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I thought I’d turned a corner with my night sweats, but they’re getting worse! How can I get some sleep?

Q:During quarantine I got into the habit of using pads. I tried tampons again during my last few cycles and they wouldn’t go all the way in. It felt like the tampon was hitting a wall! I have a few beach trips scheduled and I was planning on using tampons when I swim. What can I do?

A:This sounds like vaginismus, involuntary vaginal muscle spasms that create tightness and inhibit penetration. Though you’re only discovering it now that you’re trying to use tampons again, the trigger could have been an infection, an orthopedic issue like back or hip pain, an experience with painful sex or even stress—92% of women say their stress levels rose this year, according to a new survey.

The good news is that vaginismus is very treatable. I suggest buying an inexpensive set of vaginal dilators (like the Dr. Laura Berman Intimate Basics Dilator Set, Amazon. com) to progressively retrain these muscles to relax with penetration. It’s best to start with the smallest dilator, approximately pinkie-sized, add a water-based lubricant and set a timer for 10 minutes. Aim to take deep breaths, relaxing the pelvic muscles as you slowly insert the dilator. If you feel resistance or if your discomfort reaches a 3 out of 10, pause, take deep breaths and gently contract, then relax the muscles around the dilator and try to insert it further. Continue this 10-minute practice every other day until you can comfortably insert the dilator as far as a tampon, then start over with the next size. It may take several weeks or more until you’re ready for a tampon again.

As far as swimming with your period, some of my patients love swimwear designed to absorb blood (like Ruby, RubyLove.com) so you don’t need tampons to enjoy the water.