Painful Sex, Orgasms and the Pill
This is a guest post by the beautiful Nicole Jardim of The Healthy Elements. This girl loves to chat about all the things I love most: Periods, fertility, birth control, all the goodies! This post is no exception so gear up for some womanly wisdom! 
A couple of weeks ago I wrote an article on how the birth control pill affects a woman’s sex drive. After hearing an expert named Dr. Andrew Goldstein speak on the subject, I felt that I had to tell as many women as possible. Today I want to continue the discussion by highlighting the causes of painful sex and decreased orgasms as well as give practical steps to help reverse these common issues.
The Pill
As I mentioned in my previous article, one of the main causes of painful sex for many women is the birth control pill. Here’s the deal: The vagina is a hormone-dependent organ, meaning that it needs adequate amounts of hormones in order to function properly. This of course is different for each woman, because we all have different hormonal needs. When a woman is turned on, her body sends hormonal signals to the glands at the opening of the vagina. This causes them to produce something called mucin, a slippery lubrication that causes a woman to feel wet. Here’s the kicker: These glands depend only on testosterone to work. Believe it or not, the vulva is more testosterone-dependent than estrogen-dependent. If a woman does not have enough testosterone in her body, these glands literally stop working, and she stops lubricating. Since the pill reduces the amount of testosterone in the body by a significant amount (up to 90% in some cases!!), there is decreased lubrication and ultimately painful sex for some women.
This can continue long after a woman stops taking the pill. Here’s why: The pill causes the liver to make a protein called Sex-Hormone Binding Globulin. SHBG binds to testosterone and makes it inactive. Therefore, when SHBG goes up in the body, it lowers the amount of free testosterone available. A woman not on the pill typically has a SHBG level of 20-30, but a woman on the pill can have a SHBG level of 200-300 and even up to 500!
A woman’s free testosterone level should be 0.8-1.0 but it dramatically goes down when SHBG levels are too high. Dr. Goldstein described a 27 year-old patient of his who had a free testosterone level of .01, which is 1/70th of what she was supposed to have! That is below the average levels of women in their 60’s!
In some women, SHBG levels stay high which means testosterone stays low. This can take awhile to reverse. This is why women who develop pain during sex while on the pill, might continue to feel pain even if they stop taking it, because of the pill’s long term effects on SHBG levels and testosterone levels. In some cases, the SHBG levels never return to their normal levels, yet doctors rarely if ever warn their patients of these consequences when prescribing the pill.
Tight Pelvic Floor Muscles
“If sex hurts, you just need to relax.” Have you ever heard that before? I bet that discussion is one of the most played-out scenarios in OB-GYN offices all over the world. Women who have pain during sex either have it all in their head, or they are involuntarily contracting their muscles upon the possibility of intercourse. Dr. Goldstein thinks that is ridiculous. He instead suggests that tight pelvic floor muscles can cause pain during sex.
A couple of things that can cause tight pelvic floor muscles:
- Upper and lower back pain and hip pain. This causes many women to hold tension in their pelvic muscles.
- Holding your urine, if you have a job that doesn’t allow you to leave and go to the bathroom (I’m a notorious pee-holder for no reason at all…time to change that habit ASAP!)
- Too many pelvic floor muscle exercises with too much emphasis on the contraction and not enough emphasis on the relaxation part. This makes muscles tighter, not stronger.
Dr. Goldstein says, “A tight muscle is not necessarily a strong muscle. A tight muscle will cause a decrease in blood flow, which then causes a decrease of oxygen going to these muscles. This increases lactic acid in muscles, which increases burning, aching, throbbing and soreness.”
This is the same as if you worked out other muscles in your body too hard and didn’t focus on the relaxation part that comes afterward. We definitely need to exercise our pelvic floor muscles but we must put a special emphasis on the relaxation of these muscles in order to relieve any tightness.
Nerve Endings
Some women have a different kind of painful sex. The kind where sex becomes virtually impossible because the pain is so bad. According to Dr. Goldstein, this is a very common problem with a long name that I can’t spell. Sorry! Basically you can be born with too many nerve endings at the entrance of the vagina. These nerve endings are the types responsible for feelings of burning and cutting. This means that women who attempt penetration feel like they are being stabbed. Holy ouch!
Dr. Goldstein says that there is a very simple surgical procedure that has a 97% success rate as well as topical medications that can cut the pain by up to 70%. Hello, this is amazing for any woman who has a condition like this. He suggests getting his book When Sex Hurts to start finding solutions. By the way, all the book profits are donated to the National Vulvodynia Association.
A Word about Orgasms
If you are wondering when the last time was that you had one of those amazing, bedpost-gripping orgasms then keep reading.
Remember what I said about the pill’s effect on testosterone levels? Well, testosterone is not only responsible for mucin production in the vagina but it’s also pretty much solely responsible for your sex drive and orgasms. This means that if your testosterone levels are kind of like what I described above, you most likely aren’t having your best orgasms. They probably feel a little muted yes?
You might want to consider getting off the pill if you’re experiencing any of these issues. Dr. Goldstein says that the Copper IUD has the highest satisfaction rate yet it has the lowest rate of use in the US. It is as effective as getting your tubes tied. I’d say that’s a pretty awesome alternative to the side effects of the pill. I also recommend looking into the Fertility Awareness Method. This involves taking your basal body temperature and observing your cervical fluid. I know this doesn’t sound too sexy but it has seriously changed my relationship with my body. If you want to know more, get your hands on the book Taking Charge of Your Fertility.
Okay back to our pelvic floor muscles! According to Dr. Goldstein, up to 30% of women have tight pelvic floor muscles. Just a 10% increase in pelvic floor muscle tightness can decrease blood flow to your pelvic area by 50%, which means less quality orgasms because of less blood flow.
In addition, decreased blood flow to the vagina, and subsequently decreased orgasms, are a very very early warning sign of vascular problems and potential heart disease. This is why it’s so important to pay attention to what you’re eating. Not only does it affect the quality of your orgasm but it also eventually affects your heart health. See, it always comes back to food! Dr. Goldstein says, “your orgasm is the window into your body.” LOL I love it!
As you can see, there are a number of different factors that play a role in the proper functioning of your lady bits – hormones, pelvic floor muscles and blood flow. This can be quite a balancing act but it is indeed possible to start taking back control of your sex drive and your sexual pleasure by implementing the small action steps I discussed above.
Nicole is a Women’s Health Coach and creator of FixYour Period, a series of private and group programs that empower women to heal their menstrual conditions in a sassy and fun way. She passionately believes that optimal nutrition, self-care practices and more mindful living are essential to maintaining feminine vitality at any age. Sign up here for her free Period Survival Guide.
Disclaimer: Information in this post and on this web site is provided for informational purposes only. The information is a result of practice experience and research by the author. This information is not intended as a substitute for the advice provided by your physician or other healthcare professional or any information contained on or in any product label or packaging. Do not use the information on this web site for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem.
Tired of Birth Control Options? Take Charge of your Fertility!
I have been on Birth Control Pills since I was 19 years old (7 years!!) and I have been wanting to get off of them for the last 2. I was left in constant indecision about where to turn. It wasn’t that I was unhappy with my pill, but I was freaked about the consequences! Everything I have read and researched about health has been entirely contradictory to what my chosen method was doing to my body. Once I was diagnosed with food intolerances and discovered that my birth control pills were laced with dairy- I decided that was the final straw and quit cold turkey. The plan was to use barrier methods until I made up my mind. Luckily hubby has been really supportive!
Fertility Awareness
In the midst of my anguish over what to choose- I happened to meet two people that offered an alternative! Talk about meant to be. BOTH of them use the “Fertility Awareness Method.” Apparently FAM is 1) NOT the Rhythm Method, 2) It works, and 3) both of my friends have been using it successfully for several years. I bought the book “Taking Charge of your Fertility” by Toni Weschler instantly to get to work on some more research.
The result?? I am a completely new person! I highly recommend the book to every woman- regardless of whichever method you choose! I can’t believe how much I didn’t know about my own body! Not to mention, as I have been researching I have found that a lot of women with food intolerances are consequently on the pill- is it possible that synthetic hormones could be spurring this on? There are soooo many health risks associated with pills, patches, shots that we use simply to avoid getting pregnant! Isn’t that horrible??!! Meanwhile, woman have been going uneducated of their own bodies and don’t know that there is a more natural way to put you in control of your fertility. By tracking changes to your body such as basal body temperature, cervical fluid, and cervical position, you can be completely in charge and completely UN-pregnant (very important to me!).
Taking Charge of Your Fertility
The good news is that this method is as effective as you want it to be! It can be almost perfectly effective if you use condoms for about 8 days of the month depending on your cycle- or less days if you are thinking about starting a family.
Ok… But I have a friend who knows someone who…
Yeah there are pregnancy cases and everyone is an expert when you start talking about “natural birth control.” But really every case of an unplanned pregnancy using FAM is because of one of two reasons- 1)They get pregnant because they start using Fertility Awareness IMMEDIATELY or 2) They kind of want to get pregnant deep down (in other words- they start “risking it”).
Those are two problems that are easy to address, and if you do, you have awesome birth control for life without any horrible side-effects!! So to address the first one is easy- if you are getting off the pill or other method of birth control, you need to use a barrier method for quite awhile since your body will be out of wack for a bit and you don’t know your body well enough yet. You can slowly wean yourself off the barrier method as you get more familier. And the second one- well you can’t really “cheat” with this method like you can with other methods. Yeah, when you are on the pill and you miss a day- you might feel ok with “risking it.” That is really not an option with this method since cheating would mean having sex exactly at the time you are most fertile without using a barrier method. That is a nice little baby recipe.
There’s an App for ThatAnd one final note- don’t read this and then try to use Fertility Awareness- get your info from the woman who literally wrote the book about it- Toni Weschler! It is an excellent read that will give you plenty of information on how not to conceive, how to conceive, and how to know your body better.
I’ll let you know how it goes- but either way I seriously recommend the book! It will completely set you free! Talk to you soon! Good Health!
Hi, I'm Elle
I help women ditch their birth control and heal hormonal imbalances holistically! Free Ditch your Birth Control Guide!
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