According to recent research reported in the Journal of Sexual Medicine, nearly 30% of women report having sexual pain during vaginal intercourse and over 70% of women report pain during anal intercourse at sometime in their lifetime (Herbenick, 2015). Though pain is often under reported, it is likely that some of those women will speak to a doctor or other medical professional regarding painful intercourse. It is imperative that medical professionals familiarize themselves not only with the possible medical causes of this pain such as vaginismus or complications with hormonal birth control but also that they be familiar with healthful sexual aides that may improve the quality of life for their patients.
In many cases, “prescribing” sexual aides such as vibrators, dilators, or lubricant can help female customers overcome sexual pain. However, there may be times when these items are the cause of complaints of discomfort – discomfort such as rashes, bumps, or even bacterial vaginosis (Wolf, 2012). With this in mind, it is necessary for medical providers do their research, familiarize themselves with the range of products available, and determine which of them are healthful and helpful. Below we will explore some common complaints related to sexual pain and the sexual aides that may help (or hurt).
Painful Penetration Due to Vaginismus or Hysterectomy
Vaginismus is not a well understood condition and, as such, is often left untreated or diagnosed as a psychological rather than a physical condition (Bergeron, Rosen & Morin, 2011). However, aides such as dilators (small insertable tube-like objects that are available in incremental sizes) and quality lubricant can help immeasurably with the pain associated with vaginismus and other similar issues. Coady and Fish (2011) speak extensively about the benefits of dilation in their book “Healing Painful Sex”. Likewise, Streitcher (2014) touts the use of dilators for everything from vaginal pain to kegel strength.
Dilation can also be incredibly helpful for those who have gone through radical hysterectomies. Ducky DooLittle, author of Sex With the Lights On, notes that due to the loss of the cervix in a radical hysterectomy, many women find that vaginal tenting during arousal no longer happens. As a result, penetration can be particularly painful (D. DooLittle, personal communication, January 21, 2015). Dilation can help re-elasticize the vaginal tissues as well as gently stretch the vaginal canal to reduce pain during penetrative sex (Tobia, n.d.).
It is important to note that dilators come in a variety of materials. Soft materials such as silicone may be perfect for those just starting out while harder materials such as glass, stainless steel, or hard plastic may be appropriate for those who have been working on dilation for a bit (Soul Source, n.d.). If a medical professional does not have dilation sets available in office, many high quality adult boutiques will have samples on hand for patients to feel so that they may choose the best one for their body.
Dryness is often a chief complaint among women who experience painful penetration. Vaginal dryness can be caused by any number of issues from the type of medication a patient is on or medical procedures they have had to how much stress the person is under (Storck, 2013). Lubricant can aid tremendously in both temporarily relieving dryness as well as re-moisturizing the tissues to help the body regain its balance (Tobia, n.d.).
Lubricants are not all created equal however. It is important to coach patients through choosing healthful lubricants that do not contain irritants that may make their dryness worse. Common drugstore lubricants such as KY and Astroglide can contain ingredients that can cause far more harm than good. Alcohol, parabens, and sodium hydroxide can increase dryness and cause irritation (Mueller, 2014).
The osmolality of lubricants is another important aspect that medical professionals must address (Wolf, 2012). Research suggests that lubricants that are hyper-osmolar may dehydrate epithelial cells and cause epithelial shedding which not only creates irritation but can also lead to a higher risk of STI contraction (Fuchs, et al., 2007). Mueller states that KY and Astroglyde are noted for being incredibly hyper-osmolar and suggests that individuals look to lubricant brands such as Sliquid, Good Clean Love, and Blossom Organics that contain non-irritating ingredients and are hypo or iso-osmolar (2014). These lubricants can safely be used by patients looking to reduce dryness daily or for use just during intercourse.
Infections / Reactions
Finally, complaints of pain during intercourse can arise due to infections or reactions to materials found in some sex toys. Research suggests that the materials that sexual aides are created from can cause numerous complications not only immediately but cumulatively as well (Stabile, 2013). Porous materials such as elastomer and TPR can harbor bacteria and mold, thus creating an environment that could lead to rashes or infections (Denning, 2014). Some materials such as jelly rubber, PVC, and cyberskin contain phthalates and heavy metals at alarmingly high rates which can leach into the bloodstream. In 2006, the Danish EPA did a random sample testing of sixteen sex toys. Of those sixteen toys, fourteen of sixteen contained toluene, four contained phthalates, and one contained cadmium levels so high that, had they known, the Danish government would not have let it into the country (Nilsson, et al., 2006).
With the above in mind, it is imperative that the sex toy savvy medical professional do research on what products are available and what they are made from. If sexual aides will be suggested to a patient, or if it is believed that a sexual aide may be causing a patient’s discomfort, it is needful that to suggest safe materials such as medical grade silicone, ABS Plastic and stainless steel to reduce the chances of reaction and infection (Denning, 2014).
A variety of issues may come up when “prescribing” sexual aides. Patient and medical practitioner comfort levels may vary. Many patients may not want to talk about the use of sexual aides because of religious background or moral standpoint. None the less, the suggestion of sexual aides for the easing of sexual pain can be incredibly helpful to patients and may reduce the need for more intense medical intervention down the road. With a bit of research and a dose of humor, helping your patients by prescribing sexual aides can do wonders.
Bergeron, S., Rosen, N. O., & Morin, M. (2011). Genital pain in women: Beyond interference with intercourse. PAIN, 152. Retrieved fromhttp://www.sophiebergeron.ca/images/publications/24_Bergeron_2011_Genital.pdf
Coady, D. & Fish, N. (2011). Healing painful sex. Berkley, CA. Seal Press.
Denning, D. (2014). The safety dance: Sex toy safety for a new generation. Retrieved from http://kinseyconfidential.org/safety-dance-sex-toy-safety-generation/.
Fuchs, E. J., Lee, L. A., Torbenson, M. S., Parsons, T. L., Bakshi, R. P., Guidos, A. M., … Hendrix, C. W. (2007). Hyperosmolar sexual lubricant causes epithelial damage in the distal colon: Potential implication for HIV transmission. Journal Of Infectious Disease, 195(5). Retrieved from http://jid.oxfordjournals.org/content/195/5/703.long.
Herbenic, D. (2015). How common is pain during vaginal and anal intercourse. Retrieved from: http://mysexprofessor.com/uncategorized/how-common-is-pain-during-vaginal-and-anal intercourse/
Mueller, S. (2014). What’s in your lube. Retrieved from http://badvibes.org/whats-in-your-lube/lubricant-ingredients/
Nilsson, N. H., Malmgren-Hansen, B., Bernth, N., Pedersen, E., & Pommer, K. (2006). Survey and health assessment of chemical substances in sex toys. Retrieved from https://system.netsuite.com/core/media/media.nl?id=4816&c=1143818&h=2e6bd389259c3cffefa6&_xt=.pdf.
Soul Source FAQ. (n.d.). Retrieved from https://www.soulsource.com/faq/#products-q05.
Stabile, E. (2013). Commentary: Getting the government in bed: How to regulate the sex-toy industry. Berkeley Journal of Gender, Law & Justice, 28(2). Retrieved from http://scholarship.law.berkeley.edu/cgi/viewcontent.cgi?article=1318&context=bglj.
Storck, S. (2013). Vaginal dryness. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000892.htm.
Streicher, L. (2014). Love sex again. New York, NY. Harper Collins
Tobia, S. (n.d.). Recliaming your sexuality. Retrieved from http://ugynonc.com/private-tips/reclaiming-your-sexuality/.
Wolf, L. K. (2012). Studies raise questions about safety of personal lubricants. Chemical & Engineering News, 90(50). Retrieved from http://cen.acs.org/articles/90/i50/Studies-Raise-Questions-Safety-Personal.html.