2023-08-06 05:00:00
« Dexcruciating pain and impossible penetration. Here is the memory that Lauriane, 23, has of her first sexual intercourse at the age of 19. The following year, while the pain persisted, she consulted a gynecologist. The diagnosis is clear: Lauriane suffers from vaginismus, a pathology characterized by involuntary contractions of the perineum at the time of any attempt at penetration, resulting in some cases in extreme pain.
Vaginismus is not the only pathology that can cause pain during sexual intercourse: there is also vulvodynia (the pain is located in the vulva) and so-called “provoked” vestibulodynia (the pain occurs during sexual intercourse). contact at vestibule level). These pathologies, grouped under the term “dyspareunia”, can be “primary” (they occur from the start of sexual life) or “secondary” (they appear following sexuality without pain). To treat them, several solutions exist. But it is still necessary to arrive at the diagnosis and to be offered an appropriate follow-up.
READ ALSOGeneration “no no no”: who are the asexuals? After two years of medical wandering, a gynecologist finally diagnoses Lou, 30, with vestibulodynia. She prescribed him “an anesthetic, an anti-dryness cream and an antifungal”. The gynecologist warns her, she must be patient and apply basic rules: “wear cotton underwear, pass them under boiling water following washing, sleep without panties, do not stay in chlorine for too long, avoid jeans and tights,” lists Lou. These first tips help him “tremendously”, even if the improvement is not instantaneous. Subsequently, Lou develops vaginismus. “I then started physio sessions. »
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perineal rehabilitation
Perineal rehabilitation by a physiotherapist is one of the main solutions offered to women suffering from pain during sexual intercourse. It has the advantage of being partially reimbursed by Social Security. During the sessions, the physiotherapist performs internal and external massages, via the vagina, to relax the muscles and desensitize the tissues. To relieve them, the physiotherapist has several tools: “radiofrequency (called tecartherapy, a technology to improve relaxation of the areas concerned), a vaginal probe or even vaginal dilators”, explains Catia Fernandes Mota.
At home, the physiotherapist encourages regular stretching to relax the perineum and massage the area with coconut oil. “I work as a team. I explain to my patients that I can act on the muscular side but that they sometimes need an accompaniment on the emotional level. » Sexologist, psychologist, sophrologist, hypnotherapist, osteopath or therapist practicing EMDR may be required to intervene in the context of the management of this pain. To find the right professionals, patients exchange names and contact details on social networks such as Facebook groups. A directory, published by the association Les Clés de Vénus, also lists professionals trained in dyspareunia.
READ ALSOWhy young people don’t make love anymoreMargot Maurel, osteopath-sexologist, co-author with Angéla Bonnaud of Vaginismus: understanding, treating yourself, thriving (ed. La Musardine), insists on the importance of “multidisciplinary care”. If the patient is in a relationship, the duo believes that good communication with the partner remains essential to “adapt their sexuality in order to gradually move towards more normalized relationships, that is to say without pain “.
For those who, despite everything, continue to suffer, a solution can be offered: injections of botulinum toxin, also known as Botox. Dr Éric Bautrant, pain doctor at Paris-Saint-Joseph Hospital, explains: “This toxin helps relax a muscle while modifying the pattern of pain as far as the brain. Stéphanie, 35, suffers from secondary vaginismus declared during her second pregnancy as well as a myofascial syndrome in the buttocks. Injections, six in total, were given to him in March 2021 at the Axium clinic in Aix-en-Provence.
READ ALSO“The younger generations consider sexuality divisive and unequal” The young woman felt “an immediate and very surprising effect” but would like to point out that it is a surgical act with convalescence. “I did not expect such pain. I had to buy a buoy to be able to sit at my desk for several weeks. “The benefits lasted six months, “the announced duration”, specifies Stéphanie, who did not wish to retry the injections and now consults a physiotherapist-osteopath.
- Vestibulectomy, ou ablation du vestibule
Other patients are referred to a more radical solution: a vestibulectomy, or removal of the vestibule. “You might think it’s nonsense, but studies show that this operation brings the greatest number of cures, which is quite rare in chronic pain, explains Éric Bautrant. The vestibule has no role, much like the appendix. This is a very innervated junction and when you remove it and put another tissue in its place, you can see the pain disappear. Of course, we would prefer not to come to that and just desensitize the area. » An essential point, but not always understood by patients and healthcare professionals.
READ ALSOAsexuality: when sex is boring, disgusting or indifferentOn this subject, all our witnesses agree: it is important that training on pain during sexual intercourse for health professionals is intensified and generalized. In the meantime, discussion groups, Instagram accounts and testimonials on social networks are multiplying. Lauriane and Lou share their expertise on their respective Instagram accounts while Catia Fernandes Mota posts educational content on TikTok.
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