Pregnancy
Pregnancy is one of the wild wonders of the world, a human being grown inside of another human being. WILD.
Now we don’t need to go into the birds and the bees here but we do need to talk about postpartum pain (pain following childbirth).
- Some studies show that as many as 85% of people will experience pain during their first sexual experience postpartum.
- At 3 months postpartum, 45% of people reported they were still experiencing pain.
Physical changes and hormonal changes are happening all at once, levels of estrogen and progesterone, hormones that affect sexual desire and lubrication, dramatically decrease after birth.
This can make becoming aroused or lubricated more difficult. Not to mention injuries to the pelvic floor, where the vagina or perineum (area between the genitals and anus) can tear.
New mothers will benefit from working with a Pelvic Floor Physiotherapist (PFP) to address musculoskeletal dysfunction and postnatal pelvic strengthening.
And remember, sex therapists and mental health professionals can help too! They can address low libido, body image, postpartum depression, or other emotional factors leading to sexual pain.
Menopause
Following menopause and due to hormonal changes, many people will experience painful sex. Changes in estrogen levels cause tissues in the vagina and surrounding areas to become thinner and dryer.
In addition to dryness, during post-menopause sex, many people experience sexual pain, tightness, and an uncomfortable burning sensation.
Many studies show that the regular use of vaginal dilators and lubricants can be helpful to people experiencing sexual pain post-menopause, as well as seeking help from a Pelvic Floor Physiotherapist (PFP).
Similarly, people undergoing chemotherapy for cancer will often experience symptoms of early menopause. Some chemotherapy medications irritate all mucous membranes in the body, including the lining of the vagina, which may become dry and inflamed.
Genital Reassignment Surgery (GRS)
Genital Reassignment Surgery (GRS) is a surgical procedure that changes a person’s genitalia to match that of their gender identity. During this procedure, surgeons will transform a person’s pelvic area to create a neo-vagina. This procedure is also known as vaginoplasty.
Post-operative vaginal dilation therapy is an essential part of keeping the neo-vagina functional. Vaginal dilation therapy is almost always required for life, as sexual intercourse in place of dilation may not be sufficient.
Tampons
So we talk a lot about wanting to achieve a happy and functional pelvic floor about sex a lot here. However, the pelvic floor controls so much more than just sexual penetration.
Tampons or menstrual cups may be a difficult hurdle when suffering from vaginismus and many young people may struggle with this step during puberty and well into adulthood, and that’s ok!
There are lots of options for dealing with menstrual bleeding apart from tampons and during your therapy, it might be better to stick to something non- penetrative like pads or period underwear until you can get a bit more comfortable with your pelvic floor and vaginal insertion.
Tampons could be something you work up to once you become comfortable with different-sized dilators.
Or you could just ditch them altogether not everyone likes using them and they may not be right for everybody. No big deal!