09/30/2021
2 months ago, a woman came to my office with a concern about pain during in*******se. This is not unusual, in fact it is one of my favorite types of visits because it is an issue that can arise from a lot of different underlying problems (physical, “geometrical”, hormonal, psychological, musculoskeletal, etc) so it is always a puzzle to figure out what is going on.
This woman tells me that she has been experiencing some dryness for a little while and it has made it hard to have s*x. Ok, she’s post menopausal, and most women will need some additional lubricant as their estrogen levels drop, no big deal. But with further questions, I learn that “a little while” means more than 10 years and “hard to have s*x” means completely unable to tolerate pe*******on. To be clear, she has been wanting to have s*x with her husband for the past 10 years but has been completely unable to because the pain is so severe. She saw a gynecologist when this first started occurring and was simply told to use more lubricant and it would get better. It obviously didn’t and she was too embarrassed to bring it up again until now.
This story breaks my heart in so many ways. It is a story of gaping holes in the medical system, of shame and embarrassment in talking about s*xual dysfunction, of self blame for how her relationship is struggling because her body is failing her. After I saw her, we were able to do a trial of topical hormones and gentle dilation exercises which has already led to significant healing of the tissue, dramatically less pain, and the able to insert a finger without anxiety or discomfort. I think that in another month or two, she will be able to re-engage with her husband s*xually and bring some intimacy back to the relationship after 10 YEARS of pain. This is not because I’m a superhero with magic s*xual healing powers, but because this woman was finally brave enough to try again to find a path forward and I care deeply about this issue.
Please, if you or anyone you know is struggling with pain during in*******se or some other type of s*xual dysfunction (low libido, difficulty with or**sm, poor lubrication), schedule an appointment with a healthcare provider ASAP! And if things aren’t getting better, don’t give up. Everyone deserves to have a s*xually fulfilling life if they want one. This can look dramatically different for different people, and it’s not always an easy fix, but together we can take the steps needed to put you on the right path.
Anna Heinz, Nurse Practitioner
