79077114 V2Women who experience significant pain during sex may be suffering from vulvar vestibulitis, a type of vulvodynia. Vulvar vestibulitis is an inflammation of the vaginal vestibule, or the entrance to the vagina. Any type of pressure, whether it’s from penetration, inserting a tampon or even crossing your legs, could cause severe pain. Burning, stinging or irritation of the vestibule area can also accompany this condition. According to the International Pelvic Pain Society, approximately 200,000 women may suffer from vulvar vestibulitis.

Find the Right Treatment to Enjoy Sex Again

It used to be that women experienced pain during sex (and were brave enough to bring it up), were dismissed by their doctors. It was never considered a “real condition” until recently. And even today, many medical providers misdiagnose the underlying reason or don’t have the knowledge to accurately diagnose and recommend appropriate treatment options. I’m proud to have helped many women find the right treatment options for vulvar vestibulitis so they can enjoy sex again.

So what treatment options may be right for you? A few are outlined below.

Treatment Options for Vulvar Vestibulitis

  • Biofeedback helps patients understand their body’s natural responses – such as heart rate, muscle tension and temperature – and how to control them through calming techniques. Women suffering from vulvar vestibulitis may learn what triggers pain and what may help control or reduce it.
  • Injections of interferon may provide relief for some women. Interferon is an antiviral and antitumor medication that may block the inflammation that causes vaginal pain in some women.
  • Physical therapy has also helped women experience moderate improvement in their condition.
  • Surgery to remove the inflamed tissue may help reduce pain. Surgery is usually a last resort in very difficult circumstances that have not improved with simpler treatments. However, surgery in the wrong hands may make the condition worse.

The bottom line: Painful sex is not something you should suffer through in silence. There is a real, medical reason for your pain. It may be vulvar vestibulitis, or it may be another condition. I encourage you to speak openly and frankly about the symptoms and pain you’re experiencing. Because vaginal pain, whether it occurs daily, sporadically or only during sex, is never anything that you should be embarrassed about.

Contributed by Lucy Davies Treene, MSHS, PA-C


Interested in women’s sexual health? Contact us for an appointment.

A new study, released this past November, offers some promise to women suffering from low testosterone levels following a hysterectomy and/or oophorectomy (the removal of the ovaries). A woman’s hormone levels, including estrogen and testosterone, will dip after the ovaries are removed. And because of that dip, some women may find that they are tired more often, feel weaker or experience sexual dysfunction – including loss of desire, weak or absent orgasm.  But researchers found that testosterone helped boost sexual function, muscle mass and physical performance, such as chest-press and stair-climbing power in participants.

Testosterone therapy for women has been a long debated treatment approach. The FDA does not currently approve it for women because of the lack of long-term studies weighing its risks and benefits. The research published this fall did make one important step to FDA approval: it identified the testosterone levels needed for women to see improvements to their sex drive, strength and alertness. The next critical step is to complete studies that clearly outline any adverse long-term risks, such as increased risk of heart disease or certain types of cancers.

The good news – testosterone therapy is not new. Men and women have been undergoing it since 1940s, with no adverse side effects associated with testosterone. The testosterone patch is approved in Europe for increasing sexual desire  in women just like those in this study. Doctors in Britain and Australia prescribe it for women to help with many issues, from lack of mental clarity, sexual dysfunction to muscle weakness. Many women in the U.S. who receive testosterone therapy rave about it. And side effects many might associate with testosterone – excess facial hair, deeper voice or acne – have been minimal to non-existent in studies published to date.

So, what does all this mean for you? It means there may be one more option to help get your sex life back on track after midlife, menopause or hysterectomy. And that research is finally starting to catch up with what many doctors have already recognized – testosterone therapy can benefit many women. If you have questions about this study or testosterone therapy, please give me a call. I’m happy to answer your questions and help find a solution so you can feel like yourself again.

Interested in women’s sexual health? Contact us for an appointment.

Menopausal women who suffer from a common physical problem – so common it may impact 80 percent of them – will soon have a safer treatment to consider. And I’m proud and humbled to have authored the pivotal research study data leading to this breakthrough that has just been published in the journal Menopause.

A little background first: up to now the FDA has only approved treatment that is hormone-based to relieve hot flashes and night sweats associated with menopause. Considering that those symptoms are reported to be the most bothersome aspects of menopause, significantly affecting quality of life, one type of treatment that is not ideal for many women has been terribly limiting. For a variety of reasons, hormone-based therapy can carry certain risks for significant groups and the pervasiveness of symptoms makes it clear that the need exists for other options. I am thrilled that our work has produced such an option.

A product called Brisdelle is a new, already FDA-approved product that is about to be introduced to the post-menopausal health marketplace. It is unique as the first and up to now, only non-hormonal treatment for the most pervasive of what’s known as vasomotor symptoms (VMS) – night sweats and hot flashes. Clinical trials had shown that some drugs commonly used to treat depression and other psychiatric issues could be helpful, but further study was needed.

It was needed because studies released about ten years ago had pointed to some risk concerns for hormone-based treatments that made patients and clinicians reluctant. For a couple of years, prescriptions for the hormone therapy dropped drastically, leaving many patients without a viable option for treatment, and making it clear that a large group of those impacted simply chose to suffer through the symptoms, which can be severe. Alternative therapies gained some attention in popular media, but without the right kind of research and controls, additional risks were identified.

Our team studied the effects of the specific kinds of drugs designed for depression but in smaller doses, now known as LDMP treatment. The research followed standard protocols, involving nearly 600 participants in periods of up to six months. We were able to conclude that the treatment is safe, well tolerated and effective in reducing the frequency and severity of moderate to severe VMS symptoms due to menopause. The study also made evident that benefits persisted over time.

The results make it clear that LDMP treatment, now approved and on the market as Brisdelle, is an effective non-hormonal option for women and their health providers who need an alternative to estrogen-based therapies for this highly common problem.


Interested in women’s sexual health? Contact us for an appointment.

(Role) Play it Safe with Open Communication

Everyone is once again buzzing about the popular erotic novel, “Fifty Shades of Grey.” This time, people are talking about a recent study that’s reignited debate on whether books promote violence against women. The study, “Double Crap! Abuse and Harmed Identity in Fifty Shades of Grey”, found that the behavior of the main character, Anastasia, is consistent with that of women in abusive relationships. In the book, Anastasia is often stressed, changes her behavior to please her partner and avoid conflict, and experiences feelings of disempowerment and entrapment – all as a result of her relationship with Christian Grey. According to the study’s authors and the Center for Disease Control, these behaviors are hallmarks of intimate partner violence.

I’m all for sexual freedom, but never at the expense of your safety, confidence, health or well-being. It’s one thing to experiment with subservient role play, but another thing entirely when a partner demands subservience 24/7 or uses emotional or physical abuse against you.

Done correctly, however, role playing, BDSM and some other sexual activities explored in the book, can actually help boost confidence, health and happiness and improve relationships with your significant other. (Check out my blog post from last year on Fifty Shades of Grey for more insight on this pop culture phenomenon.)

So, how can you safely explore your sexual fantasies?

The key is, as always, open and honest communication and mutual respect. Sit down with your partner outside the bedroom to discuss sexual fantasies, and what you each feel comfortable exploring. Use safe words to quickly and clearly communicate your comfort level with what is happening during sex. Many couples find using the colors of the stoplight – green, yellow and red – work well. Keep the discussion up afterwards, too, to continue the dialogue on what you enjoyed, didn’t enjoy or may want to try next time.

If you ever feel like you are the victim of abuse, please immediately talk to a counselor, friend or family member. Making someone do something they don’t want to do is never okay, particularly under the guise of exploring sexual fantasies. If you don’t know where to go for help, please call or click any of the resources below.

National Domestic Violence Hotline – 1-800-799-SAFE
DC Rape Crisis Center – 202-333-7273
RAINN (Rape, Abuse, Incest National Network) – 1-800-656-HOPE


Interested in women’s sexual health? Contact us for an appointment.

Recent Posts