Dealing with Dyspareunia: Turning that “Ow” into “Wow!”

Happy late February, dear readers! I’m writing this to you shortly after Valentine’s Day, so maybe you’re basking right now in the glow that comes with having recently had some delicious chocolate, a nice dinner out, and a long, romantic evening with the one you love.

But a lot of you might not love Valentine’s Day because sex causes you pain. And, unfortunately, unlike Valentine’s Day, hardly anyone talks about that

So maybe you blame yourselves. Maybe you blame your partner. Maybe you stop having sex. Maybe you’re too embarrassed to talk about it, even with a doctor. Maybe you’ve avoided dating because of it. The inability to enjoy one of life’s greatest pleasures could understandably make you feel depressed and hopeless.

But you don’t have to suffer! 

First of all, take heart. Sex that hurts, otherwise known as dyspareunia, is common, so you are not alone. It happens to almost three out of four women at some point. It may even affect up to half of postmenopausal women. (Sex can hurt men too, but it’s rarer.) 

So what causes it? While you should always see a doctor to get a diagnosis when you are experiencing painful sex, here are just a few possibilities:

Vaginismus happens when your vagina tenses outside of your control. It doesn’t only happen during sex. It can even happen when you’re just putting in a tampon. It may be caused by anything from anxiety to sexual abuse. Pelvic floor physical therapy can help, as can dilator therapy, CBT (cognitive behavior therapy), and sex therapy. (If you come to Revitalize Physical Therapy, we are happy to guide you in how to use dilator therapy to treat this!) Vaginismus can require some patience, but it can ultimately be resolved, as can vulvodynia. 

And just what is vulvodynia? Well, it’s chronic pain in your vulva that goes on for a minimum of three months and doesn’t have a definitive cause. (Here is a diagram of the vulva for those who need it!) The Mayo Clinic describes vulvodynia as feeling like “burning,” “stinging,” “rawness,” or even a “sharp or knife-like pain.” Pain can also feel like it is constant or intermittent, be in the whole vulva or just a certain part. And while the medical community doesn’t know what causes it, some theories are previous vaginal infections, inflammation, pelvic floor muscle weakness, or pelvic spasm. Having vulvodynia and dealing with the fear of sex being painful might even lead to vaginismus! This can be a vicious cycle. Pelvic floor physical therapy, CBT and sex therapy can also help with this. 

Then there is vaginal atrophy, which can affect middle-aged women: Decreased estrogen results in decreased lubrication, which can result in painful sex. If you haven’t had sex in awhile, that can also lead to atrophy, so again, if you are avoiding sex due to a painful sex condition, you may find yourself with another painful sex condition. (Vaginal atrophy can even be caused by antihistamines!) Treating vaginal atrophy can be as simple as using lubricant (which can help make sex more pleasurable) or you may need vaginal estrogen from your doctor. Dilators may also help.

I know that all this information is overwhelming, but it is worth taking the time to learn more. Proper diagnosis leads to proper treatment, and hopefully, by this time next year, you might be enjoying some sweet new memories of your best Valentine’s Day ever!   

Why AI is a Girl’s Breast Friend

Can AI Help Catch Breast Cancer? The Surprising Answer.


October is almost upon us! Every year, we see the famous pink ribbons that mean another Breast Cancer Awareness Month has arrived. Unfortunately, even with all the progress that’s been made, women are still being diagnosed with and dying of breast cancer in large numbers. The World Health Organization reported that as recently as 2020, over 2 million people received a breast cancer diagnosis and 685,000 succumbed to breast cancer. Those who survive breast cancer are lucky, but they are also more likely to face a range of health challenges even after they’ve been treated — including lymphedema and pelvic floor issues. For all women affected by breast cancer, we owe it to them to do everything to help them survive and thrive.  


So, what is AI, anyway?


AI, or Artificial Intelligence, utilizes computers and machines to mimic human performance, and that includes the performance of doctors!  AI can check you for skin cancer, discover if you have COVID-19 by hearing you cough, and interpret mammograms. Pretty amazing, right?


Why doctors need help from AI


Although we don’t like to think about it, a radiologist could possibly miss breast cancer while reading a mammography. Did you know, in fact, The National Cancer Institute believes that approximately 20 percent of breast cancers may remain undiagnosed after mammograms? And as we all know, early detection and treatment for breast cancer can make all the difference. 


AI has the potential to help mammography become a more powerful breast cancer detection tool, allowing it to discover 20% more breast cancers, according to the initial results of a Swedish study published in August of this year. The doctors in the study also spent 44% less time looking at mammograms, thanks to AI. Less time with images equals more available time for patients, and any patient who has been rushed by a stressed doctor can see the potential benefits of that!   


What AI means for the future of breast cancer screening


This doesn’t mean AI will or should put doctors out of business. Computer scientist Peter Kecskemethy, co-founder of Kheiron Medical Technologies, told The New York Times, “An AI-plus-doctor should replace [a] doctor alone, but an AI should not replace the doctor.” Humans are still vital to providing healthcare—that’s not changing any time soon! But powerful tools can make us more powerful healthcare providers. In the same way physical therapists rely on tools like foam rollers and dilators to supplement care, these radiologists may some day rely on AI.


AI may not be used at your next mammography, but it might eventually. I look forward to reading more about AI’s potential in all aspects of healthcare, as I have a feeling we haven’t even seen the tip of the iceberg.