the goal.
With clear communication and an agreement that activity will be stopped first sign of pain, panic, or stress, you may then choose to get naked with one another, exploring each other’s bodies the same way you explored your own with your solo sex. Only when this can be done without pain (and even with a degree of eagerness) is it time to move on to mutual masturbation or the many other forms of sex.
You see what I’m getting at here?
-No pain.
-Go slow.
-Respect needs.
-There is so much more than penetration and orgasm.
6. TOOLS
Lubrication - When engaging with the above practices, you will want to be well prepared. Be sure to use a good, natural lube like Smooth Operator or Wild Thing. Avoid perfumes, synthetics, or petroleum as these are the ones most likely to negatively impact your vulvar/vaginal microbiome.
Dilators – If you experience vaginismus (painful, involuntary contraction of the vaginal walls) or other forms of vaginal pain, you may wish to invest in a set of dilators. These phallic instruments vary in size and are used to make penetration during pelvic exam, and sexual encounter more comfortable.
First, starting with the smallest size, lubricate, and insert slowly until slight discomfort or muscle tension is experienced. Stop and remove at the first experience of pain. If tolerable, you may consider practicing a few Kegel exercises while inserted. You may also consider moving the dilator back and forth or spinning it while inserted. After 10 minutes, remove. Depending on your experience, you may choose to stop there or move on to the next size up. Inserted vaginally and kept there for 10 minutes. Practice this 3-4 times per week.
The subject of sexual pain is heavy and weighted with history for a lot of people. My final tip is to bring lightness into the experience however that might look for you. Turn your sexual practices into one’s of lavishness and enjoyment. Journal about it. Remove the pressures of the outside world and focus on what works for you yourself and in your partnerships. Take things slow and make your sexuality, whatever it might look like, your own.
For more information, please contact Miranda Abild at Miranda.abild@gmail.com.