Sexual Pain Disorders
When should a woman see a doctor about painful sex?
I mean generally the first time that somebody has sexual relations it's not going to be entirely comfortable and perfect. If the problem persist over a series of sexual events, then I say to seek medical attention, speak to your doctor about it. It can be, you know the causes for sexual pain are multiple, and it needs to be addressed and the earlier it's addressed the better than letting it go on being a chronic on going problem.
How are sexual pain disorders diagnosed?
Sexual pain disorders are diagnosed a lot by history because it depends . . . sexual pain can be due to an infection. Sexual pain can be due to inflammation and irritation. Sexual pain can be due to spasm of the pelvic floor muscles. Sexual pain can be due to endometriosis or fibroids or problems with the uterus. So it really is diagnosed through history and physical exam.
How is female 'sexual pain disorder' treated?
Sexual pain disorder is treated based on what the cause is. So, probably the most common cause that I see is, a condition called, vulvodynia which is, inflammation, irritation, pain in the opening of the vagina. It's a disorder of the small nerve fibers in the opening of the vagina that cause a sheering, tearing, ground glass, burning kind of pain that is absolutely debilitating, and the really you know, horrible thing about this problem is that it co-exists with other inflammatory problems such as irritable bowel, interstitial cystitis, lupus, sjögren's, things along those lines, and there is no cure. There is only treatment and palliation of symptoms, which include in this case of vulvodynia, not unlike interstitial cystitis, dietary changes, vaginal physical therapy, topical hormonal therapies, medications that eliminate nerve pain, and anti-oxidants and anti-inflammatory products.
What causes sexual pain?
I'd say the most common causes of sexual pain in my practice are vulvodynia which is the inflammation irritation of the vagina. That's an autoimmune syndrome. Other common causes include infections or sexually transmitted diseases. And other causes can be due to dryness, the woman is not adequately lubricated, and/or something higher up, meaning a problem with the ovaries and uterus.
Do bladder infections cause painful sex?
A lot of women experience Bladder Infections related to sexual activity and then they develp a lot of anxiety related to sexual activity because they think every time they have sex, and they generally do, get a bladder infection and that just happens in some women and that's treated a very specific way and they don't necessarily have pain during sex. They have pain and irritation after sex and tingling and burning in the urethra after sexual relations.
Why is penetration painful for some women?
If penetration is painful, it's generally due to lack of lubrication or arousal, or spasm and clenching of the pelvic floor muscles, assuming that everything else is normal. If there's not vulvadenia or infection or anything else. But spasm of the pelvic floor muscles, which is called vaginismus, which is an involuntary contraction of the lower third of the vagina, occurs as a reflex reaction in anticipation of pain. Women need to learn how to relax that muscle. Once that clenches, then it even causes more pain. So the pain begets pain.
Can women have pain even from noncoital sex?
Noncoital, or pain in your genital area is not associated with intercourse. It is a subvariant of vulvadenia, which is called vestibulitis, or vulva vaginitis. That is treated in a specific way as well. But it's not really sexual pain, because you're not having sex, but it's pain in your genital area that occurs even when you're not having sexual relations.
