Painful Sex from Birth Control: Vulvodynia (Episode 473)

Full Transcript: Episode 473

Lisa Hendrickson-Jack: This is the Fertility Friday Podcast, episode number 473.

Welcome to the Fertility Friday Podcast, your source for information about the fertility awareness method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Charting Workbook. I’m a certified fertility awareness educator and holistic reproductive health practitioner with over 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormone health, and optimizing the menstrual cycle without hormones. I have been consistently outspoken about hormonal birth control over the past two decades and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I teach women’s health professionals how to utilize the menstrual cycle as a vital sign in their practices. And I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys and a brand new baby girl. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health. And I’m so excited that you’re here with me today.

I’m excited to share today’s episode with you. Today I’m actually sharing a replay of an episode deep in the archives that you probably haven’t heard before. This is episode 159, and in this episode I interviewed Madeline who shared her story with vulvodynia related to her pill use. She goes through and talks about what it was like to experience this, some of the other issues that she experienced that were kind of related with birth control, and also what her journey was like getting treatment and what finally worked.

This is a story that I shared also in The Fifth Vital Sign in the pill chapter, chapter seven. And in that chapter, I shared a few different actual women’s stories who either were clients or women on the podcast or whatever the cases. Because with these types of scenarios, I find that it’s really helpful to hear what actual women are experiencing. And obviously, with the podcast, I’ve taken every opportunity to share those real world experiences in their own words, so that we can have a bit more of a tangible present representation of how this affects people in real life.

And what I always find interesting is, I mean, I find that there’s a lot less pushback these days. When I was first sharing about this information seven, eight, nine years ago, I feel like about a decade ago, things were a bit different. There was a different environment. There was an environment where from a feminist perspective, you were really looked down at for criticizing the pill and getting into these types of side effects because it was looked at negatively like, oh, you’re trying to take away the pill from people or you’re trying to dissuade women from using the pill or you’re trying to scare them off of using the pill or whatever.

And so I just want to clarify, you know, for anyone who doesn’t know, this is not about access. I’ve never had the perspective that women shouldn’t have access to the pill. I think that we should have all the options available to us. I’ve always been a fan of informed consent, meaning that we should know what it could do to us and no one should be scared to tell us about what the side effects are because we’re grown-ups. And if someone tells us what the possible side effects are, then we have the opportunity to make the decision about how we’re going to engage with this medication.

So as I always say, some women hear this information and they decide it’s not for them, and they have the right to make that choice. Other women will hear that information and they’ll still use it because they need to for whatever reason. I’ve used the pill as well. I used the pill when I was a teenager. I used it because I had really bad period pain, really heavy periods, and I didn’t know what else to do. And I did use it during that time, and I did find some temporary relief from that situation. And certainly I did have some side effects associated with it that I had no idea were related at the time.

So I do believe that with this information, some women will continue to use it and potentially modify their use. So if they know about the side effects, they can be aware. They can see how it affects them. And they have the opportunity to kind of switch, try something different, or whatever the case is. And then in the third category are women who will use it for just as long as they would have regardless. And I think, again, we have the ability to make that choice.

I always find it interesting though, that when I highlight some of these types of side effects from birth control, there’s always someone that comes out of the woodwork like, you’re trying to take away our access to the birth control. But no, I’m not. I’m not trying to take away anyone’s access. I’ve used it too. I’m just trying to highlight the need for informed consent. So I just felt the need to share that, I guess, at the beginning of the episode. But without further ado, let’s jump into Madeline’s story with vulvodynia.

Well, I am so excited to be here with Madeline. Madeline reached out to me to share her story of being on hormonal contraceptives. And Madeline, I’m so glad you did because this is one of the aspects of hormonal contraceptives that I haven’t really seen talked about a whole lot. And you mentioned in your message to me that you really had to search kind of like the ends of the internet to find even something remotely that connected that for you. So a good place to start, maybe you could just share a little bit about when you took the pill, when that started, and then what your experience was like on it.

Madeline: Sure. So I started taking the birth control pill when I was 20 in 2008. I was on it for about two years with no major problems. In about 2010, I started having really severe chronic yeast infections. They just wouldn’t go away. I was going to the doctor and getting anti-bacterials and then I would have bacterial infections. And then they would just go back and forth between yeast and bacteria. And somewhere in there, I started to develop a pain in my vaginal opening.

And you know, for a long time, I thought it was a part of the yeast infections, just skin being raw or things like that. All this time, you know, I’m on the pill and I’m dealing with what I think is, you know, yeast infections.

At one point I went to a naturopath, about three years in, 2013, a little ways down the road that I’ve been dealing with these issues. And I told her that I was a little suspicious of the birth control just because I felt like I’d tried so many things to get rid of these yeast infections. And she recommended to get off the pill and to try no grains and no sugar for about six weeks. And that was the point at which the yeast infections went away, but the pain didn’t.

So, you know, I was dealing now with this symptom of just pain with intercourse, not really understanding it. No one really being able to tell me what it was. I went through a few rounds of pelvic floor physical therapy. And one of my physical therapists told me about a doctor who she thought might understand what I was going through.

So that was about at the end of 2013. I visited this doctor who finally said the words vulvodynia to me. And so, you know, at this point I’ve gone, you know, almost three years just feeling like what’s going on, what’s wrong with me, going to all sorts of gynecologists who are telling me things like I must be having rough sex. Like just weird, you know, like just it being so wrong and feeling like, how are all these people doctors and how is what I’m going through like not recognizable by anyone, you know.

So anyway, I go to this specialist, she tells me what I have, she recommends doing everything but surgery to begin with, but ultimately surgery is what we went with.

Lisa Hendrickson-Jack: Well, you know, first of all, I just want to say that I’m really sorry that you had to go through that because that’s completely unacceptable on a thousand different levels. And even not just the issue itself with vulvodynia and the surgery afterwards, but also the humiliating experiences of being in doctor’s offices and having to hear garbage like that. Yeah, I don’t even know what to do with that. That kind of stuff just really gets me upset.

So, maybe take us through a little bit. You said that you’d gone through a variety of treatments and, you know, nothing was working. Tell us about that and then why was surgery necessary.

Madeline: So, you know, dealing with the pain and trying to understand it. I’d been given many sorts of estrogen creams or hormonal creams. I’d been on everything. I’d tried lidocaine, type of like numbing the skin so that then it would maybe forget the pain. Having gone through pelvic floor physical therapy, wondering if it was a nerve issue, I’d just tried about everything there was that options people were giving me and none of them were working.

And so this specialist, she had done the surgery before, she had dealt with people with vulvodynia, and that was a solution that she was presenting to me. It was very specific where she would examine me with a point and I would be able to say yes, that’s where I’m experiencing pain with touch, or no, that’s not. And so she actually mapped out the area of my vaginal opening that was experiencing pain and she removed that skin.

And so, you know, you ask why is surgery necessary? Like I’m not exactly sure because no one seems to know much about this at all. And so even I, as someone who had it for many years, feel fairly uneducated on it, you know, and what causes it and what cures it.

And, you know, sort of an open end for me was I had this surgery, and I went back into physical therapy afterwards to get just the opening and the skin back to normal and stretching and things like that. And the pain wasn’t gone after surgery.

It was about that time that the physical therapist I was working with pointed me in the direction of an article that she had read that was titled “Do Oral Contraceptive Pills Cause Vulvodynia?” You know, and this doctor—I don’t know if he’s a doctor—but the author, Goldstein, he proposed that yes, you know, this causes it.

So that was the first I’d ever heard of any sort of evidence or theory that what I was going through was caused by birth control. It had always been my theory up until then.

So I actually went to a follow-up with the woman who did the surgery and I brought the article and told her what I’d read. And the only solution that the article presented was testosterone cream as a topical way to potentially change the vulvodynia. And so I told her I wanted to try it because at that point, why not? I tried everything, you know. I was still experiencing, you know, less pain after the surgery, but still pain, same kind of, you know, pain.

And so she was like—she didn’t believe the pill would have any connection. But she said, fine, I’ll prescribe you this cream. And I applied the testosterone cream and that was actually when the pain went away.

So I have no idea, you know. She told me that there could be a delayed recovery after the surgery. So it’s at a point where I have no idea what even solved or cured it for me. But after 2014, when I had the surgery and went through the recovery, I haven’t had any pain. Still very mysterious to me even.

Lisa Hendrickson-Jack: That just reminds me of a few different situations where when you have an issue, maybe that the physician isn’t fully informed about. And then there’s this something that you do that actually works, and they’re very quick to dismiss it and say that no, it was the surgery.

I think that that is really powerful. Yeah, I like—it’s another thing, like, it’s like I just don’t know. That just seems to me really arrogant and really just to dismiss it after so many years that you had this issue. The surgery was done, you still had the pain, and then you apply this cream and then it actually works. And the physician is very quick to say, but no, that couldn’t have had anything to do with it. It was delayed recovery. Delayed at the exact time that you actually used the cream. That’s quite convenient.

Madeline: Yeah, and I remember she was very firm about—I remember her telling me, I would put you on the pill tomorrow. She had no wavering. There’s no connection. I believe in it. I would put you on the pill tomorrow.

And I just remember, I think, you know, going through—you know, at this point, I’m like four years in going to doctors and listening to them, and you just develop this inner compass, this inner voice that, you know, we’re supposed to be able to trust our doctors and that would be a wonderful world. But you get an inner sense of when something a doctor is saying isn’t truth for you.

And I just remember when she said that, I just knew that I didn’t think that was right, and so I never went back on the pill.

But honestly, it wasn’t until this year when I started listening to your podcast that I started encountering people who believed that the pill causes problems. And it’s been years since I’ve dealt with all this. This has just been eye-opening for me to hear this information. And it was just amazing to me that you wanted to interview me. Like no one’s ever wanted to talk to me about this, and you know, I’ve rarely ever talked about it. So thank you.

Lisa Hendrickson-Jack: I just shared my screen with you. You’ll see why I wanted to do that in a second. I just want to validate your experience. That’s the reason why I’m sharing my screen here.

Because for some—I’ve spoken about this in other parts of the pill segment—but essentially, as women, our own experience of something apparently isn’t enough, right? We always need to have scientific proof to validate what’s literally happening in our own bodies right now. So that’s a problem. And I think that we need to kind of caution about that. Because if you have this experience, you know your body better than anybody else.

So when you contacted me, I had already been doing a bunch of research about hormonal contraceptives. And to be honest with you, it wasn’t hard to find a link. And it’s not a huge stretch to think that it could be related.

So I just want to show you a couple interesting things here, because I know you said that you weren’t able to find a whole lot of information. So there are independent researchers who have studied the connection between oral contraceptives and vulvodynia, vulvar vestibulitis—those are all kind of synonyms for the same thing—but it’s basically pain during sex.

And so there’s a connection. It’s not in your head. Obviously, not every woman experiences it, but there are enough women who do experience it directly related to their use of hormonal contraceptives that it is actually, in fact, a thing.

And a couple other things I want to show you. You can see that I have quite a bit.

Madeline: Yeah, this is amazing. I would love to read one of these.

Lisa Hendrickson-Jack: Yeah, because it’s not like—again, it’s important to point out—it’s not like one study that was done once.

So I think it’s Dr. Sara Gottfried. If you’re listening, Sara, I’d love to have you on the show. Many of you listeners, if you happen to have a relationship with Dr. Gottfried, I would love to have her on the show. She’s spoken about that, the link between hormonal contraceptives and shrinking your clitoris.

And so what I thought was really just jarring in the research is that there is a connection between hormonal contraceptive use and the decreased vascularization of your clitoris as well as your vulva tissues. So specifically around the vaginal opening, what happens is when they actually measure the thickness of the tissue around your vaginal opening, it’s usually oral contraceptives in particular that they’re testing, but hormonal contraceptives are associated with a decrease in the thickness of the tissue around your vaginal opening specifically. And then, of course, you have that association with painful sex, and it’s like right there.

So I shared my screen with Madeline here. And so this is just the abstract of this particular study, but I think that you can see what their results were.

So it says after the therapy—which is what they call oral contraceptives, that’s the therapy—so after therapy, the testosterone levels were reduced in both groups, whereas the estrogen decreased in only one group. The clitoral volume—so the actual size of your clitoris—decreased in all the women.

Madeline: Oh my gosh.

Lisa Hendrickson-Jack: So then they go on to describe a little bit more about that. And they also say there was a reduction in the number of intercourse per week and a reduction of orgasm frequency. The pain during intercourse worsened after OC use.

And so ultimately they concluded that the pill was associated with increased pain during intercourse. So I just—yeah, you can see very obviously why I wanted to share this with you because this is not something that there’s no support for in the research. This is something that’s actually quite well researched actually, if you think about it, because it wasn’t hard for me to pull up a bunch of studies on it.

It was not difficult like, “Oh, how am I going to find?” It was fairly straightforward for me to locate this information. And so it’s a real thing. And I don’t know how it’s acceptable. And this is not something that, obviously, when you went in and were prescribed this treatment, they didn’t advise you that this was a possible side effect of it.

Madeline: No.

Lisa Hendrickson-Jack: And then your doctor actually told you that she would prescribe the pill again. The same doctor that has already, and will continue to, perform surgery to remove parts of women’s vulvas. Yeah.

Madeline: Yeah.

Lisa Hendrickson-Jack: I couldn’t help it. I had to show you.

Madeline: Thank you.

Lisa Hendrickson-Jack: But part of it is just because I just get that sense, like that energetic sense, that you’re still kind of just like, is this really in my head? Or was this like—

Madeline: Yeah, I’d never seen any other studies. Like that one article that I had read that my physical therapist back in 2014 sent me was the only thing I’d ever heard.

And you know, even—it’s just so counter-cultural to believe that the pill is harmful, it seems, you know. I mean, coming into the Fertility Friday community is like a place where it’s okay to believe that, and you know, it’s supported, and it’s people’s realities. But just in having conversations, you know, with my family or whatever, it was still just, you know, there are a lot of people who don’t want to doubt doctors and science.

Lisa Hendrickson-Jack: Well, it’s interesting because it’s also there right in the science, right? So that is actually the science. So arguably your doctor didn’t read the science, right?

So I find that to be interesting as well because the difference between now and, you know, 1964 was that then there hadn’t been hundreds of thousands of research studies done on oral contraceptives and the interplay of this particular synthetic hormone and that particular synthetic hormone and all that kind of stuff.

But now we’re in a situation—and I keep saying this on these many interviews that I’m doing—we’re in a situation where the research is there, but the corresponding procedural changes have not been put into place. The corresponding recommendations have not been updated. But the actual research is there, quite literally.

And I think it’s interesting. I mean, I just pulled up some studies to show you. Does it really change what your experience was? Does it make your experience any more real? You know what I mean?

So we’re at a point where also I think part of the reason that I wanted to do this segment is because I think that things won’t change until, as women, we’re able to put our experiences into our own voice and just share it. And you don’t need to have a scientific study every single—I mean, yes, I say that and at the same time I hear in my head someone yelling at me and saying, but you do need a scientific study. And it’s—but, you know, why can’t we have both?

So I think that it’s important not to invalidate our individual experiences. And so I just want to be clear that I don’t. And I recognize, and I totally appreciate, that every single woman will not have this experience. And I think that’s really important to point out because that’s never been my message, that, “Oh my goodness, everyone’s going to have vulvodynia.” Obviously, everyone doesn’t, right?

But it’s important to know that these hormonal changes affect women differently. And so it’s important to know that it is a possibility. How many women out there do you think have painful sex, pain with intercourse, and they just think that there’s something wrong with them?

Madeline: Yeah, there’s so much power, you know, in being able to name it. I mean, that was a huge gift that that surgeon doctor—she did give me—was by sitting down with me and telling me, yeah, this is called vulvodynia. Or, you know, there’s different names.

But asking if this changes my story or changes my experience—I mean, it gives it a name, it gives it, you know, an identity. Now I can say that I had pain with intercourse or vulvodynia from being on the birth control pill. That gives it some—and that gives it relatability, and that, you know, that’s something you can share with people.

You know, I’ve always wanted to be able to share this with other women, you know, like, I didn’t have a good answer of what to do necessarily. But, you know, just to be able to know what it is and know that other people out there must have had it. I mean, there’s so much power just in being able to name something and then relate with others about it.

Lisa Hendrickson-Jack: I couldn’t agree more. And I also feel like if you go into something knowing that these are possible things that could happen—so in your case, if you had been kind of properly briefed on the possible effects that this could have on your body in different areas, whether it’s emotionally, physically, etc.—then when you did experience issues with libido or when you did experience pain, or just in like the first instance, like at the earliest instance of this, then you would have had that like, “Oh, you know, I think that the doctor mentioned that this could be… Let me just… Let me make an appointment.”

That’s what happens when we’re informed. Then we just have more information to which that allows us to make those types of connections and choices.

Madeline: Right. And even if you know, like, you know, this is a potential side effect of being on the pill. At the first sign of it, you can identify it and then choose to get off the pill if you want.

I mean, you know, I was on the birth control pill for five years with chronic yeast infections and pain with intercourse. And like, only towards the end did I go, “Maybe I should get off the pill.” I mean, it’s just, you know, whereas if that were something someone had explained to me is a possibility, I probably would have gotten off a long time ago, you know, as soon as I started to have bad symptoms.

Lisa Hendrickson-Jack: So, it’s kind of an awkward question to ask, but I know that there’s at least one listener who’s wondering. Could you describe what it feels like, the pain that you had with sex?

Madeline: Sure. So, for me, it was pain that was associated with the initial stretching that occurs with penetration. So it would vary. There were times when it was so painful, such a sharp stretching, almost like dry skin kind of pain, that penetration was not possible.

But often it was this kind of feeling that was kind of pinchy, kind of sharp with the stretching. But, you know, as sex continued, it would kind of fade away. And so it wasn’t something that was completely present, you know, throughout, you know, the whole of intercourse, but it was always something that just was present in the very beginning.

And so it was something that caused me to clench, to anticipate pain. It was something that, you know, that was one of the theories of the physical therapy, was that, you know, I was too tight from that. And I think that the physical therapy helped a lot. So I do encourage anyone who has had vulvodynia or pain with intercourse to pursue physical therapy because I think we do clench and anticipate, you know, and sort of brace ourselves.

I would love to know how other people experience the pain because I don’t know. But for me, that’s how it was.

Lisa Hendrickson-Jack: So then you had the surgery and then you used the cream. And so then how was it different in your experience after that once it went away?

Madeline: Yeah, once it went away, it’s funny, it’s still something that my mind is trained to anticipate even after years of there being no pain. It’s something that still sometimes pops into my mind.

But for me now, you know, with the pain being gone, intercourse, penetration, it’s comfortable. There’s no pain. There’s no feeling of skin stretching. There’s nothing, you know, very present there. It’s something that feels very natural and comfortable. So it’s a big difference.

Lisa Hendrickson-Jack: One question about that then lends itself to how were you able to negotiate that with your partner over the years?

Madeline: Yeah, my partner, I’ve been with him from the beginning that this started, and I’m still with him now. And he was just incredibly supportive. He didn’t like the idea that I was experiencing pain during intercourse, but it was something that we spoke about and just knew that it was a reality and didn’t want it to stop our intimacy.

We would use lubrication, very slow, easing in to sex, that kind of thing. And so he was very aware of it and was very respectful of it. And there were times when it was too bad or I was having yeast infections and we would go a month or more just like, I need to try resting or having none of this or whatever. We’ve gone through long periods.

And it doesn’t have to be a big—it is a problem. But I think, you know what I mean? It doesn’t have to be a big, scary conversation to have at least.

Lisa Hendrickson-Jack: It doesn’t, you know, it depends on your relationship with your partner.

Madeline: You know, I would still have feelings of almost like guilt. Like, I’m bringing so much drama into your sex life. You know, if only you could have like a normal person, you know, like not have to deal with all of this. And he would always just try to assure me like, “I love you and this is what we are working with and that’s just part of life.”

So that was very fortunate to have someone so understanding at my side. But yeah, I think it’s normal to have feelings of guilt or being embarrassed, you know, “It’s happening again. I’m sorry.” Yeah, those are normal feelings too, no matter who you’re with, I think they were for me.

Lisa Hendrickson-Jack: Well, and as you talk about your chronic yeast infections. You know, one of the other women who I interviewed for this series had a similar experience, not with the painful sex. She wasn’t on it for as long because in her case, these yeast infections just kind of came out the woodwork. And after never having had any, all of a sudden she was just having them all the time.

And what you said too, with it was like the fight between the yeast and the bacteria. And it was like, kill the one and the other. That was exactly her experience. And every time she went back, what her doctor told her basically was that, well, because you hadn’t been sexually active before, you’re probably just reacting to your partner’s, you know, like that. Like that kind of stuff when it’s like, just kind of along the lines of like what the rough sex comment. It’s like, what are you talking? You get paid to say stuff like that?

Madeline: Yeah, I know. Yeah, I was told that too. Maybe that’s what it was.

Yeah, I mean, it’s so good to be informed as well because when people say things like that, you have more of a filter or a guard that those comments can go through, you know, in terms of if you’re going to believe them or accept them. Or even other procedures.

Like early on, I went to a certain gynecologist talking about the pain and he just kind of decided that he was going to like scrape some of the skin, like right there in the office. And saying like—like a similar idea of the surgery, but like much less, you know, thought through or whatever. And just was like, lay back, and he just like scraped part of my skin away around the vaginal opening. And it was very painful and it felt—and I, you know, you’re in the doctor’s office, you want help, you want help, and you know, you’re willing to try and trust the doctor.

But you know, if you are informed, you can tell someone, no, that’s not—you know, I’ve heard of other people’s stories or whatever, and you can have a much more successful interaction with doctors and just with your own journey of being healed.

Lisa Hendrickson-Jack: Well, and I have a question for you and there’s no answer to it, really. So, given your experience, do you think looking back that it’s so impossible to even know if that would have worked?

Madeline: It is. It’s impossible. I would have tried it. I had tried everything. I had gone through, you know, the physical therapy. I’d gone through acupuncture, dieting, you know, the different diets, all kinds of creams. I can’t even remember all of them. I think I have a drawer somewhere where they may all still be and I could find them.

But, you know, and yeah, so that’s why even for me, it kind of—the story ends with a bit of a question mark, because the cream kind of coincided with my recovery period from the surgery, though it had been beyond the time that I was told to expect to see the pain be gone, which was why I went in there asking for the testosterone cream.

But yeah, I would have tried it. Who knows what it would have done.

Lisa Hendrickson-Jack: I’m curious if in your research, you’ve seen other ways of curing vulvodynia that people talk about.

Madeline: To be honest, the research that I’ve done has mainly been to determine if there’s a link between hormonal contraceptives. And so I have not gotten that far to offer any real solution in terms of it. I am curious to look into it more.

Lisa Hendrickson-Jack: But something that did strike me, and again, part of that like validating your experience, is that one thing is very clear in the research.

So I’ve said this before as well, but what’s helpful when you recognize how your reproductive cycle works and how those hormones interplay? What’s helpful is that it helps you to know why the pill is so effective.

So the pill is super effective because it prevents your ovaries from producing the estrogen that is required for ovulation. So we know that it doesn’t always prevent ovulation 100% of the time, but ultimately that is a huge part of the modus operandi. And then it has effects on your mucus so you don’t produce cervical mucus that can support sperm life, and then it also changes your endometrial lining to make it so that it’s too thin to support pregnancy. So those are the three main modalities.

But essentially, when you are using this contraceptive, it prevents your ovaries from producing estrogen. And so basically, it kind of just shuts down your ovaries. And so your ovaries produce a small amount of testosterone. So as women, we produce about a tenth as much testosterone as men, but we require it.

So even though we produce a whole lot less, we need all of it. And so when you go on hormonal contraceptives, what the research shows is that your testosterone levels go down like a quarter, or like a third of what they are when you’re not on it.

That’s not something that happens to some women and not others. That’s something that happens to all women. Maybe to the extent could be different, but that’s actually how it works. It works because it prevents your ovaries from producing these hormones.

When you say that you used this testosterone cream and then it seemed to make a difference in your pain, it really gives me more questions. It doesn’t give me any answers, but it gives me that question because there’s a very well-known established link between the reduction. When you’re on it, you have markedly less testosterone, and that’s why many women experience a loss of libido, a loss of energy. Depression is even associated with low testosterone.

And so I guess that leaves all of our listeners with a bit of a question there, because we need testosterone for healthy sexual function, for lubrication, for just the health of our tissues and our vulva and our clitoris. And so, you know, the fact that we’re losing testosterone and the fact that these tissues have been shown to shrink under the influence of these hormones, it’s not a stretch to think, well then in a severe case, maybe that could have helped it.

Madeline: Yeah, and definitely, you know, looking back with the information I have now, something I would have done back then—you know, it wasn’t even a year after getting off of the birth control pill that I opted for the surgery. And I think that I would have given my body some time to just get off the pill and try to get back to normal, or do some kind of post-pill detox or whatever, and just invest more in my health and supporting my hormones and all of those functioning systems to recover from what they’d experienced on the pill. And so with that information, that’s something I would have done.

Lisa Hendrickson-Jack: Well, and as I hear you say that, I just think to myself, how many years did this issue kind of take over your sex life?

Madeline: Four years.

Lisa Hendrickson-Jack: So like four years. After four years, you lasted four years. So I—looking like, you know, you can look back and say like, oh, you know, how I would have handled it differently. But I feel like you were just at your wit’s end. So I would encourage you to be gentle with that. And just remember that you were doing exactly what you needed to do at that time because justifiably it had been so long of dealing with this issue. So I think you made the right choice for yourself at that time.

But I really appreciate you coming and sharing your story, Madeline. I can just imagine what’s happening in some of the listeners’ minds right now, especially the small percentage of listeners who may have experienced something similar, or may have had painful sex for a while and just thought that there was just something wrong with them.

If men experienced pain with sex, they would probably run to their doctor that second. If there was a pill that shrank—well, they say steroids shrink a man’s testicles, so maybe they’d totally be cool with it. But I kind of doubt that that would be okay if there was a pill that shrunk your penis.

So I’m just, yeah, I really appreciate you for sharing your story, and I know that it’s going to be really helpful for some of the listeners.

Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/473.

All right, I hope that you enjoyed today’s episode. I hope that you found it informative. And if you’ve experienced something similar, I hope that it was validating to know that you’re not the only one who’s experienced this.

And if you have been struggling with, you know, painful sex, painful insertion, those types of issues, and you have a history of pill use, I think that it is important to just know that there could be a connection. That’s one of the things that frustrates me about a lot of different scenarios.

And I think I alluded to this in last week’s episode where we were talking about the pill’s impact on vulvar tissues. And what I find to be frustrating is that there’s still this trend in medicine or even in psychiatry or psychology to kind of make assumptions about women’s painful experiences with sex and moving away from the physicality.

And I’m not sure if it’s just a lack of awareness about the potential link between the hormonal contraceptive options and sexual side effects. But I recognize that there could also be psychological aspects of it. Of course, there could be a history of trauma there that could be related. But on the other hand, it could be a profound deficiency of free testosterone induced by hormonal contraceptives that is thinning the tissues, literally, physically, that is leading to her pain.

And so not that it’s that every time, but I mean, I think that this is something where we should at least be aware that this could be a factor. So if I had my kind of perfect world scenario, if I could wave a magic wand and change something, I would just put this as one of the possible reasons for painful sex or other types of sexual side effects, a little bit of those kinds of things. I would put that as one of the possible options on the screening form or whatever when a woman is seeking support for these types of issues so that that question is asked alongside all the other questions that could potentially be asked. You know, have you used hormonal birth control before? Did you ever have this type of experience before you used the hormonal birth control? Whatever it is, like, I feel like that should be there.

So public service announcement over. I hope that you enjoyed today’s episode. I really wanted to share this. I felt like it was really relevant and a good follow-up to last week’s episode.

I know there was some interesting responses to that episode. I think I said this on the episode itself, that it is one of the scariest pieces of information that I share in that book. There’s always a really significant reaction when I share it. Because it’s scary to think that this medication has been shown to actually, you know, shrink the clitoris and thin the vulvar tissues and things like that.

And I think what’s most bothersome about it as well is that most people have never heard this. And I mean, I hadn’t heard it. It was something that I came across in the research when I was looking at the sexual side effects of the pill.

And again, I also find it really interesting that it wasn’t really followed up. And so you have all these women who are having all these sexual side effects and their doctors are basically telling them that it’s in their head. And there’s not really anything there to validate those experiences.

And that’s the hole that I hope to fill with these episodes, which is just that if you’ve experienced it, you’re not alone. There are other women who are experiencing it. There’s research behind why you may be experiencing this. And there’s hope.

In Madeline’s case, she really did have to search for support, right? She had to go to multiple practitioners, and she had never even heard the term vulvodynia. Who has, right? Unless you’re kind of in the mix with all of this kind of stuff.

And she had to fight for it, but she managed to find a solution that actually worked after going through, you know, quite the ordeal and many years of suffering.

So hopefully this episode at least gives a beacon of hope and a potential avenue of things to look into or ask your practitioner about if you’ve experienced something similar.

So with that said, I hope you have a wonderful week, weekend, whenever you’re tuning into the show. And of course, as always, until next time, be well and happy charting.