A couple of weeks ago, I met up with a couple of friends for a glass of wine at the end of a busy week. As usually happens when you mix girls and red wine, the topic of our conversation turned to relationships and sex. That’s when one of my friends confided that for the past two years she’s experienced terrible pain each time she and her boyfriend of five years have sex. She said she had seen her OB/GYN, who had run tests, found nothing, and told her she was perfectly fine. Since then, she said, she’s just dealt with the awful pain.
I took a pause and inhaled deeply to contain the rage that had overtaken every cell in my body. I have this reaction every time I hear about a doctor telling a woman in pain that there is nothing wrong with her. Why can’t they just say “I haven’t been able to find out what’s causing your pain, so I highly recommend you seek out a specialist for another opinion.”
Unfortunately, women who experience pain with sex are often bounced from doctor to doctor before a cause is uncovered. A lack of knowledge exists in the medical community even though painful intercourse is a common problem. Indeed, up to 60% of sexually active women can suffer from varying degrees of painful intercourse at some point in their lifetime. The medical term for painful intercourse is “dyspareunia.”
The good news is that a number of treatment options exist to lessen and even break the pain cycle for women with dyspareunia. The first step involves finding the right physician who understands the problem. Try to locate a urogynecologist or a pelvic floor physical therapist who specializes in treating painful intercourse. Getting the correct diagnosis and treatment from the right practitioner can put you on the road to recovery.
A specialist might prescribe one or more treatments, depending on the diagnosis. Among the treatments are: lubricants, medication for infections or nerve pain, hormone replacement therapy, biofeedback to re-educate pelvic floor muscles, internal electrical stimulation, self-treatment using vaginal dilators, an exercise program directed by a physical therapist, psychotherapy or sex therapy, and in some cases surgery.
Some of the most common causes of dyspareunia, or painful intercourse, are:
• Insufficient lubrication
• Hormonal changes (common during menstruation and menopause)
• Decreased arousal
• Thinning of vaginal tissues
• Surgical scar tissue
• Childbirth/improperly healed episiotomies
• Infections
• Allergic reactions to lubricants or condoms
• Vaginismus - Involuntary spasms of the vaginal muscles known as the pelvic floor.
In severe cases, penetration is not possible.
• Physical trauma – Falls onto the hip, back or tailbone.
• Emotional trauma – A history of abuse or religious/cultural restrictions.
• Chronic constipation
• Fibroids and endometriosis
• Retroverted (tilted) uterus
• Bartholin’s gland cysts – Growths on ducts from glands in the genital area.
• Vulvodynia/vulvar vestibulitis – Inflammation of tissues surrounding the entrance to the vagina.
• Dermatologic conditions such as lichens sclerosis
Bonnie Bauman is a freelance journalist living in Los Angeles. One of her specialties is writing about women’s health, specifically issues having to do with pelvic pain. Check out her blog at pelvicpainmatters.com.
Thank You for this article. So many women are left in the dark about dyspareunia. It is highly treatable. If a woman is not finding answers she needs to seek alternate care. The vulvar pain foundation is an excellent resource.