I have mucosal atrophy and vaginismus.

[u/hawlge]

W20. I’ve been married for 2 years, and before that, my husband and I dated for 3 years. We both matured early and were emotionally ready enough to get married at this age without regretting it. I believe he’s the person I’ll spend my life with, and he feels the same.

I’m severely underweight. At 165 cm tall, I weighed 46 kg. That wasn’t a big problem for me — I always looked fine — but I’ve always had very long periods, about 9–14 days. Before the wedding, I saw a gynecologist because my period lasted 26 days straight (that was the only time it happened). He explained that I have many eggs but very low body weight, which causes long periods. He prescribed hormonal pills, and after that, my periods averaged 8 days. Everything was okay.

But about six months after the wedding, I started having gynecological problems. The first thing I noticed was that my libido disappeared, and I stopped producing natural lubrication. I thought it might be due to the birth control — I’d heard that can happen. But then, gradually, during sex, each time felt worse and worse. Based on symptoms, I started thinking I might have vaginismus, because there was a cycle of pain → fear of pain → even more pain → reinforcement of fear → muscle spasms. Later, I became 100% sure I had vaginismus — I couldn’t even insert the smallest tampon without pain. Penetration was out of the question.

I struggled a lot with this. I worried that if I couldn’t get better, my husband would leave me. (He’s also 20, and people that age have a lot of sex. He has a high libido and wants it every day, and I can’t give him that.) I tried exercises, I tried vaginal dilators, but almost nothing changed.

By that point, we hadn’t had proper sex for about 8 months. We tried occasionally — lots of lube, very slowly. At first it was very painful, then the pain would go away, but there was no pleasure either — just a rubbing sensation, and after a few minutes it would start chafing.

I went to another gynecologist (both times at private clinics). I didn’t go because of the vaginismus — since gynecologists don’t really treat that, it’s more of a psychological issue — but because my birth control pills were becoming less effective: my periods were getting longer again, lasting 13 days. Going to that gynecologist was a mistake. She seemed incompetent from the start. Before the exam, I warned her I might have vaginismus and asked her to be very gentle. She waved it off, said it was probably just vaginal dryness, but when she did the pelvic ultrasound — well-lubricated as the probe was — she inserted it abruptly and I jolted. Then she agreed it was vaginismus.

I had blood work done for hormones, and my levels were quite low. She prescribed different pills, and for vaginismus: chamomile tea, vitamin D3, amino acids, and advised me to relax before sex — like taking a hot bath (as if I hadn’t tried everything by then). And the key part, lol — she prescribed Phenazepam. I didn’t know what it was; she said it would relax me and to take it before sex.

So I go to the pharmacy, hand over the prescription, and the pharmacist says, “Do you know this is a tranquilizer? I can’t sell it without a prescription.” I called the clinic and explained. They told me Phenazepam was listed as a recommendation, not a prescription, because she doesn’t have the authority to prescribe psychiatric drugs. Except her instructions didn’t say “recommendation” at all. Anyway. Those pills didn’t help. I even got Phenazepam through someone else (who it was prescribed to), just to test it. Of course, it did absolutely nothing.

After that, I stopped taking hormonal birth control. Deep down, I hoped at least my libido would come back. Of course, it didn’t.

After all this, I had no idea what to do, where to turn, or how to treat this. My only idea was to gain a normal amount of weight — then my hormones would stabilize and everything would be fine. But that was very hard for me. I’m one of those people who eats and doesn’t gain weight. At home, I just couldn’t do it.

Then I went to work as a camp counselor — live-in work with 5 meals a day, eating with the kids. There, I managed to gain a bit of weight because you’re running around all day, which gives you a good appetite. I ate a lot in the cafeteria, took extra portions, and drank protein between lunch and afternoon snack. When I got back, I weighed 51–52 kg. At home, I tried to keep the same eating routine, but I couldn’t eat as much, so I lost the weight. Now I weigh 50 kg.

While I was at camp, I randomly found an AI prompt online for an intimate health consultant. Since I’d lost faith in the gynecologists in our small town, I decided to try it. It turned out to be genuinely effective. I uploaded my hormone blood test results, and the AI explained everything perfectly. Before that, I never fully understood what was happening to my body — now I did. After a very long conversation, listing every detail of my symptoms, discussing my lab results, DeepSeek concluded that I have hormonally mediated vulvar atrophy and vaginismus secondary to hypogonadotropic hypogonadism (functional ovarian suppression due to CNS/pituitary issues).

I fully agree with this. Gynecologists would never have given me this diagnosis because they don’t listen beyond 5 minutes of my explanations — they move straight to the physical exam and make incomplete conclusions. But this fits exactly. I’m sure this is what I have.

You can judge me for trusting an AI over a real doctor, but based on my experience, the AI turned out to be more competent in my situation. Let me explain my diagnosis in simple terms: because of my underweight status, my brain shut down my ovaries — they’re dormant. As a result, my ovaries don’t get the signal from my brain to produce estrogen. Without estrogen, I have no lubrication, no arousal, long chaotic periods, and my mucous membrane is thin and fragile as parchment paper. Friction causes micro-tears and pain.

The gynecologists prescribed hormonal pills, but they didn’t treat the problem — they only masked it. I had monthly bleeding caused by the last pills in the pack, but that didn’t mean I had normal short periods. I should also emphasize that I have functional infertility — I already knew that. The very first gynecologist told me I don’t ovulate because my periods are so long. In effect, the lack of proper treatment worsened the dryness and mucosal atrophy.

It sounds painfully logical, damn it. I’m sure that’s exactly what’s going on. The AI outlined my next steps: weight gain, a detailed eating plan for gaining weight, exercises for treating vaginismus, which vitamins to take, and recommended an estriol vaginal cream.

So — I was a camp counselor two months ago, meaning only two months ago I gained a little weight (still far from the ideal 55–56 kg) and started treatment. Now, as I said, I weigh 50 kg. I finished a course of vitamins. I try to use the estriol cream, but unfortunately I often forget. I can feel it helps in the moment — after applying it, I get a rush of blood to the vulva, like. But not much has changed overall. I’d even say the only improvement is that I have a little more lubrication now. But my libido feels even lower. Before, I would at least get aroused occasionally from porn. Now, sex genuinely repulses me — porn too.

Honestly, sometimes I think that if it were up to me, I would never have sex. I just don’t need it. But for my husband’s sake, I want to get better as quickly as possible.

I forgot to mention: when I stopped taking birth control, I broke out in pimples all over my back and above my chest. I haven’t been able to get rid of them for about 4 months.

Now I don’t know what to do because progress has stalled. Inserting anything still hurts. I can’t gain weight at home. I’ve signed up for another camp session this summer because that’s where I gain weight successfully. I’ll try to reach 55 kg there. Worst case, I’ll drop to 53 kg, but that’s still progress. I have no other ideas.

I’m open to any questions. If anyone has experienced something similar, I’d be grateful for your advice.

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