Expert: Inna Apolikhina, Doctor of Medical Sciences, Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology of the I.M. Sechenov First Moscow State Medical University. Head of the gynecological department of rehabilitation treatment and day hospital of the Federal State Budgetary Institution "Scientific Center of Obstetrics, Gynecology and Perinatology named after Kulakov" under the leadership of Academician G. T. Sukhikh.
Women face this problem more often than men. According to statistics, every third person knows about this first-hand. There can be many reasons for such pain - both physiological and psychological. The manifestations are also varied - from sharp and stabbing to pulling. In any case, you should not endure it, and if unpleasant sensations appear, the first thing you need to do is run to a gynecologist in order to rule out dangerous diseases and, of course, get rid of discomfort. Let's look at the most common causes of pain during sexual intercourse.
Not ready, what's wrong?
Feel
During penetration, pain occurs, a feeling of tightness and unpleasant friction during friction. After sex, the vagina becomes inflamed or irritated.
Probable Cause
Insufficient lubricant release. Sometimes this happens simply because the woman is not aroused. Perhaps the foreplay is too short. In this case, the problem can be solved without a doctor. However, vaginal dryness can also be caused by taking oral contraceptives, breastfeeding and menopause. In this case, the reason is a decrease in the level of estrogen in the blood, this leads to a sharp thinning of the vaginal mucosa, it becomes susceptible to damage and painful sensations may occur during sexual intercourse. Inna Apolikhina notes that from the age of 30, women’s levels of sex hormones decrease by 1–3% annually; by the age of 50, the drop in hormones is 20%. But this is not scary, the doctor can prescribe suitable medications, estrogen-containing creams, suppositories, various moisturizing substances based on tea tree extracts and extracts, and PH-neutral lubricants. All this helps to moisturize the mucous membrane and reduce discomfort.
Treatment
Treatment of coitophobia
To eliminate such a problem, you no longer need to consult a gynecologist, but a psychiatrist or psychotherapist:
- A thorough conversation is required to find out the cause, the factor that begins to frighten the woman, etc. In most cases, she may only need psychological help.
- To eliminate coitophobia, it is possible to prescribe herbal preparations that have a sedative effect, these include chamomile, mint, motherwort, etc.
- Methods of therapy and stress relief include massage, hypnosis , etc.
- In severe cases, it is possible to use antidepressants.
- If necessary, gradually dilate the vagina. Sometimes a herbal group of sedatives, muscle relaxants, as well as tranquilizers and painkillers can be used for this method.
- In some cases, surgical intervention may be required , aimed at the process of surgical defloration.
Treatment of vaginismus-like disorder
To reduce or completely eliminate pain during sexual intercourse, treatment is aimed at eliminating the initial pathology:
- For various structural anomalies, consequences of surgical interventions, such as adhesions and scar processes, the use of a surgical method of treatment is required.
- During the inflammatory process, appropriate therapy is necessary.
- The atrophic process can be eliminated by applying a lubricant before sexual intercourse or long-term treatment with local hormonal agents that promote the production of secretions by the body’s own glands.
Treatment for spinal injuries
Treatment of pain during sexual intercourse associated with traumatic injury to the spine involves eliminating pathology from the spinal column.
If the process is acute, has arisen recently, but is accompanied by a certain clinical picture, then it requires mandatory surgical intervention.
In case of damage that occurred earlier, surgical intervention is usually futile, since changes have occurred at the morpho-functional level.
Treatment for organ deformation
Treatment in this case is a controversial issue, since in cases of physiological deformations of the organ, treatment may not be used, since there is no exact method for it.
There is a possibility of an independent change in shape after the onset of natural childbirth. In the event of a tear of the ligamentous apparatus, it is necessary to use an operative method aimed at restoring integrity.
Also, to reduce the severity of pain during sexual intercourse, you need to change your lifestyle with the exception of physical activity, as well as heavy lifting, etc.
Treatment of pain during adhesions
As a treatment for pain due to adhesions in the pelvic organs, repeated intervention aimed at releasing adhesions - laparoscopy - can be used. Rehabilitation is a prerequisite for this treatment. It is carried out using medications aimed at resolving possible fibrin deposits.- In addition, early inclusion of physical activity is mandatory. To do this, the patient is recommended to get out of bed as early as possible and start walking without heavy physical exertion.
- Preventive anti-inflammatory therapy is also carried out to eliminate possible tissue swelling and re-adhesions.
Treatment of pain due to cystitis
You can eliminate pain during sexual intercourse associated with cystitis quite easily:
- For this purpose, a large number of herbal remedies with antiseptic and anti-inflammatory effects are prescribed. Such drugs are available in a wide range and have fewer side effects.
- Antibacterial agents can be used as etiopathogenetic therapy.
- Antispasmodics and analgesics are used to reduce pain.
Treatment for endometritis
Endometritis, regardless of the severity of the process, is subject to mandatory treatment.
It includes the use of drugs from various groups:
- Among them, antibacterial agents may be based. These are broad-spectrum drugs, preferably in combination of several multidirectional mechanisms of action. The course of therapy is selected taking into account the life periods of various forms of the pathogen, on average it is 14 days, it can reach 21 days.
- Along with antibiotics, the use of general nonspecific anti-inflammatory drugs, as well as non-steroidal anti-inflammatory components, is recommended . Forms of application can be different; in acute cases, injectable forms are recommended, as they have greater bioavailability. While in chronic cases, tablets are sufficient.
Treatment of pain due to colpitis
Treatment of colpitis should be carried out with an exclusive identification of the causative agent of the pathological process. Only after this are medications prescribed taking into account sensitivity to this pathogen.
It is worth noting that the funds can be used systemically or locally:
- Among local remedies, the most popular are suppositories, which contain a combination of different groups of drugs.
- , antimicrobial or antimycotic agents are used to treat pain during sexual intercourse
- After the main course, it is recommended to carry out therapy aimed at restoring the flora in the vagina.
Danger signal
Feel
Wandering pain in the perineum or lower abdomen, frequent urge to urinate, painful urination, and itching may also be observed.
Probable Cause
Urinary tract infections (UTI). Many of them can cause inflammation or neoplasms that provoke discomfort during sexual intercourse, for example, genital warts form on the external genitalia (a consequence of the human papillomavirus). Herpes and trichomoniasis can also cause pain. Such BMIs not only cause inconvenience in your personal life, but can also lead to infertility and even the development of malignant tumors. The sooner a diagnosis is made and treatment is prescribed, the greater the chances of a successful outcome. And of course, after therapy the pain should disappear.
You annoy me!
Researcher Michael Caroll from the University of Manchester, after long-term observations, discovered that itching, burning, pain, inflammation of the mucous membrane after sexual intercourse in 12% of cases is caused by a banal allergy to the sperm of the chosen one! The symptoms are similar to those of sexually transmitted diseases or thrush, but they occur about an hour after sex or immediately, rather than weeks later. In this case, it is enough to undergo a course of treatment with special drugs and you can forget about the problem.
Pathologies of the urinary system
A number of diseases of the urinary system are characterized by chronic pelvic pain
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| Disease | Clinical manifestations | Diagnostics | Treatment |
| Nephroptosis | Moderate pain that is aching in nature at the initial stage of the disease. As it progresses, it spreads to the abdominal area and intensifies, becomes permanent, and is accompanied by the appearance of blood in the urine. |
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| Chronic cystitis | A symptom of pelvic pain, which is accompanied by the urge to urinate frequently, accompanied by unpleasant sensations and blood in the urine. |
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| Congenital malposition of the kidneys - dystopia |
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| Urolithiasis disease |
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No entry allowed
Feel
When excited, throbbing pain occurs in the labia. Sometimes it can be so strong that sexual intercourse is simply impossible. You can also feel lumps near the entrance to the vagina.
Probable Cause
Bartholinitis is an inflammation of the Bartholin glands (they are located on the inner labia and are responsible for the secretion of lubricant during sexual arousal), while the channels become clogged and swelling and discomfort appear. Similar symptoms are observed with glandular cysts; if they appear on both sides, then entry into the vagina will be extremely difficult. In this case, you need to contact a gynecologist as soon as possible.
Contributing Factors
Healthy men are recommended to undergo a preventive examination by a urologist once a year. Associated factors require more regular examination - once every 6 months. These factors include:
- sedentary lifestyle with congestion in the pelvis;
- diabetes;
- hypothermia;
- foci of chronic infection in the body, carriage;
- disharmony of sexual activity: unstable relationships, frequent interruption of sexual intercourse, regular change of partners.
Urological diseases in a family history are another indication for regular preventive examination.
Just not there
Feel
With deep penetration during sexual intercourse, sharp pain is observed on the right or left. During menstruation, a pulling sensation may also occur in this place.
Probable Cause
Ovarian cyst. This is a benign formation (a cavity with thin walls filled with liquid). It can be detected using ultrasound. The doctor will prescribe appropriate treatment and possibly laparoscopy. When having sex, until the problem is resolved, it is better to choose positions that allow you to control the depth of penetration - for example, “woman on top”.
Not true to size
There is an opinion that pain may occur due to a discrepancy between the sizes of the penis and vagina. This is very rare, since the vagina is very elastic and easily adapts to shape and length.
Methods for diagnosing pain during intimacy
Pain during sex in women is not normal. If this symptom occurs regularly, it is important to seek help from a gynecologist. In the absence of timely treatment, a number of pathologies can progress, and other symptoms will be added to the discomfort.
At the initial appointment, the specialist will collect anamnesis, carefully listen to the patient’s complaints and conduct an examination in a gynecological chair. Additionally, laboratory and instrumental techniques may be prescribed:
- testing for sexually transmitted infections. If latent sexually transmitted infections are suspected, smears are taken from the vagina and cervix (the study is carried out using the PCR method);
- Ultrasound of the pelvic organs. This is a simple and safe method that does not require special training. With its help, a specialist can assess the structure and size of the ovaries, uterus and its cervix, detect foci of endometriosis, the presence of follicles and neoplasms (cysts);
- colposcopy. It involves a visual examination of the cervix, vagina and vulva under a microscope. The technique allows us to identify various pathologies of the mucous membranes of the genital organs;
- hysteroscopy. This is an examination of the cervical canal and uterine cavity using a special optical system. It is performed if endometriosis is suspected.
By-effect
Feel
Throbbing or spasmodic pain in the lower abdomen. Sharp, piercing and radiating into the leg.
Probable Cause
Any inflammation in the back, pelvis, muscles, tendons or nerves, diseases of the spine, intervertebral hernia can cause similar sensations.
In any case, even if this is precisely the problem, it is worth starting an examination with a gynecologist to rule out varicose veins in the pelvic area (the symptoms are similar). In addition, the doctor will tell you which specialist you should contact.
And men too
Like women, they may experience pain during sexual intercourse. There are many reasons for this, but most often it is due to infectious diseases. With inflammation of the glans penis, with balanoposthitis (the head does not open, the foreskin is motionless), sex turns into torture, as with the appearance of genital warts. But itching and burning can be caused by an allergy, for example, to latex.
No need for feats
Do not forget that pain is, first of all, a warning signal about disorders in the body, and you should not “endure for the sake of love.” When a woman bravely endures unpleasant sensations, the mucous membrane becomes inflamed and only gets worse. This is reflected in everyday life. Gynecologists note that such troubles often provoke increased irritability and lead to psychological problems. In addition, if the cause is infection, such heroism can lead to infertility. Therefore, you cannot waste time and put off visiting a gynecologist and treatment. Self-medication in this case is unacceptable.
Author: Maria Veselova Published: September 14, 2016
