The Injured Clam

Dear Dategirl,About a year and a half ago, I began having problems with painful sex. It got substantially worse after a bad UTI, so my doctor and I figured it had to do with that. She referred me to a urologist, who administered numerous expensive tests. He couldn't figure it out either. Frustrated with my inability to have intercourse (imagine having a burning poker shoved up your cooch), I broke up with my boyfriend and sadly resigned myself to never again having sex. I mentioned it to my gynecologist, who immediately told me what the problem was and that he could fix it.The syndrome is called vulvodynia. No one knows what causes it, but it's basically an inflammation of your vaginal opening area. I thought I was the only person cursed with this, yet the doc says he does several of these operations a week!I had the surgery two weeks ago, and am now on the mend. Hopefully I'll be able to have sex again in another month or so. Since I lied to everyone about this, I assume other women are also lying, and that's why nobody has heard of it. I'm writing so you can get the news out to other women who have permanently given up on sex due to this condition.—Sore but Hopeful

Oddly enough, Sore, I was having dinner with a friend the other night, and she confessed to having the same problem. My pal told me she'd been to a bunch of different doctors and faced all sorts of skepticism from so-called "experts." She'd even been told it was all in her head, and was advised to purchase a $250 vadge-dilator they'd nicknamed the "bride widener." Yowie.I gave Dr. Stephen Slack a call to get his take on the issue. Like any semi-responsible journalist, I'd been doing my research and had read that vulvodynia is caused by urinary tract infections, a diet high in oxalates (found in fruits, vegetables, grains, and, most tragically, chocolate), candida, strep, and/or about a billion other things. I asked the good doctor what he thought caused the hurty vagina."Whenever there are a lot of different theories on what causes something, it shows how little we know," he sighed. "We call it vulvar vestibulitis to make it seem like we know something about what causes it. But we really don't."He explained that the problem was two-fold. First, you have physical pain in the area found around the opening of the vagina. When women contract the problem, penis-vagina intercourse becomes wildly painful. It can get so bad that even sitting down can hurt. To remedy this, the doctor says he first tries a bunch of non-surgical remedies, like steroid creams or lidocaine.Often the condition disappears on its own, but in some cases surgery is the only solution. "We remove a strip of skin that's about a quarter-inch wide—a two-inch-long horseshoe shape around the vaginal opening.""A lot of family doctors and even some gynecologists have never dealt with vulvodynia. If you're not familiar with it, it's hard to detect," he adds. "You can look at it under the microscope and you don't see any sores or anything bad."The second problem is that many women develop another problem called vaginismus, which is kind of like your ladybits slamming themselves shut—the way a person who's been punched a few times flinches when they detect a fist-shaped missile headed their way. "People with this problem often develop some spasm of their pelvic floor muscles," explains the doctor. He recommends a course of treatment with a physical therapist who specializes in pelvic-floor issues.Next week, wounded willies!

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