lidocaine 101

5 Jun

In response to a question from Emily in the comments, I am going to sum up my vulvar vestibulitis treatment program from my diagnosis at the end of 2010 to now.  Here it is:

Step One:

I started treating with lidocaine as soon as I was diagnosed, on the recommendation of my gynaecologist.   The type of lidocaine I use is Xylocaine 2% jelly, and it comes in a little tube from the pharmacist (no prescription needed, but they keep it behind the counter) for about 15 bucks.  I find I go through a tube about every month or three weeks.  For the first three months after my diagnosis, I applied lidocaine twice daily.  In the morning after showering, I used a dime-sized glob on my finger and tried to press it into the vestibule area.  This was difficult at first, and I really didn’t know if I was doing it correctly.  I would try to press the area with my finger and stretch it out for a few seconds.  I have heard of some people leaving the lidocaine on for half an hour and then washing it off, but my GYN didn’t suggest that, so I just apply it and leave it on for the day.  At night before bed (and AFTER using the toilet!!!) I squeezed another dime-sized blob of lidocaine onto a cotton ball and inserted the cotton ball halfway into my vagina.  This stays in all night.  After three months of this morning/night application, I went back for a check up and my doctor found that my sensitivity had DRASTICALLY decreased.  In my initial appointment, she had gently poked the vestibule with a Q-tip and I gasped in pain, but after three months of lidocaine treatment, I felt only a dull discomfort.  I should also mention that during this time I did not attempt intercourse AT ALL and only had finger penetration a few times (with varying degrees of discomfort).

Step Two:

After the initial success of the lidocaine, my doctor decided it was time for me to start dilation.  I continued with the morning/night lidocaine routine, and added in ten minutes of dilation per day.  The dilator was purchased from the gynaecology practice for $15, and is about an inch in diameter.  To dilate, I applied a larger amount of lidocaine to my vaginal opening, waited ten or fifteen minutes for it to ‘kick in’ and then inserted the dilator (with lubricant).  At first, this was a little painful, but my body adjusted to it fairly quickly and I was able to practice moving it in and out of my vagina or moving it subtly from side to side to stretch things out a bit more.  At this point, I was feeling very motivated and I decided to try to dilate twice a day.  After a few weeks of this, the discomfort was gone, and I decided I needed something larger to dilate with.  My gynaecologist had told me that the ‘next step’ would be to use something “penis-sized.”  The difference between my partner’s size and the dilator was pretty substantial, though, so that wasn’t really going to work for me.

Step Three:

I tried penetration with my partner, and we were only able to get his penis in a couple of inches before it was too painful, so I knew I needed to dilate more.  My GYN had recommended going to a sex shop and buying a dildo, so we went out and picked something that seemed to be in between the size of my first dilator and my husband’s penis.  I have been dilating with this for a little while now, using the same technique as before, but I have to admit that it is much more painful than the first dilator had been.  I have been able to insert it fairly comfortably if I stimulate my clitoris at the same time, but I have to go very slowly in order to avoid pain.  I will admit that since this is more painful and requires more ‘work’ than the first dilator I have not been as faithful in doing it every day, but writing the post is making me realize I need to maintain my treatment schedule to see results!  I have also been able to have limited success with actually having intercourse or at least getting my husband’s penis fully inside me.  So far, I have approached intercourse by applying a generous quantity of lidocaine, then using the dilator for a few minutes to prepare my body for penetration.  I will masturbate to the point of orgasm, and then remove the dilator and attempt intercourse.  It is painful still.  I can feel three types of discomfort: the feeling of stretching that is aided by dilation; the pain of pressure on the vestibule as my husband moves in and out; and a fairly intense pain that seems to be in the cervix area and only happens when he is thrusting in more deeply.  I am hoping that by continuing with the lidocaine and dilation, I will soon not only be able to have reduced pain, but will also be able to move more freely and use different positions that will also help eliminate discomfort.

And now my question to you, my lovely ladies: What positions or techniques have worked for you in reducing your pain during intercourse?  I need your suggestions to try to make this work.  Please don’t be shy in providing more graphic details – you can always comment anonymously.  It is very helpful to know the specific mechanics of these things, as I find even a very slight shift of position can make the difference between something being reasonably comfortable or incredibly painful.


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