pain with sex

Memphis Mary 49 said:

When to start dilators?
I am new to CSN and post treatment by 17 days. When are we supposed to begin vaginal rehab (dilators, creams, PT)? Are there gynecologists that specialize in post radiation treatment? My husband and I tried it a couple of days ago - needless to say that was a big "no go"!!

Doctors
Fortunately, my gyno at my treatment facility and my gyno here are good friends and they communicate well regarding my needs. But actually, it was my radiation onc who gave me the dialator after a 3 month post visit. At the nurses station following my exam she told her/my nurse to get me a dialator. The nurse whispered to the doc, "What size?" and the doc said, "Small." I said, "Are you kidding me? Extra large please. If I've gotta do this, I'm going to enjoy it!" True story. (I did come home with a medium.)

sephie said:

size of dialtor
i have them all sizes. can NOT do the larger one- have tried and it causes bleeding and pain. will not take chance of tear. i am so afraid of tearing the anal area from pulling on the tissue that i do not have any fun even trying to have sex. i do the dilator for 10 minutes almost every day and estrace cream. i am trying but my poor hubby. i am at 25 months post tx and the docs are going to be upset at MDA when i go in Sept and tell them that i have not had sex-- the one female understands. I am going to tell them that my hubby is too LARGE> hubby laughed at this. should give him the big head ( both heads). he will be proud. sephie

Vaginal Stenosis/Painful sex
I'm six months post treatment and recently saw my GYN doctor due to painful sex and vaginal burning. I was given a medium dilator after treatment and frankly could not tolerate using it until about 3 or more weeks post treatment. Everything in that areas seems to have "shifted". Actually I stopped using it because it was so uncomfortable. My husband and I have only attempted intercourse 3 or so times after treatment ... it's pretty darn uncomfortable; burning and tightness. Ok ... so I'm now using Premarin vaginal estrogen cream for 7 days straight to get the estrogen "kick started" in and around my vagina. Followed by twice a week use. They've ordered a graduated set of dilators (the rad onc only gave one which is sort of crazy when we're trying to get my vagina "gradually" stretched out and back in shape, so to speak). And, I'm going to start to work with a physical therapist with my dilators. The issue as it was explained to my by GYN, is we have a pain response related to sex ... given it is and has been painful. The PT will work me to get beyond the pain response to impending sex ... (tightening of muscles etc.) So, PT is an option, however it's pretty specialized but not unheard of. Many men and women have PT for incontinence. So, we'll see how it goes. My husband and I do other things to satisfy our need for intimacy and physical closeness ... and if I never have penis/vagina sex, I can "live" with that .... because living is most important. In fact, my husband and I are closer than ever before and we were pretty darn close to begin with! hugs to you all! Keep up the good fight. xo

7243 said:

Vaginal Stenosis/Painful sex
I'm six months post treatment and recently saw my GYN doctor due to painful sex and vaginal burning. I was given a medium dilator after treatment and frankly could not tolerate using it until about 3 or more weeks post treatment. Everything in that areas seems to have "shifted". Actually I stopped using it because it was so uncomfortable. My husband and I have only attempted intercourse 3 or so times after treatment ... it's pretty darn uncomfortable; burning and tightness. Ok ... so I'm now using Premarin vaginal estrogen cream for 7 days straight to get the estrogen "kick started" in and around my vagina. Followed by twice a week use. They've ordered a graduated set of dilators (the rad onc only gave one which is sort of crazy when we're trying to get my vagina "gradually" stretched out and back in shape, so to speak). And, I'm going to start to work with a physical therapist with my dilators. The issue as it was explained to my by GYN, is we have a pain response related to sex ... given it is and has been painful. The PT will work me to get beyond the pain response to impending sex ... (tightening of muscles etc.) So, PT is an option, however it's pretty specialized but not unheard of. Many men and women have PT for incontinence. So, we'll see how it goes. My husband and I do other things to satisfy our need for intimacy and physical closeness ... and if I never have penis/vagina sex, I can "live" with that .... because living is most important. In fact, my husband and I are closer than ever before and we were pretty darn close to begin with! hugs to you all! Keep up the good fight. xo

PT
Your PT will likely educate you in pelvic floor exercises. I was supposed to do this, but the only PT in my area that specializes in this recently left a group practice and went out on her own and my ins. benefits for private practice PT's suck, so I didn't do it. I hope you see some benefit from it.

7243 said:

insurance
my benefits suck with regard to this as well .. may have to self pay. I've learned too much through this process. What state are you in ... share only if you want.

Insurance
I live in Georgia. My recommendation to you would be to schedule 2 or 3 visits with the PT and learn as much as you can about a home exercise program that you can do without having to rack up big bucks in PT charges. I worked in a PT clinic for quite a few years and this is common practice when people have little or no benefit for PT services. Tell your PT upfront that that's what you want--a home ex program. Perhaps a follow-up visit could be scheduled at some point so you could be evaluated for progress. Doing this will only cost you a few visits.

mp327 said:

Insurance
I live in Georgia. My recommendation to you would be to schedule 2 or 3 visits with the PT and learn as much as you can about a home exercise program that you can do without having to rack up big bucks in PT charges. I worked in a PT clinic for quite a few years and this is common practice when people have little or no benefit for PT services. Tell your PT upfront that that's what you want--a home ex program. Perhaps a follow-up visit could be scheduled at some point so you could be evaluated for progress. Doing this will only cost you a few visits.

PT Limits
Yes, that's my plan and I appreciate your input and sharing!