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citrus fruit representing vaginal scarring
Image courtesy of Healthline.com
In this Healthline article written by Gabrielle Kassel on May 29, 2020, Heather Jeffcoat was tapped for her experise on vaginal scarring and its effects on painful penetration during sex, tampon insertion, etc. Here are some excerpts from the article, and a link to the full article is shown below.

Yes, it’s possible to have scarring down there

Experts estimate around 75 percent of women find sex painful at some point in their life.

Known by medical personnel as “dyspareunia,” there are basically a bajillion different reasons this could happen.

One of them is vaginal or vulvar scarring.

What exactly is it?

Scar tissue is the body’s way of healing what’s been damaged or injured — it’s the body’s healing mechanism,” says Heather Jeffcoat, a doctor of physical therapy who specializes in sexual dysfunction, pain, and incontinence, and author of “Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve.”

Vaginal scarring occurs when scar tissue has developed inside the vagina as a result of injury, damage, or tearing — like during vaginal childbirth.

Scarring on the outside of the vagina (the vulva) is also possible.

How to recognize it (if you can’t already)

If you ever fell riding your bike or sliced a finger cutting an avocado, you know this to be true: The tissue the body lays down to heal a wound isn’t the exact same type of tissue that was there previously.

It’s stiffer, thicker, and usually either numb or much more sensitive than the surrounding tissue (or skin).

Well, surprise, surprise: This is also true for scar tissue inside the vaginal canal or on the vulva.

So, while there are different types of scars, you’ll likely be able to see the scars on your clitoris, labia, or perineum and around the vaginal opening, either by looking down or holding a mirror between your legs.

What can cause vaginal and vulvar scar tissue?

Anything that causes trauma — that’s tearing, microtearing, puncturing, or splitting — to the area can lead to vaginal scarring.

Beyond pain: How to make sex pleasurable

Once we’ve addressed the pain, we can start to work towards pleasure,” Jeffcoat says.

Here’s what that might look like.

Try sex positions that put you in charge

Penetration may not be on the sex menu for you. But if it’s something you want to try, Jeffcoat recommends positions that either limit the depth of penetration or put the vulva owner in charge of the action.

For instance:

Check out the Ohnut

If the scarring is deep inside the vaginal canal, you might also try using the Ohnut,” Jeffcoat says.

[This] is a device the penis owner or dildo wearer can slide down their shaft to reduce how deep they’re able to enter,” she explains.

And in case you’re wondering: It doesn’t feel like a cock ring. Rather, it doesn’t feel like much of anything.

Buy the Ohnut here.

Give the clit some love

Who needs penetration to experience pleasure when the clit alone has 8,000 nerve endings??

If you’re using your fingers, experiment with different types of strokes:

  • Stroke from the top down and then from the bottom up.
  • Tap on the clitoral hood.
  • Swipe diagonally left to right and then right to left.
  • Use clockwise and counterclockwise circles.

Use lube!

The reason you used a Q-tip with lube is to reduce irritating friction. And that’s the benefit of using lube during sex.

Lube cannot fix vaginal scarring, but it may help make those scars less sensitive to touch,” Jeffcoat.

There is much more useful info in the original article. Continue reading the full article at Healthline here.

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My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

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I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

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I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

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I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

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Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

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