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Category: OB GYN
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Wife has vaginal pain and burning ("feels like sandpaper")

Customer Question

Wife has vaginal pain and burning ("feels like sandpaper") during and following intercourse.
She has had a hysterectomy (no endometrium).
Put on Vagifem. Vaginal burning is intense
Submitted: 7 years ago.
Category: OB GYN
Expert:  doctor_charles replied 7 years ago.
The burning sensation & deep pain during sex can be due to any of these causes like infections of the cervix,uterine fibroids,Endometriosis, ovarian cyst,Pelvic inflammatory disease (PID). Lack of lubrication mostly causes superficial pain during sex.Deep pain is caused mostly by an abnormality or condition stated above.
A pelvic exam is critical to rule out any uterine abnormality, a cervical polyp or fibroid, or a uterine infection.Also she need an ultrasound to evaluate the uterus and the ovaries.So I advice for your wife to consult gynecologist for the clinical examination to find out the root cause & then take the treatment.
Customer: replied 7 years ago.
She has seen a gynecologist several times. Vaginal tissues look good. She has had a hysterectomy (no endometrium). She is on Premarin (0.3mg/day). She uses a cardiac pacemaker. She has been tested for the presence of yeast infections (all negative). She has stopped taking Vagifem as of this morning. Any suggestion for new tests or examinations? Getting to see her gynecologist is a difficult task (3-4 weeks).
It would seem that her gynecologist should identify, and rule out, some of the causes you have listed.
Any further advice is appreciated.
Dr, James L. Shannon, PhD
Professor of Anatomy & Physiology (Retired)
Expert:  doctor_charles replied 7 years ago.
At her age,due to hormonal imbalance,lack of lubrication is very common cause.
So lubrication is must.
Everyone has different preferences for choice of lubricant.K-Y Jelly is the old standby and it has the advantage of being available in almost every drug store.Also AstroGlide is very good as it is water-based, odorless, tasteless, light, and can be reactivated with water.So she need to try both and see which one works best for her.
Also she needs tests to rule out any STD . Certain personal products, such as feminine spray or douches, could also cause the burning sensation.
Customer: replied 7 years ago.
She has been tested for Candida infections several times and has tried Monistat and been placed on oral antibiotics. The results are always negative. Apparently, Vagifem can exacerbate vaginal fungal infection. Is there a possibility that a mycotic infection other than Candida (that is unresponsive to the antibiotic tried for Candida) be her problem? Would treatment with a different antibiotic be warranted? What antibiotic would be recommended? Oral or suppository?
We have been using KY for some time, and she always experiences a feeling like sandpaper rubbing her vaginal tissue, and then later burning and itching. Although this helps, it is not a solution to her problem.
She has not been checked (to my knowledge for any STD and I doubt this is the cause. We have been married for 49 years and have always been one partner.
Any more clues would be appreciated. I can not believe that most gynecologists in this country have never
had this type of problem with a patient.
Customer: replied 7 years ago.
Any rersponse to my question about antibiotics?
Expert:  DoctorMarcus replied 7 years ago.
Greetings. It seems that if your wife has been examined and tested on various occasions and no evidence of a yeast infection has been found that treatment with additional antibiotics is unlikely to improve her symptoms. Some of what you describe sounds like chronic pelvic pain syndrome. There are several theories about the cause of this, but one of the most credible theories involves hyperactive nerve ending in the pelvic region. There has been good success quieting the overly sensitive nerves down with a medication called amitriptylline. If she has not tried vaginal estrogen, this might also be helpful (despite the small risks of side effects) because the local effects of estrogen are more helpful than oral formulations at reversing the menopausal effects on the vaginal mucosa (making it thinner and more sensitive).