Topic
Painful orgasm
I am reposting here in hopes that someone will read my story and reply.
I am a 58 year old woman desperate to get help for a problem that I have with painful orgasm. My problem started about 20 years ago by waking from erotic dreams having very painful urethral spasms that could only be relieved by forcing myself to urinate. I went to a sex therapist after many years of seeking help from my primary care provider and specialists at UC Davis Medical Center. The sex therapist thought that my problem was physiological, not psychological, and referred me to Dr. Irwin Goldstein (Dr. G). Dr. G suggested I tell my story on this forum so here goes. A summary of visits and treatments for over a year with Dr. G follows:
Dec. 2009 Phone consult to explain problem with urethral spasms at orgasm and failure to have normal orgasm. Dr. G. ordered blood work for various hormone levels
Jan 2010 Traveled from Sacramento, CA, for first appointment with Dr. G. Blood test results indicated low testosterone and elevated progesterone. Physical tests indicated mild clitoral gland atrophy, mild clitoral phimosis, and mildly abnormal vaginal pH. Perineometry markedly abnormal indicating low tone pelvic floor dysfunction. This surprised me because I do not have any incontinence or signs of prolapse.
Plan – Continue Estradiol patch, decrease progesterone to two a week, start using a small amount of Testim gel testosterone therapy on back of calf, begin Vagifem to correct pH, daily local application of small amount of Estrace to clitoris to loosen hood, use vibrator to increase sensitivity to genital area,continue Wellbutrin, PT for low tone pelvic floor dysfunction, see Sexologist for instruction on using vibrator, kegel balls and Juno pelvic floor strengthening device.
May 2010 Second visit with Dr. G. Some improvement in genital sensation and tone of Pelvic floor. No change in occurrence of urethral spasms at orgasm. No normal orgasm.
Plan – Add ¼ Viagra and 150 IU Oxytocin lozenges prior to sexual activity. Continue everything else.
Sep 2010 Third visit with Dr. G. No change in occurrence of urethral spasms at orgasm. No normal orgasm. Developing fear of painful urethral spasms. Visited sex therapist who still thinks problem is physiological not psychological.
Plan – Dr. G thinks problem may be bladder neck spasms causing painful orgasms. Added Flomax 0.4 mg, phenozopyridine 100 mg, and Ditropan XL 5mg one half hour prior to sexual activity. Recommended soaking in a hot bath while masturbating might help.
Nov. 2010 Phone apt. No change in occurrence of urethral spasms at orgasm. No normal orgasm. Stimulating clitoris with jets from spa resulted in urethral spasms. Dr. G suggested using Ritalin, Yohimbine HCl, or medical marijuana might help. Call ended with no plan in place and me extremely frustrated and discouraged.
Jan 2011 I had bariatric surgery and stopped hormone replacement therapy due to clotting risk.
March 2011 I restarted HRT and continue pelvic floor exercises. Sexual activity still ends up with urethral spasms and ultrasensitive clitoris at orgasm. No normal orgasm.
So here I am one year later with no success or improvement with the spasms. I am easily aroused but still get painful spasms in my sleep or when masturbating with a vibrator or spa jets. I call my problem “orgasms gone bad” because the spasms occur at the point that orgasm should occur. I have searched the internet extensively for an explanation but come up with nothing. I plan to return to physical therapy to check my pelvic muscle tone otherwise I am stuck. Has anyone out there experienced or heard of a problem like this? I know this is a long post but I need help.