When Sex Hurts

“We can work this out. If we can just push past the pain, it will be OK,” I told him.

I was 27, newly married, and I had never had sex before. I thought sex might be a bit painful the first couple of times, but the pain was awful! I felt like my husband was hitting a wall inside of me.

Soon, the constant attempts and subsequent pain created a cycle. I would tense in anticipation of the pain to the point that it became both a physical and mental issue. I was so tight that at times he could not enter me at all.1

Dyspa-what?

More than half of all U.S. women experience intercourse pain, also known as dyspareunia. This widespread women’s health issue can transform what is supposed to be a beautiful part of a relationship into a time of pain and discomfort.

But it’s embarrassing

Many women neglect to discuss their intercourse pain with their gynecologist because they are embarrassed by it or feel that there is nothing that can be done. However, it is important to discuss these issues openly in order to receive the proper treatment.

The pain is not all in your head

Some specialists tell women that the pain they are experiencing during intercourse is purely psychological because they find no visible cause of the pain. This response often leaves women feeling disempowered and discouraged. The pain is real, and it has a real cause, called adhesions.

Adhesions are thick bands of internal scar tissue that form after any trauma, surgery, infection or inflammation. Women can develop adhesions from any of these common traumas:

-A fall to the hip or tailbone (e.g., cheerleading, skating, horseback riding or bicycle injury)
-A bladder or vaginal infection
-Physical or sexual abuse
-A pelvic or vaginal surgery (e.g., episiotomy, hysterectomy, c-section, etc.)
-Vaginal spasms from vaginismus

Adhesions are invisible on traditional medical tests (X-ray, CT scan, etc.), which is why they are often misdiagnosed as psychological pain. They can form on the interior vaginal wall and cause pain during or after intercourse. The pressure exerted by a partner when making love can pull on these adhesions causing pain and discomfort.

Hitting a wall

Though the pain can feel different for each woman, many experience pain with first penetration. This is often a very sharp and specific pain in one location, often at or near the opening of the vagina. For others, the pain is felt with deeper penetration. This is often a broader, deeper pain that may feel as though your partner is hitting something. Some women may also experience a combination of the two.

Finding treatment

Intercourse should be a time of great pleasure – not pain. Because the female reproductive organs are susceptible to adhesions and tailbone trauma, intercourse can become a time of pain and embarrassment. A hands-on therapy called the Wurn Technique has published results in decreasing pain during sex as well as increasing the four parameters of sexual function ? arousal, desire, lubrication and orgasm.

In a study published in the 2004 issue of the peer-reviewed medical journal, Medscape General Medicine, the Wurn Technique was shown to have decreased or eliminated intercourse pain in 96 percent of the women treated.

No more pain

Relax. Kegel exercises consist of a series of contractions and relaxation techniques to gradually strengthen the pelvic floor muscles. Studies have shown that these exercises can lessen pain and help women achieve orgasm.

Research natural therapies. Adhesions form as a result of trauma, surgery, infection, or inflammation. A hands-on therapy called the Wurn Technique uses manual techniques to treat these adhesions without drugs or surgery. In published results, this therapy showed decreased pain during sex as well as increased sexual function- arousal, desire, lubrication and orgasm.

Address the root cause. Pelvic and vaginal infections are often a source of pain and discomfort. Treating these conditions with the appropriate medication may decrease pain, sensitivity, or lubrication issues.

Achieve balance. Following menopause, estrogen levels often drop. This can decrease lubrication, which in turn causes pain during intercourse. Treatment options include prescription creams or medication for those who experience dyspareunia.

Belinda Wurn, PT, is the national director of services for Clear Passage Physical Therapy. She co-developed the Wurn Technique, a hands-on treatment for decreasing adhesions and their effects. She has worked with patients for pain, infertility, sexual dysfunction and endometriosis.

Photo credit: Gustavo Medde

1. Belinda Wurn, Larry Wurn, Richard King. Overcome Infertility and Pain, Naturally. Chapter 12: Painful Intercourse. Gainesville, FL: Med-Art Press, 2011.

Yoga for Artists: Unleash Your Creativity

I have been in the art world for nine years as a critic, curator, theorist, philosopher and artist. Most of my endeavors place me in front of a computer writing reviews, press releases, essays, catalogues and the like. This has caused my erector spinae to shorten and my rhomboids to extend beyond their normal limits. These muscles are imperative for a straight spine and an open heart but are consistently put at risk by my typing. Because my arms are always in front of my chest, I develop knots in my shoulders that ultimately travel up my neck and cause tension migraines. And of course, carpal tunnel syndrome is nearly inevitable when you do nothing but type on a keyboard all day long. The worst part about being at a computer non-stop is the stress that it places on the nervous system. An illuminated screen bombarding your retinas is not the most relaxing thing in the world. And with constant stress it is very difficult, if not impossible, to be creative with writing.

About three years ago, I began practicing yoga to gain more flexibility, and since then I’ve had limited to no pain. The restoratives, back bends, hip openers, arm balances, neck stretching, shoulder strengthening and core work have aided each of my ailments and corrected the imbalance in both my physicality and my nervous system. With a relaxed nervous system, emotions are allowed to move throughout the body and exit freely. I know that I am not the only person to feel these impediments; it’s an occupational hazard from being an artist.

Painters, sculptors, photographers, writers, new genre artists and musicians usually have shoulder and neck pain along with posture problems and possible migraines. Actors, performance artists or musicians who stand a lot most likely have lower back pain, tight hamstrings and tight hip flexors, which lead to a plethora of other physical problems such as swelling of the feet and knee tenderness. All of these ailments and body aches are occupational hazards, but can be repaired by opening up to yoga.

If the physical restrictions are not enough to make a believer out of you or your artist friend, think of it this way: No one can be creative with a closed heart. If your shoulders are hunching forward because your arms are constantly in front of you in your day-to-day activities, how can you expect your heart to be open? Imagine how nice it would feel to lay across a bolster and give your shoulders a chance to release back. Not only would it take away the pressure in your upper body, but also release a ton of emotions that are being built up behind the wall of clavicles, scapulae and muscles wrapped around your chest.

Back bending is the number one movement that can aid artists in allowing creativity to flow through them. A simple 20 minutes a day of Sun Salutations and low backbends such as Bhujangasana (Cobra Pose), Salabhasana (Locust Pose) or Setu Bandha (Bridge Pose) can do wonders for allowing you to open your heart and mind to new inspiration. The beautiful thing about back bending is that it innately comes with counter poses – forward bends – which ultimately open the hips and hamstrings and give the spine more flexibility after being extended. As an added bonus, forward bends make you confront yourself and all of the insecurities you may face while dealing with lack of ingenuity.

Counter your backbends with postures such as Paschimottanasana (Seated Forward Fold), Janu Sirsasana (Head-to-Knee Forward Bend) and Dandasana (Staff Pose), while making sure you even out the spine between going backward and forward so you don’t eventually snap like a credit card. For balance between counter poses, do twists or Adho Mukha Svanasana (Downward-Facing Dog).

If you are one of those artists who can’t shut your brain off to do 20 minutes of asana (pose) practice, or you’re a smoker like so many artists are, calming the nervous system with restoratives can also assist in your endeavors to free your body of pain and your soul of creative infertility. Salamba Supta Virasana (Supported Reclining Hero’s Pose), Salamba Setu Bandha (supported Bridge Pose) and even Salamba Balasana (supported Child’s Pose) are a few of many yummy restorative poses that will make you feel like you have innovation seeping from your pores.

Whatever artistic medium you participate in, I urge you to begin practicing yoga. Whether it’s in the form of asana for physical pain, kirtan (literally translated as “to repeat,” usually in the form of singing), chanting, meditation or pranayama (breath control), knowing the art world very well, I guarantee it will change your life. It has changed mine.

Alexx Shaw is a yoga instructor and critic living in Los Angeles. She has a background in Art Theory, Art History and Philosophy from schools both domestically and abroad. Her yoga practice begins with asana as a gateway to the deeper teachings of yoga.

Photo Credit: lululemon athletica

When Your Home Birth Doesn’t Go As Planned

Everyone who follows my blog knows I planned a home birth. “Plan” is the operative word. Even though a home birth was my first choice, my birth plan included backup plans in the event I transferred to the hospital (separate plans for hospital vaginal and C-section deliveries). I imagined the major scenarios, so I wouldn’t be forced to make difficult decisions under the duress of labor or in an emergency.

On Thursday night, I started dripping water, no gush like you see in the movies. An hour later, I started to feel light contractions. I continued to labor. It wasn’t bad either. Kind of fun. We had the lights off except for the orange glow of the salt lamp. I had soft ambient music playing. In addition to my husband, I had a crew of women there: mom, mom-in-law, three midwives and two doulas.

In hindsight, I’m not sure it was best to have so many people attending my birth. I wonder if having so many eyes on me was unnerving and delayed my labor. I was excited for everyone to arrive, but I noticed that my labor slowed down once it wasn’t just me, Greg and my mom. I’ve read this can happen in the hospital because of bright lights, rotation of doctors/nurses, etc., but I didn’t expect it with my birth team, in my own home.

Before I knew it, many hours passed. But during that time I was cruising right along, doing hypnobirthing, handling the contractions. Then something changed. The labor became agonizingly, torturously painful. Friday morning turned into afternoon, and I was experiencing hour after hour of excruciating pain that was becoming impossible to handle. The hypnobirthing techniques?  Not a chance. I tried a bathtub of warm water … didn’t help. I tried different positions … didn’t help. I began to fear something was going terribly wrong. It was then that I started contemplating going to the hospital.

As my intuition continued to scream at me that I needed to go to the hospital, I hate to say this: I was afraid to tell my birth team. Afraid of looking like a wimp, of letting them down, or of making them think they had let me down. Finally, I got the courage to say it. (With the benefit of hindsight, I realize I should’ve never felt ashamed for wanting to go the hospital, but my home birth had meant so much to me, and such a radical change takes time to process.)

My instincts told me something wasn’t right. My birth crew tried to talk me out of transferring, told me that everything I was feeling was normal. My husband looked worried though; he knew how badly I wanted a home birth and that something was probably not right. At this point, my midwife checked my dilation and found that I was only four centimeters! In that instant I knew that I had to go to the hospital. Knowing that I might not even be halfway there, with many more hours of hell to go was all it took for us to switch to Plan B. My midwife seemed surprised by my lack of progress and supported my choice to go, but technically, this wasn’t an emergency transfer. Instead of transferring to the nearby hospital 15 minutes away, we opted to transfer to a hospital 45 minutes away, but much friendlier toward home birth transfers. Most of all, it had lower C-section rates.

At the hospital it was another agonizing hour until I received pain relief, which by then was an incredibly easy decision. At that moment, my concern was for getting my baby born and being helped to do it. Two days before, I would’ve never dreamed I’d accept drugs for pain, but when new information presented itself, I knew I had to be flexible. My overriding concern at that point was to have a vaginal birth, not a C-section. That would require all of my strength. After being relocated from triage to my comfortable delivery room and receiving pain medication, everything was better. I was able to relax a bit, to be myself again. I was able to focus on my baby.

In spite of my previous concerns about hospital births, this experience largely proved me wrong, and tells me that not all hospitals are the same … in fact, far from it! At the hospital, I started to relax, get rest, and I was able to eat. Yes, eat. The hospital did allow that. In fact, my doctor brought me food! My labor was still long once I was at the hospital (about 12 hours more), but it was more manageable. When the time came for pushing, the epidural had mostly worn off, and it was hard work, but without pain. When Kamea came out … that part wasn’t painful at all. It was super cool.

For the past year, I’ve been hard on hospitals for birth. I’ve learned that not every hospital deserves that. The hospital we chose was amazing. They explained the different options I had through every step. They encouraged breastfeeding. They answered my questions. They were patient. They accepted my birth team and collaborated with my midwife, who was my staunch advocate. They respected my birth plan. They didn’t pressure me with anything (except for one formula-pushing nurse). The attending doctor even said something in front of his staff that amazed me: “We doctors could learn a few things from midwives.”

What I’ve walked away with is this: I had the chance to experience part of a home birth, as well as a hospital birth. The birth team believes that Kamea was presenting with her elbow in the up position, explaining the slow progress and extreme pain. I suspect if Kamea didn’t have an elbow up, my labor would’ve progressed faster and might not have been as painful. But she did. And as her mom, I made decisions that I didn’t expect to make, but I was happy to make them. They felt right in my gut. And the other thing I learned: Don’t be afraid of the hospital if that’s the route you need to go, yet you had planned a home birth. Choose a hospital that is midwife-friendly, if possible. Otherwise be sure to have your birth team there to advocate on your behalf.

I wonder if the labor was protracted because she just wasn’t ready to come out. Three days prior to my water breaking, I took measures to “support labor starting.” I underwent two aggressive acupuncture treatments. I now wish I hadn’t done that. I wish I had let Kamea come on her own time. I did it because she was almost two weeks past due, after which my midwife technically wasn’t allowed to do the delivery. Because I wanted a home birth, I was willing to speed things. I wonder if this contributed to my long labor.

In the end, I have a happy, healthy baby (that’s what matters), and I love her so much!

Living Pain-Free through Chinese Medicine

Many people are surprised to hear that acupuncture and Chinese herbal medicine are keys to improving health and quality of life for cancer patients. Acupuncture is great for treating and preventing pain, and it will help put an end to daily doses of ibuprofen and other pain medications. An added bonus is that there are no negative side effects.

Chinese medicine, herbal medicine, acupuncture, and proper nutrition can help other cancer-related symptoms, as well as side effects of Western treatments, including nausea/vomiting, fatigue, weakened immunity, stress, anxiety, pain, bruising, post-operative swelling, hair loss, anemia, skin issues, hot flashes, digestive disorders, loss of appetite, and detoxification/elevated liver enzymes.

A lot of people ask me how acupuncture works in general and how it reduces pain. Acupuncture reduces inflammation, stimulates nerve conduction, increases blood circulation, releases endorphins, and relaxes muscle tightness and spasm.

Quite often, pain gets overlooked or undertreated because the focus is on treating the cancer. Many of my patients also frequently ask why so many cancer patients experience pain to varying degrees while others don’t experience any pain at all. The level of discomfort depends on many factors, such as the type of cancer, the stage of the disease, and the patient’s tolerance. Pain in cancer patients can result from the following:

-Tumor putting pressure on a nerve
-Blocked blood vessels causing poor circulation
-Bone fracture due to metastasis
-Infection
-Inflammation
-Psychological or emotional distress
-Anemia leading to lack of nourishment to muscles and tissues
-Side effects from Western cancer treatments

Thirty percent of cancer patients experience pain, and up to 90 percent of patients with advanced cancer experience severe pain. As many as 50 percent of patients may be undertreated for cancer pain, yet not all cancer patients feel pain, and pain is rarely a sign of early cancer. No matter what the cause of discomfort, if you are experiencing pain, muscle tightness and spasms, numbness, and loss of muscle strength, acupuncture will help.

Cancers that are more typically painful include tumors of the bone and the organs of the abdomen. Cancers of the blood, such as leukemia or lymphoma, rarely cause any pain.

Pain can also increase due to the emotional stressors related to cancer or any chronic illness—fear, financial worries, or feelings of isolation. How a patient emotionally handles their illness and gets support does affect pain levels and threshold.

Studies at the National Institutes of Health on the benefits of acupuncture on the immune system of cancer patients showed that it improved immune system response and reduced pain levels. In one study, a majority of patients were able to stop taking drugs for pain relief or reduce their dosages. Several clinical trials have shown that acupuncture reduces nausea and vomiting caused by chemotherapy, surgery, anesthesia, and morning sickness.

Another added benefit is that nutritional and herbal support boosts immune response in cancer patients, along with minimizing the immune and white blood cell suppression that occurs with most chemotherapeutic agents.

For those of you seeking support in pain management, cancer prevention or the prevention of a reoccurrence, please find a qualified acupuncturist or herbalist. Being free from illness is how we’re meant to live. Being proactive in regard to your health will naturally make you feel better too.

Live natural. Live well.

Heather Lounsbury, L.Ac., an animal rights activist for 25 years, has been in private practice for over 15 years as an acupuncturist, herbalist, nutritionist, and Reiki master. At her clinic in Santa Monica she treats a variety of ailments, specializing in pain management, gynecology, mental health and addiction, & digestive disorders.  Her patients range from newborns to the elderly, celebrities to college students. Her weekly radio show “Live Natural Live Well” covers a wide variety of health topics, as well as how you can get more involved in your community and saving the planet.  As a well-respected physician, Heather’s unique holistic approach to healing encompasses all aspects of her patients’ needs, allowing for the best possible results.

Photo Credit: SqueakyMarmot

Secrets of a Chiropractor

By Luke Piretti

I always get an interesting reaction when people find out I am a Chiropractor. People want to ask me about their low back pain, or ask me what a chiropractor does. They want to know how on earth I chose this profession. It is understandable, as chiropractic seems to be everywhere: there are characters on TV who play chiropractors, Super Bowl athletes who fly their Chiropractor in from out of town to help them heal before the big game, or somebody’s aunt who went for headaches that are no longer a problem.

I understand these questions because I was in their shoes. Growing up as an athlete who was always in some sort of pain, my first trip to the Chiropractor left me a bit surprised. This was because I, like many people, thought that Chiropractors dealt exclusively with back pain. As I walked into the office for my first appointment I was in pain, and not really holding out much hope—it was, in all honesty, a last resort. Thankfully over the next few months I began to understand that chiropractors aren’t simply “back doctors” but are effective healers who can help the body regain optimum health through natural means. I actually became a Chiropractor because I realized that many people live their lives in discomfort and could benefit from a deeper understanding of the human body and what it needs to function properly. Medication is great, but people aren’t in pain because of a lack of Tylenol in their system. What follows is a brief summary of what Chiropractors do and common questions that people have.

Chiropractic is a profession that’s been around for over 115 years and, contrary to popular belief, is actually a Western, not Eastern, medicine. It’s a discipline that encourages people of all ages to work on lifestyle changes to improve their health. The core belief of Chiropractors is very similar to the “new age” medical doctors of today who preach diet, cleansing and lifestyle as a first line of defense. Then, if needed, proceed with more invasive drugs and surgery. The irony is that until the wellness revolution of recent years many people thought the natural approach that chiropractors spoke of was behind the times. Even today, you won’t see many Chiropractors talking about wellness care on Oprah, even though we’ve been preaching this message for over 100 years. Is it a bit frustrating? Yes, but as is true with most things, if we don’t understand something we are naturally a bit fearful of it. I hear many myths and untruths in my office, so I’ll set the record straight.

Are Chiropractors doctors?
Chiropractors must undergo 4 years of undergraduate training, 4 more years of doctoral training, 4 rounds of national board exams and then state board exams. By the time their education has been completed, they are specialists in Neuromusculoskeletal (nerve, muscle, or bone) problems. It’s also important to remember that the definition of a doctor is actually teacher, and Chiropractors have been teaching people about the importance of proper posture, nutrition, vitamins, exercise, preventative medicine and stress reduction for over 100 years—before these things were popular in mainstream media. What we lack in prescription pads we make up for in improving the structure and function of the body naturally. This has made us leaders in the wellness and preventative care movement. Are there some bad Chiropractors out there? There sure are, just as there are bad medical doctors, lawyers, carpenters, etc. The key is to find one with whom you feel comfortable.

Chiropractors only treat back pain.
Many people associate Chiropractors with back pain, but the term Chiropractic actually means “done by hand.” This means that Chiropractors don’t just deal with back pain but all sorts of ailments and problems, from head to toe, without drugs or surgery. This includes everything from TMJ pain to plantar fasciitis and from headaches to hip pain. If it hurts then they probably deal with it, whether it’s a joint, muscle or nerve. Chiropractic care doesn’t stop at pain, since they’re trained extensively in nutrition and exercise. Many people come for nutritional counseling, weight loss, cleansing, strength training programs and alternative ways to fight their ailments. The profession relates expertise in all aspects of preventative and wellness care. Does it cure everything? Of course not, but in many instances, it is a good place to start.

I heard that if I go to a Chiropractor, I have to keep going forever.
I have three goals to accomplish with every patient: work on correcting the problem, give the patient exercises and stretches to stay pain free, and teach the patient to notice signs when they need to come in for a follow-up appointment. If I accomplish these three goals, then most people won’t need my help all that often. Some problems are so severe that they warrant treatment throughout life, but the majority of issues can be taken care of relatively quickly. I believe that if a person needs to come for follow-up appointments for the rest of their life, then the Chiropractor may be missing something. The best Chiropractors will make sure that the three goals mentioned earlier are achieved, and then, if a tune-up is needed in the future, we are here to help.

It is a routine occurrence that I’ll have someone come in saying that they have tried every other doctor they could think of and I’m their last hope. This is a challenge and an enjoyment because the vast majority of people I see will experience relief in a comfortable time frame. Recently I had a woman who had crippling headaches as she dealt with cancer treatment—only to be pain-free just two weeks into treatment. There is great research on this topic from Duke University, but that isn’t what brought her in. She figured nothing else had worked, so she would give it a try. My goal is to make sure people see more of the research, hear more of the success stories, and then can make an informed decision to seek chiropractic care. They won’t have to wait until everything else fails; instead, they can stop needlessly suffering much more quickly. The next time you feel any sort of pain, weakness, or discomfort you may want to try out your local Chiropractor… my guess is that you’ll be pleasantly surprised.

Dr. Luke Piretti is part of a Chiropractic group in Boston, MA. He specializes in pain management, nutritional therapy and cleansing programs. For more information, visit his website.