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.
Women’s accounts of their own pain often fall on deaf ears, for reasons that are 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 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
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
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
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.
Menopause
“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 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 wonderfully complex, with vast networks of interconnected nerves and structures working together to keep our engines running. But 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.
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.
Psychological Trauma
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 Chief Education Officer, 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 traumatizing experiences, dysregulation of the nervous system and tension and pain within the body.
Healing Solutions from Unexpected Quarters
At Foria, we’re working to advance our collective understanding of the power of cannabinoids, and we plan to continue expanding our collective understanding of the role of cannabinoids in women’s health & healing. It’s been quite a journey so far...
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.
Want more? Sign up for our newsletter
By entering your email, you are agreeing to our terms and conditions and understand our privacy policy.