Many know that vaginal dryness can cause pain while having sex. You should also be aware of vaginal stenosis, which is a condition that can affect your sex life.

Painful sex may be a result of multiple factors. It may be your first time, or you may be dealing with a vaginal infection or endometriosis. But it also happens due to a condition called vaginal stenosis. In this condition, the vaginal canal becomes narrow and short as a result of surgery or radiation treatment for pelvic cancer, causing pain during penetrative sex.

What is vaginal stenosis?

Vaginal stenosis is a medical condition characterised by the narrowing or constriction of the vaginal canal. This narrowing can occur anywhere along the length of the vagina, from the vaginal opening to the cervix, explains
obstetrician and gynaecologist Dr Pooja C Thukral. It is a condition that can cause a shallow vagina.

Vaginal stenosis can affect your sex life. Image courtesy: Freepik

Some common causes of vaginal stenosis include:

  • Certain congenital abnormalities or developmental defects such as Müllerian duct anomalies like vaginal agenesis or vaginal septum.
  • A complication of surgical procedures involving the vagina or pelvic region. These procedures may include vaginal reconstruction surgery and vaginal hysterectomy.
  • Trauma to the vaginal tissues, such as childbirth-related tears (perineal lacerations), pelvic trauma, or severe vaginal infections.
  • Radiation therapy for pelvic cancers, such as cervical cancer or rectal cancer.
  • Chronic inflammatory conditions affecting the vagina, such as lichen planus.

What are the symptoms of vaginal stenosis?

Symptoms of vaginal stenosis may vary depending on the severity of the narrowing, but may include –

  • Difficulty or pain during sex.
  • Decreased vaginal lubrication.
  • Vaginal dryness.
  • Pelvic pain or discomfort.
  • Urinary symptoms, such as urinary urgency or frequency.
  • Recurrent vaginal infection or irritation

How does vaginal stenosis affect sex life?

During a study published in the Strahlentherapie und Onkologie journal in 2019, researchers found that sexual enjoyment got substantially reduced by vaginal stenosis. Here are some ways it may affect sex life:

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1. Painful sex

One of the most common effects during sex is pain or discomfort, particularly if penetration is attempted too deeply. The narrow or shortened vaginal canal may make certain sexual positions uncomfortable or painful for the woman, says the expert.

2. Difficulty with penetration

In some cases, penetration maybe difficult or challenging, especially if the partner’s penis or other objects are longer than the length of the vaginal canal. This can lead to frustration and difficulties achieving sexual satisfaction.

3. Decreased lubrication

Vaginal stenosis may be associated with decreased vaginal lubrication, which can make sex more uncomfortable or lead to friction-related discomfort. The use of personal lubricants can help alleviate dryness and enhance comfort during sex, suggests the expert.

A couple not having sex due to vaginal stenosis
Vaginal dilators may help to reduce pain during sex. Image courtesy: Freepik

What are the ways to treat vaginal stenosis to improve sex life?

The treatment for vaginal stenosis aims to alleviate symptoms, improve vaginal function, and enhance sexual satisfaction. Here are some ways:

1. Vaginal dilators

Vaginal dilators are cylindrical devices that are inserted into the vagina to stretch and expand the vaginal tissues gradually. This can help to widen the vaginal canal, improve flexibility, and reduce pain during sex.

2. Pelvic floor physical therapy

If you go for this therapy, you will be told to do exercises and follow techniques that will help relax the muscles of the pelvic floor while strengthening them. This can help to improve vaginal muscle tone, flexibility, and overall pelvic floor function, which may enhance sexual satisfaction and reduce symptoms of vaginal stenosis.

3. Surgical procedures

In some cases, surgical procedures may be necessary to address severe vaginal stenosis or correct underlying structural abnormalities. Surgical options may include vaginal reconstruction surgery (vaginoplasty) to widen the vaginal canal, remove scar tissue, or reconstruct the vaginal opening (introitus), says Dr Thukral.

4. Hormonal therapy

Hormonal therapy, such as estrogen replacement therapy, may be recommended to improve vaginal lubrication, elasticity, and tissue health. Estrogen therapy may be administered topically (vaginal creams, rings, or tablets) or systemically (oral medications or patches) to help alleviate symptoms of vaginal stenosis and improve sexual comfort.

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