On this episode of Dr. Emily Porter, the Austin Love Doctor’s™ podcast, she speaks with Dr. Charles Runels, the inventor of the O-Shot®, P-Shot®, and all the Vampire® Services that can be performed with platelet-rich plasma (PRP).Together, the two physicians discuss the causes of painful intercourse and options for treatments for pain during sex in Austin.
Keep reading to see the entire transcript and learn how we can help you end your suffering with treatments for pain during sex in Austin.
Narrator: The Austin Love Doctor, Episode 003. What to do about painful intercourse: dyspareunia, Sliquid, Pre-Seed, DHEA, the diVa Laser, vaginal therapy, and treatments for pain during sex in Austin
Dr. Charles R.: This is Dr. Charles Runels, inventor of the O-Shot, and thank you for joining Dr. Emily Porter, the Austin Love Doctor, as she openly discusses your most intimate questions regarding relationships, sex, and personal wellness through the eyes of a medical doctor who treats men and women for a variety of sexual issues and offers treatments for pain during sex in Austin using the latest medical advancements available. Get comfortable, relax, and welcome your host, Dr. Emily Porter.
Dr. Emily P.: Hi there! It’s Dr. Emily Porter, and I am the Austin Love Doctor, and I am here today to answer a question and provide guidance on treatments for pain during sex in Austin. I had a 57-year-old woman who says that she’s postmenopausal, and she also is a breast cancer survivor. And she’s having pain with intercourse even when she believes herself to be well-lubricated. She said it lasts about 20 seconds, and she wants to know if there’s anything to do for it.
Dr. Emily P.: So, the answer is, I think the first thing you need to do is see a physician, because a physical exam is really, really important to diagnose what might be causing the pain. If you are menopausal, postmenopausal, and have had breast cancer, you likely are … you have no estrogen left, and so it makes your vagina more susceptible to tears and fissures, which don’t sound like fun because they’re not.
Dr. Emily P.: So if the pain is in the first 20 seconds, it’s likely to be due mostly to the opening called the introitus, which is where a lot of those fissures can happen. And so I would recommend that you come in and have a vaginal exam with a speculum, or at least with some fingers of somebody that can look and see whether you have any tears. You probably have some atrophy of the tissue, which means that the tissue, like I said, is just sort of broken down.
Dr. Emily P.: The mucosa, or the tissue that’s wet that kind of lines the vagina, when you don’t have estrogen anymore it stops making as much lubrication, and that can cause pain. So, when we talk about pain with intercourse for women, it’s this fancy word and it’s called, “dyspareunia.” D-Y-S-P-A-R-E-U-N-I-A if you’re a Googler. And what it really means is that it hurts when a woman has vaginal intercourse and she may require treatments for pain during sex in Austin at my clinic.
Dr. Emily P.: But what it also means is it’s kind of lonely, it’s loneliness. Because if it hurts when you’re having sex, and you want to be with a partner, it’s very difficult to hide that pain. I think it might, in a lot of ways, it’s probably worse to have painful sex than to have no sex, especially because you’re doing it for somebody else, and you’re kind of fighting through that pain. So you can fake interest, or you can fake orgasm, but it’s really, really, really hard to have something hurt and not have your face show it, even if your mouth doesn’t say anything. So I’ve had patients that had pain with intercourse and didn’t know what to do, and they didn’t even want to hold their husband’s hand. They were out on a walk or watching a movie, because they were afraid that if they held his hand, then maybe that would signal to him that they were wanting to have intercourse that night and they really just didn’t want to, because they didn’t want it to hurt.
Dr. Emily P.: So, to make it not hurt, there’s several options that you can try and treatments for pain during sex in Austin. Again, all of them should be recommended to you by a physician. First of all, just make sure you have enough lubricant on board. You can buy some over-the-counter lubricants. Pre-Seed is sold at Target and Amazon, or any of the pharmacies. And it’s meant for people who are trying to conceive, because it’s a water-based lubricant and it has the exact same pH as what your normal vaginal lubrication has, so that it doesn’t interfere with motility of sperm. Obviously not an issue if you’re postmenopausal, but a lot of people think it is the most physiologically similar lubricant that’s out there.
Dr. Emily P.: And then a lot of people, if you’re not using condoms, like silicone lubricant. There’s something called Sliquid which you can buy that’s silicone that is kind of nice. Honestly, people use coconut oil. I mean, just be sure that if you are in a relationship and you’re using condoms, that you use something that’s water-based, otherwise you can compromise the condom and put yourself at risk. And there’s some daily moisturizers that you can use. There’s something called Luvena, that you can buy, kind of over-the-counter. It comes in a little applicator that you can kind of insert.
Dr. Emily P.: If you haven’t had breast cancer, but you’re just postmenopausal or you’re just dry, there’s some other options as well for over-the-counter treatments for pain during sex in Austin. Unfortunately, Vagifem, which is estradiol or estrogen, suppositories that you can put in or cream that you can put in, or you can have bioidentical hormone pellets put in with estradiol, or estrogen, we just don’t do that if you’ve had breast cancer because of risk of recurrence from the estrogen simulation. So you’re a little bit more limited. So I would recommend those lubricants and moisturizer.
Dr. Emily P.: There’s also these things called, it’s DHEA, which is dyhydroepiandrosterone, D-H-E-A, and the brand name is Intrarosa. It’s kind of pricey, but again, if you can use those they’re these little suppositories that go in you use every day, and they … DHEA is a steroid and it’s related to testosterone and estrogen. So when you put it in, it actually will turn into testosterone and estrogen will kind of build up the tissue, build up the lining, and help with the lubrication production. We don’t know for sure if they’re safe if you’ve had breast cancer. So that’s kind of answering the question to the broader masses of women that are just postmenopausal, but if you’ve had breast cancer I would recommend staying away from that particular medication until we know for sure that it’s safe. But for all the other postmenopausal women, Intrarosa and other DHEAs are great treatments for pain during sex in Austin. (Note from Dr. Porter: Since this recording, vaginal DHEA has been generally regarded as safe in patients with a history of breast cancer. Please check with your personal physician and follow her/his medical advice).
Dr. Emily P.: Or you can actually have it compounded. I have a great relationship with a compounding pharmacy here, and they can compound it, and it’s really, really tiny little things, like a baby-aspirin size. And you just put it in with your finger every night, and it’s much, much cheaper than the trade name that you get at the pharmacy.
Dr. Emily P.: So then, that’s kind of the lubrication and the medicines that you can try as treatments for pain during sex in Austin. But then, there’s some therapies that you can do that are non-surgical and can help, that don’t involve estrogen in any way. So there’s lots of vaginal laser devices out on the market. There’s some that just tighten, but those wouldn’t really be effective treatments for pain during sex in Austin. You need something that’s going to actually help tissue and help regenerate tissue. And so the one that we have in our office is something called diVa®. And it’s by Sciton. And they make great laser devices, and they have a very, very popular treatment called Halo for the face, and diVa is essentially the same treatment but it’s vaginal.
Dr. Emily P.: This treatment for pain during sex in Austin really pretty painless. It’s a three-minute treatment. We take a numbing gel or cream and we put a little bit of that inside the vagina and let that sit for about half an hour, and then there’s a dilator, which is a little bit bigger than maybe a man’s thumb, so it’s not very big. Once we’ve dried out the numbing cream, then we can put this dilator in. And the laser goes in, and it has some threads on it, and it goes inside this dilator, and then it’s actually fully automated.
Dr. Emily P.: It’s got two lasers. One is a wavelength that just heats the tissue, and that one kind of tightens and it also sort of thickens the area between the bladder and the vagina underneath the urethra. So if someone has urinary incontinence that happens as the tissue kind of thins if you’ve had babies, or as you age, or you lose estrogen, that space there thins and now your urethra doesn’t have as much support. So the benefit of diVa treatments for pain during sex in Austin is that, even if you’re doing it for dryness, it’s also going to help you so that you’re less likely to wet your pants, because you’re strengthening that space underneath the urethra.
Dr. Emily P.: And it’s a three-minute treatment, so we would stick the laser in and it fires around. We can target it at 90 degrees, 180 degrees, or 360 degrees. That’s based on kind of what your needs are. So if you have, for example, a scar from an episoiotomy, or a tear, a lot of people that have pain with intercourse it tends to be what we would say “posterior pain,” so it’s actually kind of along the perineum, which is that space between the vagina and the rectum where you would tear if you had a baby or you would have an episiotomy. And that’s where most of the pain that people have in the fissures tend to come.
Dr. Emily P.: So we could do some extra treatments for pain during sex in Austin, like a second round of a three-minute treatment there to kind of break apart scar tissue there, and then do the 360 degree for the whole vagina. And the second wavelength that we use, there’s the first one is heat, and the second one, it actually is an ablative laser, which is more what I think about with a laser, which is something that’s going to vaporize tissue. And so, in lots of ways, it’s a controlled burn. It’s a very well-controlled burn that a physician can set the depth of the treatment and the density of the treatment, so we can determine how aggressive we want to be.
Dr. Emily P.: Obviously, if you have estrogen on board, so if you’re on estrogen replacement therapy, for example, in a non-breast cancer patient, or have not had menopause yet, then we can offer more aggressive treatments for pain during sex in Austin because the tissue’s a little bit healthier. It heals a little bit better. But even if you’ve had breast cancer, this is a completely non-hormonal treatment, and those two lasers together will tighten, heat, and then that ablative laser will actually go and make tiny little burns in a percentage of the vagina where we’re treating. Kind of like when you aerate a lawn, and you go over the entire lawn, but you only are treating a certain percentage, so you’re only making holes in a certain percentage of the lawn. It’s the same thing.
Dr. Emily P.: So the whole vagina. The laser covers the whole area, but it only treats a certain percentage. And that varies based on the physician also how many treatments for pain during sex in Austin the patient has had. And so those two together, they allow for improvement in the lining of the vagina as well, because those cells that make the lubrication, they get regenerated. And so new ones grow. And in our case, in our office, we actually kind of add something called Platelet-Rich Plasma into ours, and think about that’s just like throwing fertilizer on the lawn after you’ve aerated it.
Dr. Emily P.: So Platelet-Rich Plasma is the goo that comes under a scab. If you fall and scrape your knee, and you make a scab, and then your mom always told you not to pick the scab but you’re like me and you did it anyway. And you pick it off, and it kind of hurts, and there’s that yellow goo underneath. That yellow goo is what recruits stem cells to then make your new skin on your knee.
Dr. Emily P.: So if you fall and get a scab, most of the time you don’t actually scar from that. The stem cells will recruit new cells there, and you’ll have new skin, which will have nerves. It will still receive blood flow and things like that. You won’t even be able to tell that you ever skinned your knee. So that’s Platelet-Rich Plasma recruiting stem cells. So what we do with these treatments for pain during sex in Austin is we would draw your blood in our office when we go to numb you, and we would take just a tube of blood and spin that down in a special machine that we use that allows us to isolate this liquid gold, Platelet-Rich Plasma or PRP.
Dr. Emily P.: And then I would, after I did the laser treatment when those channels are fresh, I just take the syringe and I squirt a little bit in there and then rub that in with my fingers to kind of go in there and fertilize that tissue. What it translates into a patient is that these are a really comfortable, very quick automated treatments for pain during sex in Austin. There’s no in-and-out motion at all. It’s very quick, and you recover very quickly. So I had this done I think four or five times now after my kids, and you’re back in the saddle in three days.
Dr. Emily P.: So we just ask you to not have anything in the vagina for three days. So that’s about how long it takes to heal. It’s not like you’re walking around lame or anything. If you wipe maybe you can feel a little bit chapped or chafed like you’d had dry sex. But most people have very little recovery with this, and with very little downtime. So we recommend doing that three times as monthly treatments for pain during sex in Austin. And then I also recommend doing a maintenance treatment about once a year.
Dr. Emily P.: And in your case, our patient, I would recommend pairing this with something called the O-Shot®, which we talked about that with PRP. And the O-Shot uses PRP to offer amazing treatments for pain during sex in Austin and help kind of restore the same things we’re trying to do with the laser, except that we’re not really tightening the vagina. So we’re injecting some of that Platelet-Rich Plasma into the vagina in the area where the Skene’s glands are, and those are the glands that produce your natural lubrication. And so when we bathe them and fertilize them, then they make more lubrication again. And so then you have less pain.
Dr. Emily P.: And there was actually a recent article in the Menopause Journal specifically about the injection of Platelet-Rich Plasma into that area of the vagina, the anterior vaginal wall, in post-breast cancer patients as treatments for pain during sex in Austin. And basically, the short story of the article is, is that every single one of them had an improvement in their sexual function, their sexual satisfaction, and their vaginal dryness, all improved in every single one of them.
Dr. Emily P.: The O-Shot we also inject some of in the clitoris, so even though that might not be your main focus or your main issue, I’ve never met anybody that said that having a nicer, more happy clitoris (and more intense orgasms) was ever a bad thing.
Dr. Emily P.: So, hope that helps. There’s lots of options out there, and I know they might sound overwhelming, but I would recommend that you find a physician who offers lots of different treatments for pain during sex in Austin so that you can really get a customized treatment to best meet your needs and exactly what you want without anything else. Thanks for listening!
Narrator: Thank you for joining Dr. Emily Porter, the Austin Love Doctor to discuss treatments for pain during sex in Austin. If you have a question about your relationship, or sexuality, please feel free to contact her directly at AustinLoveDoctor.com.
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