Men and women of all ages experience sexual problems. For older persons the aging process contributes to the cause of sexual problems, Research has indicated that 43% of women and 31% of men reported having sexual dysfunction to different degrees. At the same time not many persons are comfortable discussing their sexual issues with their healthcare providers. The good news is there are many medical and surgical solutions to relieve the pain and suffering caused by common sexual complains such as sexual pain, low libido (sexual drive), and impotence. The focus of this article is on painful intercourse and the conditions which result in many women suffering (at times) in silence. It is time to break the silence.
Persistent or recurrent painful sexual intercourse is called dyspareunia. There is usually either a medical issue or a psychological cause. Dyspareunia is far more common in women than men and can occur during or after sexual intercourse. The pain can be experience in the vagina, clitoris, labia or deeper in the pelvis when there pressure is placed on the cervix. Dyspareunia can cause problems in relationships and ruin sexual intimacy. Once the underlying problem is diagnosed and treated, painful intercourse can be alleviated.
The diagnosis requires the following:
- A detailed medical interview on the painful intercourse including:
- When is the pain experienced (during or after sex)
- Where hurts (the introitus, vault or deep in the vagina), pelvic area
- Which position worsens or alleviates the pain
- Other symptoms (post coital bleeding, urinary symptoms, vaginal discharge etc.)
- A complete gynecological examination entails visual external inspection, internal inspection with a speculum and good lighting, abdominal palpation, a digital exam. If the physical exam causes unbearable pain the doctor may then just opt to skip to the diagnostic tests
- Diagnostic tests
- Pelvic ultrasound
- Vaginal ultrasound
- High vaginal swab for culture and sensitivity tests
- Pap smear
- Vaginal Dryness
Typically a woman experiences vaginal dryness as she ages. Insufficient lubrication results in pain with potential bleeding during the sexual act. For younger women the vagina is naturally lubricated by the body as a defense against infection and injury. Once an individual is sexually aroused there is extra production of lubrication to facilitate the act of coitus and minimize bruising. Water soluble lubricants are sold over the counter to alleviate dryness. Vaginal topical hormone creams are also prescribed by the doctor