Up to 18% of women around the globe experience pain while having sex at some point in their lives. Depending on the type and location of the pain, painful sex can be known as:
- Vaginismus (involuntary spasms in the outer third of the vagina)
- Dyspareunia (pain in the genitals)
- Vestibulodynia (inadequate lubrication)
Sometimes the cause of painful sex is physical, such as a structural abnormality or hormone deficiency. Sometimes it’s psychological, such as a result of rape or other trauma.
When you come to see Dr. Rafiq Mian and our team at Mian OB/GYN & Associates, we’re discreet and understanding. First, we take the time and care to determine the type of symptoms you have. Then we conduct a comprehensive exam to uncover the source or sources of your pain. Once you receive a precise diagnosis, Dr. Mian recommends a treatment plan.
Is sex painful for you? Following are a few reasons why it might be and what can be done to make it pleasurable for you.
Hormonal imbalances
Hormonal imbalance is one of the main drivers of painful sex. As you age, your levels of estrogen, progesterone, and even testosterone decrease. The result is a cluster of symptoms that may make sex painful, such as:
- Inadequate lubrication
- Lax vagina
- Thin skin in vagina
- Atrophied (smaller) labia and clitoris
- Low to no libido
In addition to experiencing pain during sex, you may also have fewer or less intense orgasms. If you’re in perimenopause or menopause, you may get relief from painful sex and other hormone-related symptoms through bioidentical hormone replacement therapy (BHRT).
We recommend BHRT that comes in a pellet form. We insert the pellet in the fleshy part of your arm, and it starts to release plant-derived hormones that are structurally identical to your own hormones. The insertion takes minutes and you start feeling better (and sexier!) within days.
Medical conditions
Any medical condition that inflames or affects your pelvic area may make sex painful. All of the organs in the pelvic girdle can press against the others, causing pain and inflammation.
Conditions that may cause pain during intercourse include:
- Inflammatory bowel disease (IBD)
- Cystitis
- Urinary tract infections
- Hemorrhoids
- Scars from surgeries or infections
You may also have a condition that directly affects the health of your reproductive organs, such as:
- Uterine fibroids
- Ovarian cysts
- Endometriosis
- Retroverted uterus
- Uterine prolapse
- Adenomyosis
Dr. Mian may recommend surgery to remove abnormal tissue or to correct an abnormality in your uterus. If your condition is nongynecological, he refers you to a specialist for treatment and partners with them to restore your overall and sexual health.
Childbirth or pelvic surgery
Childbirth is wonderful and exhilarating, but it’s also traumatic. Your vagina may have been stretched or torn, and it may still be healing. In some cases, you may need to undergo vaginal rejuvenation to restore damaged tissues or to tighten your vagina so you can feel pleasurable friction again.
Other types of pelvic trauma, including surgery in that area, can cause pelvic pain. You may have scar tissue or adhesions, which is when tissues fuse together as a result of the trauma of surgery.
Psychological stress and trauma
One sign that pain during sex is caused by past or recent trauma, such as rape or other abuse, is a condition called vaginismus. Vaginismus is involuntary spasms in the outer third of your vagina when you (or someone else) attempts to penetrate the vagina.
Even trying to insert a tampon can trigger an episode of vaginismus. Stress and trauma can create a series of symptoms that makes sex painful, including:
- Vaginismus
- Tense pelvic floor muscles
- Feelings of nervousness or fear
- Low or no libido
If Dr. Mian determines that psychological stress or trauma contributes to your painful sex, he refers you to a counselor who specializes in helping people recover their sense of safety and control. You may learn relaxation techniques and use cognitive behavioral therapy (CBT) to help you process your trauma and begin to heal.
Don’t “grin and bear” painful sex, or ignore it altogether. Find out what’s cutting you off from your deserved pleasure and intimacy by contacting us today for treatments, including possibly BHRT. You can phone our caring and discreet team at our office in Silver Spring, Maryland, or fill out our online booking form.