Freedom from Pain: Women, Healing, and Hope
Sex was so painful for me that we stopped vaginal penetration for over a year. I used [Relief] suppositories for six consecutive nights as prep, and then used a lubricant the night of penetration. It was 90% pain-free! What a breakthrough! – Lois
A Common Problem
Get a group of people with vulvas in a room and ask them to talk about pain — specifically genito-pelvic pain — and whether they’ve had any luck getting doctors to take it seriously, and it’s a good bet you’ll hear some pretty upsetting stories.
Women are often told that pelvic pain, pain during sex, or nonspecific vulvar/vaginal discomfort are all in their heads, or not a big deal — just part of being female. This has been going on for centuries, arguably ever since a lady had a conversation with a snake over an enticing-looking apple. Why women’s accounts of their own pain fall on deaf ears is a question that’s thorny, political, complex, and often infuriating.
However, times may finally be changing. Women demand answers. They’ve taken to social media to discuss their experiences, and learned that they’re not alone — and we’re all beginning to have a broader vocabulary for our pain, beyond the dismissive “female trouble” of bygone eras.
Talk To A Doc
If you have pelvic pain, vulvar/vaginal pain, and/or pain during sex, don’t dismiss it. It’s important to rule out serious, potentially life-threatening conditions such as cancer, infections or ectopic pregnancy, and you should see your doctor right away. If they dismiss or belittle your experience, find another doctor — but if they’re sympathetic and still don’t find anything obviously wrong, there may be other reasons for your discomfort.
Diagnosis is often a tricky process, especially if you have to negotiate indifferent providers, and especially since our vocabulary for these issues is so rudimentary and limited. Pelvic pain conditions can be interrelated to one another. You may suffer from more than one, or your symptoms may not perfectly fit a recognized syndrome.
However, it’s possible to get a ballpark idea of what you might be dealing with – and just because “conventional wisdom” tells us to suck it up and get used to it, all hope is not lost.
Women are learning to manage their pain in new and innovative ways. They’re beginning to speak out about it… and giving the problem a name is often the most empowering place to start.
Vulvodynia is chronic vulvar pain that lasts three months or longer and doesn’t have an immediately identifiable cause. There are two main subtypes, localized and generalized vulvodynia. The localized type results in pain in one spot, often the vestibule or vaginal opening (a condition formerly known as vulvar vestibulitis), and the generalized type is more diffused or may move around.
Vulvodynia pain can be either provoked (with flareups occurring after pressure or penetration) or spontaneous (when pain occurs for no obvious reason). It’s most often described as burning, stinging, aching, or general soreness, and it can be constant, or it can come and go.
It’s speculated that vulvodynia may result from multiple factors interacting together, possibly including inflammation (local or systemic), pelvic floor dysfunction, or even nerve damage.
Vaginismus is an involuntary contraction of the muscles of the pelvic floor. It can make penetration — via sexual intercourse, a tampon, or a gynecologist’s speculum — difficult or impossible. Pain can range from mildly uncomfortable to severe, varying from woman to woman. Sometimes vaginismus crops up seemingly out of nowhere, even after pain-free years.
Anxiety is often a factor in vaginismus — which isn’t the same thing as a problem being “all in your head.” Anxiety causes very real physical symptoms that tend to cascade and build on one another, and symptoms can actually be worse if you’re anticipating the pain and tensing up.
But other factors may come into play, such as inadequate lubrication, menopause , side effects of medication and the aftermath of surgery.
Interstitial cystitis is a chronic condition causing pain centered on the bladder. Symptoms often mimic the pelvic discomfort and burning urination of a urinary tract infection, but won’t respond to the usual course of antibiotics. Along with pain, IC can cause urinary urgency, a frequent need to urinate that may disrupt sleep, and, often, a great deal of emotional distress.
The causes of IC aren’t clear. It can be found alongside other pain conditions like fibromyalgia, and some speculate that it’s triggered by allergies or hidden autoimmune disorders.
Systemic inflammation may also be a factor. Regardless, it can result in serious disruptions to a woman’s quality of life, and there’s no known cure.
Strategic management of symptoms may offer some relief.
“The change” is another fact of women’s lives that weren’t adequately addressed until recently… and still isn’t, really. The hot flashes, mood disturbances, and decreased libido most commonly associated with menopause in the popular discourse are, hardly coincidentally, the symptoms most likely to affect other people in a woman’s life. Women are so often told they have to live for others; but what about their own experiences?
Up to half of all women experience genital pain after menopause, usually associated with sex but not always. This is the result of hormonal changes, especially lowered estrogen, that can decrease lubrication, thin vaginal tissues and reduce elasticity. Dryness causes friction, friction causes pain, and pain can cause anxiety, which exacerbates the issue.
It’s recommended that women use a quality lubricant post-menopause, and, counterintuitively, have more sex, alone or with a partner. Arousal improves bloodflow and tissue elasticity.
Non-identified chronic pelvic pain conditions
Female genital anatomy is incredibly, wonderfully complex, with vast networks of interconnected nerves and structures working together to keep our engines running, and this complexity means that any minor disruption may cause major effects.
Old or new injuries, lifestyle stress, seemingly unrelated illnesses, nerve damage, even a lousy office chair or inadequate exercise can result in genital or generalized pelvic discomfort.
And often, it isn’t even possible to pinpoint causes. Nothing seems “wrong”. but it hurts.
A physician may ignore psychological trauma because there’s not yet a pill to prescribe for it, even though it may be a major factor in the sexual pain that many women experience.
The physical tension and deep-seated fear that can result from psychological trauma — whether it be the result of sexual violence, or the sexual shame and confusion imposed disproportionately on women, or both.
Considering the high rates of sexual assault in the US and around the world, it is safe to say that trauma should be another area that is addressed when working with pelvic pain. But the relationship between our life experiences and our physical bodies is often dismissed in mainstream medical discourse as “psychosomatic” when, in reality, this mind-body connection could prove to be a powerful avenue for healing.
Somatic therapies such as Somatic Experiencing and EMDR are proving to be beneficial for healing trauma. And there’s compelling evidence that CBD can support those experiencing PTSD (similar to the way it seems to benefit depression ).
We’ve also found that our CBD arousal oil can be a powerful ally in the quest to release old hurts and reawaken new pleasures. In this video , the formulator of Awaken Arousal Oil with CBD discusses sexual trauma with our education director, exploring the way that aroma can be a healing tool for rewiring our responses to triggering situations.
In addition to the above therapies, a sexological bodyworker is more likely to understand the connection between highly emotional or traumatizing experiences and the resulting dysregulation of the nervous system and tension & pain within the body, while also being equipped to work with a physical cause of pain that most doctors ignore: scar tissue.
Pelvic Scar Tissue
Scar tissue can result from surgery, gynecological procedures, and birth injuries as well as from sexual trauma.
Scar tissue can restrict blood flow and tissue oxygenation and (just like chronic inflammation) scar tissue creates imbalances that lead to more scarring, more inflammation, and more pain.
Therapeutic work with scar tissue deserves an entire article to itself. Stay tuned.
Healing Solutions from Unexpected Quarters
At Foria, we’re working to advance our collective understanding of the power of cannabinoids. Our newest initiative, a study tracking the results of using CBD oil suppositories for menstrual cramps , is just the beginning. We plan to continue collaborating with researchers to expand our collective understanding of the role of cannabinoids in women’s health & healing. It’s been quite a journey so far.
When we launched Pleasure , we were responding to the lack of effective enhancements to women’s sexual pleasure — there were dozens of Viagra-like products available for men, and basically nothing to help women with arousal. But once Pleasure launched, we began hearing from women who reported — often with considerable surprise — that Pleasure hadn’t only improved their orgasms. It had also helped to address their pain.
Since Pleasure is only available at licensed dispensaries in CA & CO , its remarkable success at helping to relieve women’s pain inspired us to create a CBD arousal oil, Awaken , that would be available in all 50 states and worldwide.
The response was just as moving.
“I’m 41 and I had to have a hysterectomy at the age of 26 due to pelvic congestion. I still suffer from pelvic pain and very tight muscles and tendons. I get terrible collision pain during sex. I saw your products while I was watching an episode of Slutever lol. I decided to try Awaken and also the suppositories and they’ve helped tremendously. Most doctors prescribe pain relievers and muscle relaxers and I don’t like taking those types of medicines because of the side effects. I also had a bad experience with another doctor who basically told me that my pain was all in my head. Luckily I found a physician who specializes in pelvic pain. Your company gives a platform to talk about a subject that most women don’t speak about! It also gives us our life back! Thank you for creating a safe product for our sensitive needs!” – Joanna
We hear from so many women who have struggled with gynecological pain for years, and whose quest for relief has taken them down terribly frustrating paths.
We’re privileged and grateful to hear their stories, which – not too terribly long ago – might have gone entirely unspoken.
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Women are often told that pelvic pain, pain during sex, or nonspecific vulvar/vaginal discomfort are all in their heads, or not a big deal — just part of being female. Why women’s accounts of their own pain fall on deaf ears is a question that’s thorny, complex, and often infuriating.
When Doctor’s Don’t Listen, Women Treat Their Own Sexual Pain — Here’s How
At first, it only hurt during penetration. Certain positions would cause a jagged, stabbing sensation in Kim’s vagina that would force her to stop having sex. Then, the sensation spread. It started hurting all the time — when she ran, when she stretched, whenever her boyfriend touched her vulva, even if it was barely a graze.
“It felt like I was being stabbed,” the 31-year-old digital marketing manager says.
Her boyfriend was sweet and understanding, but she stayed quiet about just how badly it hurt. She didn’t want the pain — whatever it was — to drive them apart. Plus, she thought, didn’t all women experience painful sex from time to time?
Three months after her pain started, it got so bad that she had to go to the emergency room late one night. She was in agony after having sex, but the doctor told her it was just gas. She went home confused and ashamed.
Over the course of the next seven years, doctor after doctor misdiagnosed Kim’s sexual pain, prescribing treatments for indigestion, vaginal infections, and depression she didn’t have (these are all common causes of sexual pain, but none fit the bill for Kim). Flustered, some doctors made outlandish suggestions, like proposing Kim get pregnant. She remembers being told, “Nine months of estrogen can really knock you out!”
Worse than the swing-and-a-miss treatment plans was the constant implication that Kim had been making it up: Six separate medical experts told her she was just imagining things, brushing her off with the disturbingly common refrain, “It’s all in your head.”
“No one believed me,” she says. “I couldn’t get doctors to take my pain seriously.”
Not being believed is a common occurrence for the 7 to 22 percent of women who experience chronic sexual pain stemming from conditions like endometriosis, vulvodynia, pelvic floor dysfunction, and chronic infections (though that’s hardly an exhaustive list of what causes sexual pain). Despite such a list of conditions existing, according to data collected by gynecologist and sexual pain expert Dr. Robert Echenberg of the Echenberg Institute for Pelvic and Sexual Pain, more than half of women who experience this are told their symptoms are “in their heads.” If a correct diagnosis is reached, Echenberg has found it takes an average of five to ten doctors to get there, and women spend an average of five years in pain.
That’s why many women like Kim opt to take the management of sexual pain into their own hands, either because they need something extra to supplement the surgeries, medications and physical therapies their doctors recommend, or they’ve decided to branch out and find non-medical ways to try to manage their pain and regain their sex lives.
It was through her own research that Kim discovered other women were having success with CBD, the non-psychogenic compound in marijuana known for its relaxing, pain-relieving, and anti-inflammatory properties — results which have been found in studies of rats and mice, but have yet to be widely studied in humans. The trendy compound is now available in everything from seltzer water to body rubs and brow gel.
“CBD is the only thing that’s ever worked,” Kim says. “It makes it so I can relax. I’d say it takes away about half the pain. It’s the one thing that gives me a semblance of the sex life I used to have, but not one doctor I saw mentioned it to me.” (Thus far, the FDA has only approved a CBD-related treatment for seizures.) Her own online research, and chatting in support groups, is also how Kim found out about endometriosis, a condition in which uterine lining grows in painful lesions throughout the body. Its symptoms sounded eerily familiar. A few weeks later, Kim was definitively diagnosed with the condition.
“I found both a cause and a treatment [not a cure] by doing my own research,” she says. “You have to be your own advocate. Doctors are so helpful once you find the right one, but in the meantime, real people experiencing the same thing you are can pitch in with recommendations and resources that really help.”
Curious what other sorts of recommendations and resources women devise for themselves in the absence of medical relief, I posted a general inquiry on a private Facebook group of women in Los Angeles, asking people who had experienced it, what — if anything — made their sexual pain go away.
While I’m aware this is no gold-standard study design, I was still struck by the breadth of fixes women had tried out, to good results. Most of them said their personal solution involved a combination of following the right doctor’s orders and experimenting with their own pain management strategies, many of which they say were never brought up in a medical setting. These included diet and lifestyle changes; alternative therapies like acupuncture, mindfulness training and myofascial massage; and sexual workarounds that made it so they could still be intimate without being in pain.
And while Echenberg says these non-medical solutions should always be employed alongside proper medical care, and supervised by trained and certified alternative care providers, he also encourages women to do what Kim did and become their own pain specialists — the more they know about their own pain, and the more they can relay what they know to their doctors, the more likely they are to find help.
But until then, here are some of the more common ways the women I spoke with found relief.
When doctor's dismiss women's chronic vaginal pain, or painful sex, they resort to DIY methods — here are some that work.