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Heather Jeffcoat at Healthline
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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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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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My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

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Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

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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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My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

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