Painful medical conditions linked to sex – and how to treat them yourself

Women often experience some form of pain during sex – for some it's only once and for others it's persistent.

However, just because it's common doesn’t mean that you should accept it as normal. While the occasional soreness is to be expected after sex and nothing to worry about, the reason for any intense or frequent pain needs to be looked into.

Bringing up sexual health can be embarrassing or intimidating, but it's important that you bring it up with a doctor and your partner if you’re feeling persistent pain after sex as it could be caused by one of these five medical conditions.

Vaginal pain

This pain felt inside the vagina can be caused by a lack of lubrication from inadequate arousal, medication, medical conditions, pregnancy, breastfeeding or menopause.

Another reason for vaginal pain might be because the pelvic floor muscles around the lower third of the vagina are often tight, or because of a type inflammation of the vagina, known as vaginitis.

Symptoms of vaginitis are a vaginal discharge, itching and burning sensations in the vagina and vulva. It can be caused by yeast or bacterial infection or a sexually transmitted disease.

Vulvar pain

Vulvar pain is the type of pain felt on the outside of the vagina, occurring when some part of the vulva is touched. Usually vulvar pain is caused by irritation from soaps, feminine hygiene sprays or douches, and also from scars, cysts, certain skin conditions and infections.

Vulvodynia

Vulvar pain that occurs without any identifiable cause behind it is called vulvodynia. As many as 25 percent of women may suffer it during their lifetime, and it affects the vaginal opening (vestibulitis), the clitoris or even the entire vulva.

One reason for this condition could either be damaged nerves on the hypersensitive vulva. This hypersensitivity leads to tightness in pelvic floor muscle, which then ends up increasing the pain, leading to a vicious cycle.

The syndrome also occurs more frequently in women with a personal or family history of other types of pain syndromes such as migraine headaches, fibromyalgia, irritable bowel syndrome or interstitial cystitis.

Vaginismus

Vaginismus refers to the involuntary muscle contractions around the opening of the vagina, in the pelvic floor muscles.

This diagnosis is given to those women who have a fear of vaginal penetration, because many women with vaginismus have a chronically tight pelvic floor that causes more pain with any vaginal penetration.

Deep pain

Pain that's felt deep inside the vagina, lower back, pelvic area, uterus or bladder can be a sign of an internal medical problem.

It could be caused by:

  • pelvic inflammatory disease
  • endometriosis, a condition in which the tissue that lines the uterus grows outside the uterus
  • pelvic tumour
  • bowel or bladder disease, such as interstitial cystitis
  • scar tissue
  • ovarian cysts

Treatments

Treatment for sexual dysfunction conditions such as these depends on the cause of the problem.

For instance, vulvodynia can be treated using pelvic floor physical therapy, hormonal treatments or medications to treat nerve sensitivity. Some non-surgical approaches such as Botox injections have been found effective with treating pelvic floor tightness as well.

Vaginismus can similarly be treated using vaginal dilators, pelvic floor therapy or Botox. Certain oral medication to treat pain and anxiety may be helpful for this condition, too.

In case of deep pain, your doctor might suggest some additional tests including blood tests, urine tests and scans to find out the underlying cause of the pain.

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