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Question:
I have been trying to stretch my vaginal opening but I still experience pain with intercourse. The pain is at the opening only. I have used tampons with no problem, but anything bigger really hurts. What could be the matter? I have no infections and the area is not sore to touch.

Answer:
by Daniel Stein:
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There are a number of causes for pain on insertion from intercourse aside from being just too small. These include various types of vulvar infections including herpes, vulvar cysts, such as Bartholin's Duct Cysts or Skene's Duct Cysts, congential abnomalies such as longitudinal vaginal septums and partial or circumferencial vaginal constriction rings, granulomas, fissures, epithilial atrophy, vulvar vestibulitis, vulvodynea and atrophy with sclerosis (which may be related to long standing hormonal deficit even at your age).

A thorough and competentantly performed gynegological examination is essential.

A simple test to see if you are too small is to insert two fingers into the vagina in a squatting position and attempt to spread them while your muscles are relaxed. Be sure to wash your hands and lubricate your fingers prior to attempting this. If you can spread your finger tips even 1 cm apart you probably have adequate vaginal size. The vagina in a healthy young women your age with no hormone deficit and no nutritional, infectious, neoplastic, autoimmune, or other chronic medical problems should stretch with regular dialation ( at least five times weekly for five to ten minutes).

A new vaginal exerciser called GyneFlex is available that may very simply help you become more familiar and more comfortable with your vagina and pelvic anatomy, and learn to fully relax your vaginal muscles as well. This simple, comfortable, easy to use device is easily inserted into the vagina (I am quite sure it will fit since women 92 y.o. have used it without discomfort). You squeeze your vaginal muscles against it and it contracts, then relax your muscles allowing them and your vagina to comfortably accomodate it's expanded size.

While this exerciser is intended to improve blood flow and muscle strength in order to enhance sexual response, the very fact that you have to become comfortable inserting it and learning to maximally relax your vaginal muscles may well be all that you need to overcome your obsticle to intimacy.

Reviewed by: Scott Gross M. Ed.

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