There's No Little Blue Pill for This Female Sexual Dysfunction

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There's No Little Blue Pill for This Female Sexual Dysfunction

Bad sitcom jokes and endless commercials have probably taught you more about erectile dysfunction (ED) than you ever wanted to know. But when was the last time you saw one about female sexual dysfunction?

Meet vaginismus, a condition that causes involuntary contractions or spasms and makes sex, inserting tampons, or getting a Pap smear unbearable. It can be caused by childbirth injuries, sexual trauma, anxiety disorders, or prior surgeries, and is estimated to impact anywhere from 0.8% to 68% of women (not a typo). Yet, our little blue pill is nowhere to be found.

And why is that?

Many women are misdiagnosed, underdiagnosed, or don’t even know they have it. That’s because a “web” of barriers makes it difficult to get diagnosed or treated, says Sonia Bahlani, MD, a pelvic pain specialist. This includes…

• The complexity of vaginismus. ED is, at its core, a blood flow issue. But vaginismus can involve a trickier, less-understood mix of mental, muscular, hormonal, and nerve issues. 

• Lack of research. You might have heard there’s a gap between men's and women’s health research. That’s partly why many providers aren’t trained to recognize and diagnose vaginismus, putting a lot of the investigative work on you, says Bahlani. Meanwhile, “you can find telehealth doctors that will just prescribe [ED medication to men].”

• Lack of insurance coverage. Many providers don’t specialize in it because insurance doesn’t cover treatment for it, adds Bahlani. ED, on the other hand? “Way more vastly covered.” If only we were surprised.

Your move

Your pain — especially pain that impacts your quality of life — deserves to be taken seriously. And vaginismus is treatable, says Bahlani. Your PCP, OB-GYN, or pelvic floor specialist can help make a treatment plan for your situation and medical history. That can include…

• Physical therapy, which might involve learning strategies to relax your pelvic floor. 

• Vaginal dilator therapy to slowly stretch the vagina. 

• Prescription medications to help with pain.

• Botox to relax the pelvic muscles. 

• Cognitive behavioral therapy to help navigate anxiety or trauma that contributes to vaginismus.

Last week, we asked you to vote on a question to answer. The winner was:

What key questions should I ask during my annual physical?

FEATURED EXPERT:

Tiffany Di Pietro, DO

A cardiologist and concierge primary care physician

• What screening exams am I due for? For example, that could be a mammogram or colonoscopy, depending on your age.  

• Based on my family history, are there any additional tests I should do outside of typical screenings? This helps further personalize your care and, ultimately, helps prevent disease. “If multiple family members had heart attacks, you might want to consider screening for heart disease,” says Di Pietro. 

• Can we review my lab results together? This allows you to talk through anything abnormal.

  Speaking of, if you’re prone to peeking at your test results before talking to your doc, read this first.

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"Summer penis"

The supposed growth in length and girth that happens this time of year. No, we still don't want a pic.