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Women's Health

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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.


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.

For patients who have a secondary condition called lichen dermatoses -- a group of skin conditions in the vulva that can cause severe itching and/or scar tissue -- a mix of topical steroids with a tiny dab of estrogen cream can help heal the damage to the vulvar tissue and decrease symptoms.

Physical therapy (with a highly trained specialist) is another valuable form of treatment for some patients. By correcting misalignments, strengthening pelvic floor muscles (the layers of muscles stretching between your legs and supporting your organs, bladder, uterus, and ovaries), and working to loosen muscles that have become painfully tight, these therapists can help dramatically reduce pain.

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