Pain during intercourse : Recognizing and Treating Gynecological Disorders

Author :-

Dr.Shwetha MP

Obstetrics & Gynaecology

Introduction: Understanding Pain During Intercourse

What is painful intercourse (dyspareunia)?

Copulation-related pain is a common issue. Sometimes, this pain recurs during or after sexual activity. In any circumstance, anyone can experience such pain. The medical terminology for this pain is dyspareunia.

Common Causes of Pain During Sex

Some physical reasons for the painful copulation depend on the entrance thrust. Moreover, various types of painful intercourse often involve emotional issues.

Pain during the entry thrust: The intensity of pain during penetration depends on a wide range of factors. Some are given below:

Trauma from injury: In this case, the pain occurs owing to an accident, any pelvic surgery, circumcision, or any cut during childbirth to enhance the birth canal, medically, which is called an episiotomy.

Vaginismus: These are the muscle spasms in the vaginal wall, which cause the penetration to become painful.

Not prominent lubrication: A healthy and proper warming up before intercourse is important; without that, there is a high possibility of less lubrication, which would lead to painful sexual intercourse.

Any infection, swelling, or skin issue in the genital area can lead to painful copulation.

How Gynaecological Disorders and Pain During Intercourse

Nearly all females face gynaecological problems or disorders in their lives. Some women experience extremely painful phases, while others experience these pains during their menstrual period. In general, the pain appears in the pelvic area. Therefore, individuals sometimes misidentify it as a stomach problem or a high perirectal absence; when it comes to urinary issues, it appears to be interstitial cystitis and calculi.

However, this specific pain could be differentiated from all these dysfunctions or disorders according to their recurrence. Some gynaecological issues stand out, including irregular or massive bleeding, spotting, back pain, acute pelvic pain, and post-coital bleeding.

Vaginal Pain During Sex: Identifying the Underlying Causes

The sexual urge is not prominently aroused
Lacuna of foreplay
A partial oestrogen reduction at post-childbirth
Genital injury
Vaginal thin wall
Infection occurs in the vaginal or pelvic region
Vaginal lesion

Vaginal dryness and discomfort during sex

This issue can arise for a woman at any time. Most women are born as females, and during the post menstrual period, their oestrogen levels begin to decrease. The Estrogen levels help keep the vaginal area healthy and moisturised. Vaginal atrophy is a common menstrual condition.

Vaginal pain can be caused by infections and inflammation.

Vaginitis refers to a variety of factors that can cause inflammation or infection in the vagina. Similar to this term, vulvovaginitis also describes inflammatory issues in both the vagina and the vulva, the external part of the genitals. There are several common causes of vaginal infections. These infections can occur at any point in time during the reproductive ages or the late teens and early 40s.

Anyone can develop an infection in the vagina, irrespective of any copulation. In addition, a sexually transmitted infection (STI) differs from vaginitis.

The Role of Hormonal Changes in Pain During Intercourse

Estrogen is present in both men and women, but it is predominantly dominant in women. Therefore, when the oestrogen level begins to decline, both the sexual urge and the intensity of pain tend to decrease. When pain arises after sexual activity, the hormone cortisol, responsible for stress, begins to release. These might affect the serotonin and dopamine hormones, which are responsible for moods.

Bleeding During and After Intercourse: What It Means

Understanding the causes of bleeding during sex

Bleeding during sexual intercourse or menstruation can occur for various reasons. Changes in hormones, the development of small polyps or fibroids, and sexually transmitted infections such as Chlamydia are all potential causes.
Additionally, the surface of the cervix changes, leading to cervical ectropion and a parched vagina.

When to Seek Help for Bleeding After Intercourse

First, understand the reason behind the bleeding. To figure it out, it is important to visit a healthcare expert, who is a specialist in such cases. So, the moment a female starts feeling extreme pain and if she had sexual intercourse before that pain occurred, then it is high time to seek help. The expert may request the patient's medical history, and may also prescribe certain blood tests to identify the issue.

Recognising gynaecology problems and symptoms

Common gynaecology problems affect sexual health.

The sexual response cycle in females is complicated. There are numerous overlapping dimensions in the sexual response cycle, with the physiological appeal of the binder serving as the foundation for dysfunctionality. Some of the issues include difficulties with orgasm, vaginal shortening, lymphoedema, sexual dissatisfaction, hysterectomy, and genital stiffness.

Key Symptoms of Gynaecological Disorders to Watch For

The vagina is experiencing constant itching and a burning sensation.
Completely change the amount of vaginal discharge.
A burning feeling while urinating
Spotting in the vagina
Excessive vaginal bleeding
Pain while penetrating during intercourse
Colour-changing vaginal discharges

Gynaecological Disorders Symptoms: Identifying Warning Signs

Soreness in the vulva
The vaginal wall tissue breaks immediately after the intercourse, causing bleeding.
No more sexual urges
Recurrent vaginal pain
Feeling like there is a vaginal lesion

Pelvic Inflammatory Disease (PID) Symptoms in Women

The infection can affect one or multiple reproductive organs, including the uterus, fallopian tubes, and ovaries. Some females may not exhibit any symptoms, while others may experience mild to severe pain in the abdomen and pelvis. Experiencing pain during sexual activity, experiencing a fever immediately following copulation, and encountering difficulty or burning discomfort during urination are all possible symptoms.

Recognising endometriosis, fibrosis, and other gynaecological disorders

If any woman observes any disorders, it is important to acknowledge them.

Painful menstruation for a longer period.
Bloating
Pelvic Pressure
Blood while urinating.

The impact of infections and STDs on sexual health

STDs can lead to a variety of issues, including prolonged illness. The immediate effect on health after it is less urge for intercourse, some syndromes, such as neurological problems, cardiovascular disease, potential deficiency, pregnancy hindrances, ectopic pregnancy, and most dangerously vulnerability to being exposed to HIV.

Painful Sex Causes: From Physical to Psychological Factors

Physical Causes of Painful Sex (Dyspareunia): Psychological Factors Contributing to Discomfort During Intercourse

The most common issue is sexually transmitted diseases, but there are numerous other issues as well.

Previous history of injury: During the post-delivery period, women typically experience small tears inside the vagina, which are expected to heal over a certain period.

Herpes in the genital area: It is caused by swelling and blistering, and it can lead to a painful penetration during intimacy.

Women mostly experience lower levels of oestrogen during the post-menstrual period. This issue leads to thin vaginal lines, which become less stretchable.

Lichen Sclerosus: This condition causes the skin in the genital area to become scaly and swollen.

Anxiety: In most cases, females experience anxiety attacks due to the intense pain they experience after sexual activity.

Depression: Recurrent anxiety can become a pattern, causing thoughts to spiral out of control, ultimately leading to severe depression in women.

Loss of intimacy urge: Due to the previous painful experience, the female has lost interest in having intimacy, and that leads her to a miserable relationship.

Diagnosing the root cause of pain during sex

Diagnosis is an essential step in identifying the problem. Exams are conducted to comprehend these issues.

During the pelvic examination, the doctor looks for structural abnormalities and signs of infection. A doctor gently presses the genital and pelvic muscles to determine disease location and assumption.

Pelvic Ultrasound: This pelvic ultrasound helps detect the abnormality in terms of structure. Additionally, it can identify diseases like endometriosis, fibroids, or cysts.

Treating Painful Intercourse: Medical and Natural Remedies

Gynaecological Treatments for Painful Intercourse

Medicine is an imperative part of treating this disease. The Food and Drug Administration, USA, approved a drug named ospemifene in the year 2013. The recommended daily dose was 60 mg.

Home remedies and lifestyle changes for reducing vaginal pain

The first and foremost goal is to bring about changes in sexual behaviour.

Water-based lubrication
Communicating properly with the partner
Comfortable intercourse posture
Prioritise each other during intimate moments.

Kegel contractions: This exercise might help strengthen the pelvic muscles. Squeeze the muscles for 10 seconds, then immediately relax them. This could help to reduce the pain itself.

Medications and Therapies to Address Underlying Gynaecological Disorders

Some drugs that require a proper prescription are listed below.

ertapenem
Invanz
cilastatin/imipenem
Primaxin IV

Preventing pain and discomfort during sex

Don't rush
Proper positioning
Talk to the partner.
Understanding partners requirements
The use of lubricants

Best Practices for Maintaining Gynaecological Health

The gynaecologist's follow-up is crucial. Reducing stress and managing it with proper scheduling can help in terms of day-to-day life. Steer clear of junk food, particularly those that trigger allergies. Practising safe intercourse is one of the core values to maintain gynaecological health.

The role of communication and emotional well-being in sexual health

Communication is crucial in this situation. Effective communication can thrive in every moment of a relationship. The moment both partners connect emotionally, they tend to be in healthy intimacy, even if it does not go as planned.

Relationship equilibrium: Quality matters when it comes to a relationship. Quality is the only key, which can unlock the hurdles between intimacy.

Empathy: If the female partner is having recurrent pain after the intercourse, then it is of utmost importance to take care of her mental well-being. The first step should come from the male apartment itself.

Psychological therapy or a psychiatrist may be necessary if a couple experiences recurring intimacy issues due to the post-intimacy pain of the female partner, as this could potentially impact their mental health. Then it is high time to visit a mental health expert, who can treat or counsel as per the couple’s need or the female’s requirement.

Regular Gynaecological Check-Ups: Key to Early Detection and Treatment

Regular follow-up is crucial to identify any developments or new symptoms that a layperson, such as a female, may not initially understand or experience.

Conclusion

Pain is a part of life, and vaginal pain is a part of sexual intimacy. But no pain should be dragged for the sake of stigma. Rather, the stigma should be eradicated. Communication with the partner and proper follow-up with the gynaecologist are important. In both cases, the male partner has a crucial role to play, which is to help the female partner understand her pain. If she requests a break from intimate time, the male partner should respect her request.

FAQ

1. Should I visit a doctor if I face vaginal pain without intercourse?

Indeed, even if a woman hasn't had an intimate relationship but still experiences vaginal pain, it's a concerning symptom that requires professional attention.

2. Could this result in abnormal sexual behaviour?

In this case, it is impossible to definitively answer yes or no. Every female has a unique experience immediately after intimacy due to their unique physiological patterns. However, gynaecologists do not recommend unusual sex experiments, which can lead to vaginal pain.

3. Can I have anxiety after this?

In most cases, anxiety develops over time due to recurrent pain experiences.

4. Can this lead to a messy relationship?

Indeed, improper care can significantly impact a relationship.

5. Which drugs are recommended to reduce such pain or treatment?

Here, ibuprofen has a good role to play in reducing acute pain. Ibuprofen has antimicrobial activity. This medication possesses strong antimicrobial properties, particularly targeting Gram-negative strains. Additionally, ibuprofen disrupts the adhesion of Gardnerella vaginalis and Candida albicans to the vaginal epithelium.