Painful sex is a topic many women don’t talk about with their partners, let alone discuss in a doctor’s office.
You may search for answers online or worse, ignore the issue altogether, which can hurt more than just your health. Pain before, during or after sexual intercourse can affect your relationship with your partner, your self-esteem and confidence and overall, your happiness.
You are not alone
Heather Sommers, OB/GYN physician assistant with Marshfield Clinic Health System, says this condition comes up every day in her practice.
“Sexual pain can be different for everyone,” she said. “In younger women, it can be due to endometriosis or pelvic floor muscle issues. In older women, it is more commonly due to vaginal atrophy or menopausal changes.”
And sometimes, sexual intimacy concerns are related to psychological health, like anxiety or depression.
Although you may struggle talking about your sexual health, it’s important to be honest about your concerns. A routine female exam may include questions like:
- Any change in sexual partner in the last year?
- Any pain or discomfort during intercourse?
- Any concern for vaginal infection?
- Any other concerns about sexual health?
Even if your primary care provider doesn’t ask these questions, Sommers said, “Bottom-line, pain is a symptom of something, and it’s always good to listen to your body. If you are having pain or discomfort, it is important to ask what it might be and what help can be given.”
So, what happens next?
After you explain to your provider about your pain, you might be afraid of what your doctor asks next. But, answers to this next set of questions are important for your doctor to accurately provide the quality care you need. To prepare yourself for the discussion, ask yourself:
- Does the pain happen every time?
- Has there always been pain?
- Have you ever had pain free sexual activity, such as with other partners?
- Does the pain occur with other types of activity such as riding a bike, running, walking or sitting for long periods?
- What have you tried to improve the pain – position changes, lubricants?
- Describe the pain. Is it sharp, stabbing, dull or achy?
- Is the pain during or after intercourse, or both?
- Is the pain at the entrance of the vagina or more in the pelvic region, or both?
- Any history of trauma (sexual abuse, straddle injury, childbirth difficulty)?
After more discussion, your provider can help determine if it’s a lubrication issue, anatomical concern like fibroids, pelvic floor prolapse or pelvic floor muscle issue, some other etiology, such as endometriosis, or a mental health condition that’s causing you concerns or pain.
Talk to your primary care provider or OB/GYN physician about any sexual health concerns. Or, try Marshfield Clinic Health System’s Women’s Intimacy Clinic, a team specialized in sexuality and emotional intimacy.