Fertility problems are traditionally thought of as problems with the womb, tubes or sperm that prevent pregnancy. But what if all these systems are functioning normally and the problem is actually an inability to have sexual intercourse?
Currently, somewhere around 13% of women suffer with a vulval pain syndrome which means that intercourse is either extremely painful or not possible at all. Often, other day to day activities like sitting in hard chairs, cycling and even wearing jeans and underwear can cause pain. These conditions can be long-term. Some do not resolve and require control rather than being cured, other women find their symptoms disappear after a period of time.
All this can make the business of starting a family extremely challenging.
What are Vulval Pain Syndromes?
There are several different groups, Vestibulodynia Syndrome, which is where a woman experiences burning pain and discomfort whenever the vulval area is touched (by tight clothing, tampon usage, sex). The area can become inflammed, although frequently there are no outward findings. Sometimes there may be itching, although this isn't common. This syndrome just causes provoked pain and the woman is pain-free the rest of the time. Vulvodynia, this is the same as vestibulodynia except the symptoms are constant and not in response to touch, but often worsen after any sexual contact is attempted. These syndromes are both regularly misdiagnosed as thrush, which has similar symptoms.
Lichen Schlorosis, this is characterized by extreme itching which can cause scarring of the skin. The clitoris, labia and other areas can become deformed or disappear altogether and the vagina may narrow or close off which would require an operation.
How Can I Get Pregnant?
Topical steroids may be given to reduce symptoms and this may enable you to have intercourse. There are also anesthetic preparations called lidocaine which can be applied prior to intercourse to numb the area. Sometimes an anti-depressant drug is given for the same affect, to numb nerve endings.
Other measures include dilators, which stretch the tissue to help relieve pain and help a woman achieve intercourse, and physical therapy exercises. Some women have taken valium prior to intercourse to relax their muscles. Natural therapies include flaxseed or linseed daily, tea tree or lavender baths and omega 3 fish oils, which have resulted in a cure for some people.
If you still can't have intercourse, your doctor may refer you for artificial insemination.
