Just the Tip is a sex and relationship column from queer non-monogamous kinkster Jera Brown. Here you will find interviews with sexuality researchers and educators as well as smart and compassionate responses to anonymous questions. If you would like to be interviewed or have a sex or love question you’d like Jera to answer, email email@example.com or DM Jera on Twitter @thejerabrown.
About five months ago, I had a yeast infection from stress, and on the last day of the treatment for the infection, I had sex because my doctor said it would be OK. The sex was not enjoyable in the beginning and became gradually painful to the point where we had to stop. Since then, I have a new boyfriend but we have only had sex a handful of times because of my fear that sex will hurt again. The first time we had sex I had to stop because I couldn’t tell if it was hurting or not, and now I feel as though I can’t tell if I’m in pain or not; I feel as though I can’t trust my own body. I went to the gynecologist after this and was diagnosed with another yeast infection; before having sex after this more recent infection, I went back to the doctor for the all-clear, but she refused to even examine me, saying that I need to trust if I don’t have the symptoms I don’t have another yeast infection. Most recently when we had sex, I didn’t have to stop but it felt simultaneously good and like my labia were slightly burning. My partner has Herpes Simplex 1 on his genitals, but we have both been tested for other STIs. We are careful about always using condoms, and I have read that HSV 1 on the genitals isn’t that contagious, especially if you already have HSV 1 on your lips as I do. Is the burning sensation in my head, or is it a sign of an issue? We use lube, and I have had experiences before where lube stings me. What can I do to have pleasurable sex again, how can I win the battle in my head?
I reached out to Stephanie Ring, a gynecologist in Wheat Ridge, Colorado, to respond to this question. According to Dr. Ring, sexual problems are rarely only physical or mental. “Your sexuality is an expression of who you are as a person on many levels: physical, emotional, relational, spiritual. The best approach to sexual health problems addresses all of these.”
Here’s the rest of Dr. Ring’s advice:
Good for you for proactively managing your health and advocating for yourself! It is absolutely legit to ask for another exam, if “only” for reassurance. As you allude to in your question, all that itches is not yeast. Furthermore, the presence of yeast on an exam doesn’t mean that yeast is necessarily the culprit (yeast can exist in small numbers as part of the normal flora). Sometimes, we (health care providers) will treat yeast because that’s what we know how to do, and it’s definitely important to eliminate this as the cause. While a repeat exam isn’t necessary for most patients, not all yeast infections will respond to a single, standard course of treatment. Finally, folks who suffer with chronic, recurrent infections can also be at risk for developing a neurological condition known as vulvodynia (or vestibulodynia) due to sensitization of the nerve endings in the vulva and around the vaginal opening. Not all gynecologists are familiar or comfortable with treating vulvodynia, so you may want to seek out someone with special expertise in vulvar conditions.
As far as regaining your sexual pleasure, it sounds like you’re on the right track. One problem that is common among people with vulvas (PWV) is that we tend to be “pleasers,” meaning we tend to prioritize our partner’s pleasure above our own. This is a mistake, especially for folks with sexual pain. I can’t stress how important it is for you to ONLY permit penetration when you are in a give-it-to-me-NOW state of arousal. This will help ensure you’ve had time and proper stimulation for your own natural lubrication to occur. Especially if you’re having sex with a person with a penis (PWP), sex = penetration and everything else is “foreplay.” Learn your own turn-ons, don’t be afraid to communicate these with your partner(s), and Never.Rush.Penetration.
Finally, by virtue of being human, you are incredibly tough and resilient in body, mind, and spirit. This means, with time and the right support, you will be able to experience amazing sex again if that is your desire.