Painful sex the unintentional kind can make life and relationships less satisfying. Sex is not a necessityβit is not like oxygen, food, or shelterβbut it is important to many women. If you are experiencing painful sex then you should schedule a gynecology consultation today". Many women are embarrassed to discuss this with their healthcare providers. If this is an issue for you, you are not alone! There are two main categories of dyspareunia, deep and superficial.
I will discuss each of these separately. Deep dyspareunia means that the pain is deep in the pelvis, almost like a belly ache. Gynecologic conditions such as ovarian cysts can cause this kind of pain, but other organs live in close proximity including intestines, bladder and even muscles. Other potential causes of temporary pain include severe constipation and bladder infections. If you have pain and it goes away or occurs every once in a while, do not worry.
If you have persistent dyspareunia, there are a few possible causes that should be considered:. This tends to be a deep ache and is worse with certain positions.
It is progressive, getting worse over time, and often persists for hours or even days after sex is finished. If this describes you and you also have very painful periods, you should be evaluated for endometriosis. Myofascial pain. This is best described as a spasm of the muscles around the vagina and also tends to be progressive. I have had many patients that have had an instigating event such as complicated child birth, rough sex, assault, or perhaps just sex while unlubricated.
They subsequently anticipate pain, sometimes unconsciously, and this leads to pelvic floor tension and pain. This type of dyspareunia responds very well to pelvic floor physical therapy. Yes, really. PID is often accompanied by vaginal discharge, sometimes fever and malaise, and is a serious condition that requires immediate attention. In the past, we were taught that it was caused by an STD such as chlamydia or gonorrhea.
