Even though good sex can be an important part of physical and emotional health and well-being, good sex should also feel good.
Unfortunately, many women struggle to even enjoy sex at all due to pain they can't seem to avoid.
Some women have pain with just general stimulation, while others may have problems only during penetration or burning, stinging pain that seems to radiate from their vulva or deep inside of their pelvic floor.
In any case, the discomfort can be the detriment of any good sexual relationship and should spur any female to seek medical advice.
Painful intercourse (a medical condition called dyspareunia) can have so many underlying causes:
Tissue inflammation
Tight pelvic floor muscles
Menopause
Low hormone levels
Psychological factors
Quick FAQs
Yes, the primary drug used in them is lidocaine which is a very safe numbing agent that has been in use since the 1940's
Yes, there are several natural alternatives to vaginal numbing creams. Everything from massage and vaginal trainers, to surgery.
Yes, lidocaine is often prescribed as a treatment option for vulvodynia.
The three primary types are anti-inflammatory gels, anesthetic creams, and topical hormones. Discuss which one is best for you with your doctor.
While the underlying factors do need to be addressed by a doctor, a topical agent to numb the sensitive areas may be something to consider.
Let's take a closer look.
What is a vaginal numbing cream?
A vaginal numbing cream is essentially a topical product that can be applied to sensitive areas before sexual activity to deter discomfort.
These anesthetic products come in a lot of different forms: creams, as a gel, and even incorporated into a lubricant-type product for women who deal with both lacking moisture production and vaginal pain.
The purpose of the topical is to numb the sensitive areas that may otherwise be so sensitive that intercourse or contact with the area is painful.
Therefore, many women use a cream to numb parts of their vagina before other activities that can be painful beyond just sexual activity, such as riding a bike or even getting a pap smear.
According to Dr. Karyn Eilber, from the Down There Doctors, “There are vaginal numbing creams available without a prescription, but the amount/strength of the numbing ingredient (usually lidocaine) isn't as strong as with a prescription. For mild discomfort and pain, a vaginal numbing cream without a prescription may be effective, while women with more severe pain or sensitive skin may need a prescription numbing cream.”
Dr. Eilber noted that vaginal lidocaine may be recommended for vulvodynia.
This medical condition that affects women is a bit more specific than dyspareunia in that it is usually characterized by painful sensations in the vulva area or vaginal opening specifically.
Therefore, using a product to numb the vulva or opening of the vagina can sometimes lead to positive outcomes when it comes to sex and even everyday activities.
In addition, vulvodynia is chronic, which means the problem lasts longer than three months.
Therefore, using lidocaine to numb the painful areas can sometimes be a fitting treatment option.
Can I use vaginal numbing cream for sex?
Vaginal numbing cream can definitely be used for sex. In fact, Dr. Eilber notes that it's a common reason that it’s used.
If you experience pain with penetration, applying a bit of lidocaine on the skin in the vulvar area or at the opening of the vagina could be helpful.
Be sure to only use a small amount and keep the cream directed away from the clitoris so you can retain sexual sensitivity.
What are the different types of creams available?
Even though using a cream or gel to numb the vagina is one way of dealing with dyspareunia, other products may be recommended by your health advisor.
The three primary types of cream that may be recommended include:
Anti-inflammatory gel - Anti-inflammatory cream or gel may be recommended if you are dealing with some type of skin irritation or itching that is thought to be related to inflammation
Anesthetic cream - Anesthetic products (like numbing cream) contain lidocaine or other desensitizing agents that absorb through the skin to temporarily stall sensations in particular areas
Topical hormones - Products containing estrogen and even testosterone are a common medicine recommendation for women during menopause to help with moisture production and relieve discomfort
If vaginal lidocaine doesn't relieve the discomfort you feel during intercourse, several different and healthy alternatives may be worth a try.
When we asked Dr. Eilber, she stated, “Many of my patients alleviate pain with ice packs or some type of cooling gel. There are also prescription and non-prescription anti-inflammatory creams.” Here are a few other options to consider.
Pro Tip: One great alternative is Promescent numbing spray for sex. Originally intended for premature ejaculation, it contains lidocaine and is meant for sensitive sexual areas of the body.
Acupuncture
Acupuncture may offer some relief for dyspareunia, and the treatment is totally natural and free of undesirable side effects for most.
In clinical studies, acupuncture seemed to enhance pelvic pain among women who had been diagnosed with endometriosis and were dealing with dyspareunia.
Even more noteworthy, some women did still report positive effects of acupuncture therapy even two months after treatment.
Pelvic Floor Relaxation Exercise
Exercising the pelvic floor muscles may offer some relief for vulvodynia specifically.
In some cases, pain in the vulva can actually be relative to trigger points in the pelvic floor.
In other words, when certain trigger points in the muscles of the pelvic floor tense, the uncomfortable sensations may actually present in or around the vulva.
You should consider working with a pelvic floor physical therapist to figure out how to relax certain muscles that trigger pain during penetration or sexual interaction.
Perineal massage
The area of skin between the vagina and anus is called the perineum, and massaging this particular area may actually desensitize the vulva.
To massage the perineum, apply a bit of lubricant to your fingers for moisture and gently massage the area with a finger or two or a small vibrator.
Use very light pressure at first, and then gradually apply more pressure.
Use of vaginal trainers
Vaginal trainers are an effective way to help with dyspareunia in some situations.
This is a purely physical option that encourages the opening of the vagina to accept penetration comfortably.
You can find a lot of FDA-approved vaginal trainers out there, but most offer the same concept: you are inserting a dilator into the vagina, allowing the vagina to grow comfortable with the size of that trainer, and then working your way up to bigger sizes.
If you do opt for vaginal trainers, always use a good lubricant to make insertion easy and take your time.
The general recommendation is to leave one size inserted for 10 minutes before moving up to a bigger size.
TENS units have been used in medicine and physiotherapy for years to target a litany of types of pain and may help with dyspareunia.
These units deliver electrical impulses through the skin to certain points of the body that are directly related to neural sensations.
TENS can even be a good idea with pelvic floor pain.
Electrical impulses can also be sent to the lower parts of the spine with a TENS unit to stimulate the nerves that supply the vulvar area.
However, a probe that delivers impulses may also be inserted into the vagina to directly target nerves within the body.
Psychological help
Dyspareunia was once actually viewed as a purely psychological issue, even though history and current research have proven that the problem can be just as much physical as emotional.
Nevertheless, psychological help could be helpful, especially for women who have a history of sexual abuse.
Dyspareunia is also more prevalent among women who are generally unhappy, and the condition itself can be linked to both depression and anxiety.
Surgery
Only a few procedures have been used throughout history in an effort to help a woman have pain-free intercourse.
One procedure involves completely removing the vestibular glands (Bartholin's glands), which are situated at either side of the vaginal opening.
While the procedure has a 60 to 75 percent success rate, recovery is a lengthy process and skin grafts may even be necessary afterward.
Laser therapy has also been used to treat vulvodynia, but these procedures have actually been shown to be not just ineffective but likely to cause worsened symptoms.
Risks of Using Numbing Cream for Vaginal Area
One of the perks of using vaginal desensitizing products with lidocaine is the fact that the risk of side effects and adverse outcomes is low when products are used properly.
The primary complaint is that desensitization can get passed onto the partner during sexual activity.
However, if you use a well-made topical product and allow the solution to properly absorb into the skin before sex, even this problem can be avoided.
Rarely, an overdose of numbing medication is possible if too much enters the blood through the skin, but you would have to use an obscene amount that your body could not process.
Just the same, it is important to start with the smallest amounts of topical lidocaine and use only what is necessary.
Cover just specific points, monitor your sensations and adjust in small increments as needed.
Additionally you may feel some pain return after the numbing wears off.
Skin irritation may occur when using numbing cream on vagina areas, as this is a possibility with any treatment that involves applying something to the external parts of the body.
Dr. Eilber noted that local rashes can occur if there's an allergic reaction, but in general, significant side effects are unlikely unless more cream is used than recommended.
If you are using a lidocaine treatment and notice any skin issues, be sure to discontinue use and contact a doctor for advice.
For those who are pregnant and wondering if numbing creams are safe, Dr. Eilber states “Generally, they should be, but I would caution against using excessive amounts or putting it deep inside the vagina where the cervix is, as this is the entrance to the womb. As with all medications, reading the pregnancy warning on the label and asking your doctor are always the safest things to do.”
Takeaways to Remember
Treating dyspareunia can be difficult because so many factors like menopause and sexual history have to be considered.
Using external lidocaine to numb specific areas before sex could offer situational relief and lead to pain-free sex and a natural transition to a healthy sex life.
While some women may need medicine or medical advice to fully address their issues with painful sex, lidocaine cream could still be a valuable tool during the treatment process.
If you struggle with dyspareunia, discuss the details of your situation with your doctor in order to get a proper diagnosis and find out which options would be most effective for you.
Dr. Karyn Eilber is a urogynecologist who practices at Cedars Sinai in Los Angeles. She has published multiple peer-reviewed manuscripts and presented her research at numerous national conferences. Her research focuses on female sexual health, and is passionate about empowering women with knowledge about the pelvic floor. As part of her mission to educate and empower women regarding pelvic floor health, she co-authored A Woman’s Guide to Her Pelvic Floor: What the F*@# Is Going on Down There?
Sources:
Absorption Pharmaceuticals LLC (Promescent) has strict informational citing guidelines and relies on peer-reviewed studies, academic or research institutions, medical associations, and medical experts. We attempt to use primary sources and refrain from using tertiary references and only citing trustworthy sources. Each article is reviewed, written, and updated by Medical Professionals or authoritative Experts in a specific, related field of practice. You can find out more about how we ensure our content is accurate and current by reading our editorial policy.
Bartholin's gland. 2022 January 18. Wikipedia. https://en.wikipedia.org/wiki/Bartholin%27s_gland
M Meana, Y M Binik, S Khalife, D R Cohen. October 1997. Biopsychosocial profile of women with dyspareunia. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/9380320/
"Meet The Experts - Down There Doctors." Downtheredoctors.com, 2023, https://www.downtheredoctors.com/meet-the-experts. Accessed on Jul, 10, 2023.
Women's College Hospital Staff. (n.d). Treatment. Women's Health Matters Women's College Hospital. https://www.womenshealthmatters.ca/health-centres/pelvic-health/vulvodynia/treatment/#:~:text=Biofeedback%20training%20for%20vulvodynia%20helps,the%20walls%20of%20the%20pelvis.
"Meet The Experts - Down There Doctors." Downtheredoctors.com, 2023, https://www.downtheredoctors.com/meet-the-experts. Accessed on Jul, 10, 2023.
Tatiane Regina de Sousa, Bruna Cruz de Souza, Kamilla Zomkowisk, Priscila Cibils da Rosa, Fabiana Flores Sperandio. 2016 November. Science Direct. https://www.sciencedirect.com/science/article/abs/pii/S1744388116300834
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
