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Vaginal Problems That Affect Your Sex Life

Vaginal disorders ranging from chronic infections to vaginitis, fibroids, and stress incontinence can damage your sexual health and general well-being.

Vaginitis continued...

Treatment is painless and easy; most women simply insert at bedtime a prescribed cream or an ovule (a soft suppository) -- generally soothing but messy -- or they can take a prescription oral antifungal such as Diflucan. You’ll avoid the mess, but relief might take a few days longer.

Atrophic vaginitis can develop if you’re breastfeeding or taking progestin-only birth control pills; both may cause a dip in estrogen levels. This condition feels like an infection with burning, itching, and pain, but there’s no active infection. Treatments such as estrogen creams or a vaginal estrogen ring (inserted by your doctor) can help.

Trichomoniasis, a sexually transmitted infection, can cause a greenish-yellow frothy discharge, with some itching and burning. Women might notice irritation with intercourse. Like BV, “trich” is easily treated with oral or vaginal antibiotics.

If you think you have any of these, see your doctor. Loading up on over-the-counter creams will only make the problem worse if you have a different type of infection. And whatever you do, don’t douche. “When a woman douches, she rinses out the bacteria in question but also [healthy] bacteria that are responsible for normal secretions,” says Kellogg.

Vulvodynia

Imagine vaginal burning and pain so severe you can’t sit comfortably, wear fitted clothing, or have intercourse. That’s the reality women with vulvodynia face -- and there’s no quick fix. Some suffer for years before finding the right treatment (or even any relief).

That’s why Phyllis Mate, executive director of the National Vulvodynia Association, was incensed by a recent episode of ABC’s Private Practice, in which Dr. Addison Montgomery (played by Kate Walsh) diagnosed and cured a patient’s vulvodynia in a single episode. “While the producers deserve credit for trying to depict the symptoms of vulvodynia, 13 million women in the real world would painfully disagree with the show’s fairy-tale ending,” Mate says.

Doctors don’t know exactly what causes vulvodynia, but possible contributors include injury to nerves in the vulva, hypersensitivity to Candida, and pelvic floor muscle spasms. The most common form of vulvodynia is vulvar vestibulitis syndrome (VVS), which affects the tiny glands that lie at the top and bottom of the vaginal opening.

For years, patients have been treated with tricyclic antidepressants (to block pain receptors in the vulva), topical estrogen creams and anesthetics (such as lidocaine), anticonvulsants, and surgery. But newer, less invasive treatments are working wonders. To curb pain and restore sexual function, Kellogg treats some patients with Capsaicin cream, a specially compounded ointment that contains the active ingredient in chili peppers. It might cause discomfort on contact but can dramatically reduce symptoms.

If a woman’s condition is flared by a Candida hypersensitivity -- to which even a slight imbalance can cause itching and burning -- weekly doses of an oral antifungal medication over several weeks or months can help alleviate symptoms.

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