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What causes burning sensation in the vagina during intercourse?

Answered by
Dr.
Dr. Nishikant Shrotri

OBGYN

Practicing since :1968

Answered : 2916 Questions

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Posted on Sat, 3 Sep 2016 in Pregnancy
Question: hello,

I was living with my wife for 15 months and due to a complication I wasn't able to have intercourse. She had been to a gynecologist who had prescribed a lubricant and a anesthesia ointment to be mixed and applied but it never worked. she complained of burning sensation, pain upon insertion and I sensed a strong muscle spasm around her vagina which made penetration seem impossible. The gynac did indicate surgery as an option but we haven't gone ahead. What are the chances that this condition can be over come through medication or therapy than going for surgery. She is 30 yrs old.
doctor
Answered by Dr. Nishikant Shrotri 55 minutes later
Brief Answer:
Vaginismus

Detailed Answer:
Dear XXXXXXX

At the outset, let me assure you that you have got a good enjoyable sexual life ahead of you if both of you manage the problem scientifically.

Your description suggests that your wife is having vaginismus. This is a condition when a woman is very apprehensive to the sensitivity of vagina and contracts her vaginal sphincter muscles making the penile entry difficult. Forcible entry will cause more pain and lead to further more contraction of these muscles. Then she believes that penile entry is impossible and the whole vicious cycle starts.

She needs to have a good sexual counselling from a very good specialized counsellor. She should understand the anatomy of the genital tract and sexual intercourse also. Explain her that vagina is a very distensible organ which can even accommodate the head of the baby during delivery. It is the question of relaxing her vaginal outlet only.

Then she should believe that she is going to enjoy the sexual intercourse though first initial attempts may be somewhat discomforting.

Handling the woman's genital organs dry is always painful and discomforting. Hence, attempt penile insertion only when she is completely wet. In women, the vaginal secretions start when the arte sexually excited. You may try some erotic literature or media to excite her during intercourse. Then also, initially try to put your fingers in the vagina gradually which will help the dilatation of vagina. Then when she is fully excited, then only attempt penile insertion. During penile insertion, ask her to take deep breaths by mouth with the mouth full open. This prevents the contraction of vaginal muscles.

Due to the presence of hymen at the vaginal opening and vaginal muscles tightness, full penile insertion is not possible for many first months. Initial many intercourses are performed only with the entry of penile head into the vagina. Gradually, with each attempt, the penis will entre more and more.

Use of appropriate lubricant always helps; still you have to be gentle. If you use local anaesthetic cream along with, it will take away the sensation of both, vagina and penis and you may not enjoy it. Then she may start loosing interest in the sex. I will not advise use of such anaesthetic creams. In majority of such women, surgery is not required. Proper counselling of both the partners with some technical advise succeeds.

I would advise you to spend more time in body play to excite her and attempt penile entry only when she demands. Please understand that every day, sexually excitable areas in women change. You have to explore her body. Lips, nipples, buttocks, breasts, naval are few common erotic areas on women's body.

In your history, you have mentioned that there were some complications. Will you please elaborate the type of complications which prevented you from penile entry?

I hope this should guide you for successful intercourse. Please remember the few tips like:

1. Be patient and gradual.

2. Use finger before penis.

3. Give pleasure to her complete body. Sex is not only coming together of penis and vagina.

For any more information or guidance, I am always available for you, XXXXXXX You may post a good review for me with 5 stars rating if you find this discussion useful.

Dr. Nishikant Shrotri

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Nishikant Shrotri 28 minutes later
The complications I mentioned were regarding impossibility to penetarte. it was like hitting a wall. I want to know under what circumstances will surgery become necessary ?
doctor
Answered by Dr. Nishikant Shrotri 2 hours later
Brief Answer:
Tough imperforate hymen or fibrotic rigid vagina

Detailed Answer:
Dear XXXXXXX

There is a fibromuscular membrane at the opening of vagina. It has a small opening in it through which the menstruation flows. It is a very supple membrane and gets ruptured during first sex, cycling, tree climbing, horse riding, sitting astride, etc. If the hymen is without any opening in it, it needs surgical opening. However, since your wife is getting regular menses, she is having perforated hymen. Try to put your well lubricated finger through the opening in the hymen under vision. Go very slowly inside till she can tolerate. Ask her to take deep breaths by widely open mouth while you are doing this. It may require time and few attempts to succeed in this. This is how you dilate the hymen opening by finger. This will give her also some confidence about the elasticity of her vagina.

Before entering the vagina, please avoid touching or handling of clitoris which may be uncomfortable. Handle it, and that too with good lubricated finger only if she demands it.

Secondly, if there is fibrotic tissue not allowing the vaginal sphincters to open, then the surgical incision may be required.

By doing surgery at this stage, there is risk of fibrotic tissue formation at the site which may be more painful and she will resist more. Scar after surgical incision may remain tender. Moreover, you are creating a feeling in her mind that her genital organs are not normal. This will create more diffidence in her mind towards sexual intercourse.

Kamsutra by Vatsyayan will give you good guidelines on your problem.

Please feel free to ask any more explanation or information, XXXXXXX

Dr. Nishikant Shrotri


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Nishikant Shrotri 28 hours later
I thank you for the suggestions Doctor. My marriage is in the rocks and my wife and I have been living away for almost 2 yrs now and she's in denial of this condition and ignores to address her condition till date. I am in the process of going legal for nullity of marriage.
doctor
Answered by Dr. Nishikant Shrotri 2 hours later
Brief Answer:
Try my advices first

Detailed Answer:
Dear XXXXXXX

I do empathize your condition and feelings.

She seems to be in a denial mode and hence needs expert sexual or marriage counselling.

As far as your sexual performance problem is concerned, I have advised you sufficiently. I can offer you only medical advice and not any legal advice for which you might have to consult legal expert(which you've also mentioned). However, before taking any extreme drastic step, you may try with my medical advises.

For any medical advice, I am always available for you, XXXXXXX

Dr. Nishikant Shrotri
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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