Now in my menopausal years I found out I have vaginismus and vaginal atrophy. Two conditions that are common for women, but hardly talked about.
(Just in case you are new here – This article is part 3 about my journey of living with Vaginismus and Vaginal Atrophy. You can view part 1, and part 2 below.)
These conditions are often misdiagnosed.
My story (Part 1) – When Down There Is Too Tight And Painful To Have Sex – My story – Part 1.
Part 2 – My Vaginismus Came Back Over 30 Years Later! My Story – Part 2 (Part 2 also covers ‘How I was diagnosed with Vaginal Atrophy’.)
In summary – I first experienced vaginismus (tight vaginal area) for about 6 months, years ago in the 1980’s.
However, I wasn’t familiar with what Vaginal Atrophy (also known as Atrophic Vaginitis, Vulvovaginal atrophy, menopausal atrophy) was, until I was diagnosed with it in October 2018.
Some doctors just say it’s vaginal dryness. Well, that type of statement doesn’t really explain why you have vaginal dryness and soreness.
My gynecologist explained that my vaginal walls, tissues were shrinking/thinning, drying and inflamed due to having less estrogen.
So now rolling into 2019 I will continue to tell you about my journey of living with Vaginismus and Vaginal Atrophy…
January 2019 – Vaginal Area Still Tight & Sore
During the Christmas (2018) holiday season I was still feeling general soreness, burning in the vulva, and vaginal area, even while just sitting down watching tv.
My tight vagina was also still too tight for penetration (PS: I would check while in the bath).
Late December, early January 2019 I purchased a vaginal moisturizer, a dilator set, a pleasure bullet, and vaginal lubricant to use with the dilator.
(“DISCLOSURE – Lady Parts Gone Wrong.com may get commissions for purchases made through various links and/or banners in this post.”)
PELVIC FLOOR EXERCISES: I was still doing kegel exercises but still focused more on reverse kegels to relax my vaginal/pelvic area.
HRT – Ovestin cream: I started using the Ovestin cream again. This time I just used half the amount, and only used it every four days (as my doctor had suggested in December 2018).
The headaches that I got on it before Christmas 2018 didn’t come back, but some bloating and achy legs did.
After using the Ovestin cream every 4 days over an eight-day period, I then started to take it every five days.
Using it every five days, lessened the bloating, and the aches in my legs went away.
NOTE: Ladies, if you opt-in to use HRT (estrogen) vaginal creams, I have noticed like many other ladies do, that it is messy. I have found that since using it, I get a whitish chalky type fluid on my underwear most days.
Apparently, this is common so you may find it beneficial to use panty liners. In my case I know I have not got any infection as I have been tested.
You can get this medication in a vaginal tablet, ring (pessary) form, and from what I have read, some find these types less messy as well.
The Vaginal Moisturizer:
I had read about moisturizers that are made specifically for the vagina and vulva area.
I didn’t want to buy any product for my sensitive lady area that had chemicals in it, as this can aggravate the soft delicate skin further, particularly if you already have soreness.
So after doing some research, I purchased an organic vaginal moisturizer. The one I got is a water-based one called YES Water based vaginal moisturizer.
I have found this moisturizer to be very soothing. During the first week of using it, I applied it once to twice a day on my vulval area, and around the entrance of my vaginal area, with my finger.
By the end of January, I only needed it about once every 3 days.
NOTE: If you have Vaginal Atrophy (dryness), are in a sexual relationship and find sex painful, you can get the same product that comes with pre-filled applicators (similar to an applicator that inserts canesten creams), so you can easily apply it deeper into your vagina.
If you want to take a look at these – See: Yes Organic Pre-filled Vaginal Moisturizer.
TIP: When you purchase a vaginal moisturizer, always read the instructions carefully. NOT all vaginal moisturizers are made to be inserted into the vagina. Some can only be used externally, on the vulva area.
The Dilator set, Pleasure bullet & Lubricant:
When you have Vaginismus the most common form of treatment is dilator training. In Late November 2018, my Pelvic Floor Physiotherapist (PFP) had already implied that she would get me to insert something at some stage.
The thought of this repulsed me at first, and I was worried she would get me to insert something at my next appointment, which was due in mid January.
For this reason, I read a lot about dilator training and purchased my own dilator set. In case you don’t know what a dilator set is, it is a set of tube-shaped objects that range from a small size up to a real penis size.
You can read more about them – How To Use A Vaginal Dilator
There are many types of dilators out there. Some are made from glass, while others are made from various plastics.
The sets can vary in how many dilators are in the set. The more dilators there are in your set, the more sizes you have. The sizes often start with a small tampon sized dilator and gradulate up to be similar to a penis size.
One set that has a small tampon sized dilator in it is the Inspire Silicone Dilator Set.
There are also dilators that have a vibrating function. This is the type of dilator I chose.
The reason for this is because I had read that the vibration can help to relax the vaginal area before and during insertion. You can also turn the vibrating function level up or down, and off if you don’t like it.
You can view or purchase the vibrating dilator set below…
The smallest size in the vaginal dilator set I got is about the size of a medium-small large tampon, so I also purchased a tampon-sized mini vibrator.
Vaginal Lubricant: There are two types of vaginal lubricants, water based and oil based.
TIP: Depending on what your dilator is made from, will depend on what type of lubricant you can use with it.
It’s important to read the manufacturer instructions about what type of lubricant you can use with your chosen dilator.
From what I have read, most vaginal dilators recommend using a water-based lubricant.
Just like the vaginal moisturizers, there are many out there.
Again I searched for a natural one, and managed to find a water-based organic one – You can view/purchase here: SLiquid Organics Natural Lubricant.
This lubricant is soothing and doesn’t leave a sticky residue.
Using the Dilator & Pleasure bullet – My Dilator Training:
I got myself in a relaxed mindset, and applied the lubricant on the Dilator, and on myself.
On my first attempt of penetration, using the smallest dilator in the set, there was no way I was going to be able to insert the dilator. I could only get the tip of the dilator on the entrance of my vaginal opening.
Luckily, when I purchased the dilator set, I also purchased a Pleasure Bullet at the same time. (A pleasure bullet is often referred to as a vibrator because it vibrates).
I didn’t let myself get upset about it, and tried using the Pleasure Bullet with the vibrate function turned on to gentle instead.
I purchased the pleasure bullet because it is a lot smaller in length and diameter than the smallest sized dilator in my set. I’m so thankful I did this.
Wow! I was amazed at how the vibration of this small gadget started to relax my vaginal area, and surrounding areas.
From this time on, I always use the vibrate function.
*Just in case you were wondering, the vibration also stimulates the clitoral area, so if you are a lady that finds it hard to get aroused or orgasm, you may want to get the vibrating type of dilator.
For the first half of January I just used the Pleasure bullet and always started my dilator training (vibrating function switched on), with the PB on my vulval area, and then worked my way down to the vaginal entrance.
After a few minutes in this area, I would gently try to insert the Pleasure Bullet until I could feel a slight discomfort.
During the second week of January, I could insert the Pleasure bullet.
(Please note: The concept behind dilator training is to stretch the vagina, so a little discomfort is normal. If you experience pain, NEVER keep pushing it in any way. If you do, you risk doing more harm than good).
I left the Pleasure bullet inside me for 3-5 minutes, then stopped the session. I did this once to three times a week for the rest of January.
My Pelvic Floor Physiotherapist (PFP) Appointment
Unlike my first appointment with the PFP, this was a follow-up appointment, so was only booked for half an hour, not an hour.
She asked about how things were going so I let her know I was still doing the reverse kegels more often than the standard kegels.
I also told her I had researched dilator training online, and had purchased a dilator set, and a mini bullet, as I knew she was going to introduce me to dilator training.
My PFP is open-minded, and felt it was good that I was learning as much as I could about it.
*I must mention here: Learning as much as I could about my conditions and dilator training before seeing the PFP was beneficial, as it gave me time to gain insight into things. Which also gave me time to write down any questions about things I was unsure of, for my PFP to answer.
I showed the PFP the Pleasure Bullet, and let her know that I could now insert this, but was unable to insert the smallest dilator in my dilator set.
Although most pelvic floor specialists only tell you to use a dilator set, my PFP was happy with what I had done, and about my progress.
She reminded me to take things slowly, in other words, not to rush into graduating up a size to using the smallest sized dilator.
She was also happy that I had started using the Ovestin vaginal cream again, as she felt this would help to heal the inflammation and soreness a lot.
February 2019 – Vaginal Improvements
I continued doing the pelvic floor kegel exercises, but still focused more on the reverse kegels.
The HRT treatment: Using half the amount of Ovestin cream every five days was working well now and the aches in my legs had stopped. I only had a little bloating.
I was still applying the vaginal moisturizer, but only needed it a few times a month.
The Dilator Training: My dilator training was still going well, and I was now using the smallest sized dilator, (on the vibrate function).
I had progressed to being able to I gently move the dilator sideways, to help stretch things a bit.
HOWEVER: On the second week of February I did what I knew you should never do! I went past the point of discomfort, and kept going when I had too much pain.
Because I was really happy with my progress I also started to penetrate the dilator up and down (similar to when you have sex).
There was only a little pain when I did the penetration and sideways movements. At the time I thought it was just mild pain and kept going for 5 – 10 minutes.
The next day I felt bruised and a little swollen. This set me back. I was unable to do another session for about a week.
TIP: If you are starting or new to dilator training, take things slowly. Once you get to the stage you can move and/or penetrate the dilator, do it for short durations to start with.
If you suffer from Vaginal Atrophy or vaginal dryness, you may also need to re-apply some more lubricant during your dilator session, as some lubricants can evaporate quite quickly.
My Pelvic Floor Physiotherapist (PFP) Appointment
Again this was a half hour appointment. This time I took my dilator set to show my PFP.
She was happy with my progress with the dilator training, but reminded me to take things a bit slower, and to try having shorter durations of penetrating the dilator.
TIP: A useful tip she gave me for when I felt I might be ready to go up to the second sized dilator was to: Use the first size first, and then try the second size in the same session.
But again not to rush up to the second size.
Then I asked her a question that had been plaguing my mind…
‘Why Hasn’t Anyone Told Me I Have Vaginismus?’
My doctor, the gynecologist, and my pelvic floor specialist all told me I have Menopausal Atrophy (also known as Vaginal Atrophy, Atrophic Vaginitis, Vulvovaginal Atrophy – VVA), yet none of them mentioned I had Vaginismus as well!
(If you don’t know what Vaginismus is, it is tightness of the vaginal muscles that make penetration, painful or impossible to achieve.)
Instead, I was lead to believe that the dryness, shrinking, and thinning of my vaginal skin was causing the vaginal tightness.
While the Vaginal Atrophy certainly caused my soreness, the flow on effect was a tightening of the vaginal entrance muscle (Vaginismus).
She agreed I had Vaginismus (tight vaginal muscles), as well as Vaginal Atrophy. She followed on to say, ‘They don’t tell patients (re about the Vaginismus in my case) because quite often the patients will look it up, read about the worst case scenarios, which can have an adverse effect on the patients’.
In other words, many patients will not get treatment, or continue treatment because they are very upset, or too scared etc.
My response was, “I’m not one of those patients. I like to know everything so I can make an informed decision about what to do”.
Her response to my reply was, ‘Not every patient is like you’.
This made me feel very disappointed in the medical profession. I don’t think every patient should be put in the same basket. Sure some may get upset and not go back for further treatment, but that is their decision.
I asked why there are NO pamphlets at the doctor’s, and was told some issues are not appropriate to put in the pamphlet holders at doctors practices. For example, children could get hold of them.
While I personally understand this, I think all women should be told everything by their medical team, and the appropriate pamphlets/information etc to be given to them.
Please note: Your health care district/board may be different in how and what they tell their patients, but I thought what I have experienced was worth mentioning to you.
So ladies, if you feel you are not being told everything, do your research, and don’t be shy to speak up about how you feel!
March 2019 – Ongoing Vaginal Improvements
March rolls in and I’m still making sure I do standard Kegel exercises regularly, but do the reverse kegels more often, as I feel this works well for me.
For the first part of March I still made sure I have vaginal moisturizer handy and only use this whenever I feel tender or sore in the lady bits. On average this is every few days, but can vary.
The Dilator Training: Due to overdoing things with the dilator training last month I was taking things slower this month. I certainly didn’t want to get sore and bruised again.
By the middle of March I was able to use the second size in the dilator set without any soreness.
After doing a few sessions of this I took my PFT’s advice, before I went up to the size 3 dilator.
I geared myself up to use the size 3, but used size 2 first (in the same session) before using size 3. This helped things a lot.
I was able to insert size 3 just a bit, so just held it there for a few minutes without penetrating, or moving it. Yes, this bigger size felt uncomfortable, but it did not make me sore.
I did the above for the rest of March.
The HRT treatment: I stopped using the Ovestin cream!
Up until halfway through week 3 of March I was still using half the normal amount of Ovestin cream every five days.
However, I got sick of the messiness of it (the whitish pastey excess cream/discharge) that comes out from using it.
Yes I could use panty liners so at least my underwear didn’t get the excess cream, but when you have vaginal atrophy (vaginal dryness), wearing a pad or liner can rub the sensitive vulva skin, and create more soreness etc.
Due to the above and the progress I’m having with the dilator training, I took the plunge to see what would happen when I stopped the HRT Ovestin treatment.
PLEASE NOTE: Estrogen vaginal creams can also help to stop bladder leakage (incontinence) that is caused by low estrogen levels. I wasn’t experiencing this type of leakage when I made my decision to go off the Ovestin cream.
In replacement of the Ovestin cream, I apply the Yes Vagninal Moisturizer (using my finger), in and around my vaginal area once to twice a day on most days.
I have got into the habit of doing this upon waking in the morning, and at bedtime.
NOTE: Some doctors advise women to go off vaginal estrogen creams after they have been on it for a while, to see if the body has corrected itself.
I have also read that some doctors prefer women to stay on the estrogen cream, as no matter what, the body (vaginal area) and symptoms you had before being on it, will come back if you go off it.
Personally – I believe we are all unique. We are NOT all text book cases.
For this reason and the reasons I stated above, I made my decision knowing, I could always go back on the Ovestin cream if my vaginal area reverts back to being a sore no go zone.
Also, I must mention that when I asked my family doctor if there was any other medication I could use other than Ovestin cream she said, “N0”.
She understood my despair about the messiness though.
My Pelvic Floor Physiotherapist (PFP) Appointment
This appointment was for half an hour again. It was before I went off the Ovestin treatment, so I didn’t get to tell my PFT about it.
Again my PFT was happy with my progress, and that I had taken her advice when proceeding to the size 3 dilator.
So happy in fact, that she told me she didn’t need to see me anymore as she felt I was progressing well.
Before letting me go, she reminded me to keep up with the kegel exercises (standard kegel ones). We had a short discussion about how easy it is to forget to do kegels regularly as time goes by.
Her tip on this was: To get into the habit of doing them while waiting at the traffic lights, or bus stop.
I thought this was quite a good idea as no one around can see you doing them.
END NOTE: I will check back in here in a couple of months time to give you an update on the dilator training, and how it’s going since being off the Ovestin HRT Treatment.
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“(DISCLAIMER: I am not a health care professional, the information in this article is based on my own personal experience of living with vaginismus, vaginal atrophy (including menopause issues), and what I have learned along the way. Some articles on this website will include other womanly issues that I feel women need to know about. If you have any concerns about your health, it is best for you to seek advice from a health care professional – Full disclaimer)“.