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I recently received this question in my inbox: Why does it burn and itch during sex?

Unfortunately ladies there are many of us that are too ashamed to admit that we are having painful intercourse. Perhaps we are too afraid to share this information with our partners or we think there is something we are doing wrong. This is a question I have been receiving quite often and I would like to hopefully provide some information that will help someone in the future.

Physical causes of painful intercourse tend to differ from woman to woman. Here are some of the most common causes:

Vaginismus. A common condition in which there is a spasm in the vaginal muscles, mainly caused by the fear of being hurt. This is why it is very important that you relax, which can be difficult if it is your first time or you have preconceived notions about what is going to happen.

Vaginal infections. These conditions are common and include yeast infections.

Problems with the cervix (opening to the uterus). In this case, the penis can reach the cervix at maximum penetration, so problems with the cervix (such as infections) can cause pain during deep penetration. There is also a possibility that his penus is too big for you.

Problems with the uterus. These problems may include fibroids that can cause deep intercourse pain.

Endometriosis. A condition in which the endometrium (tissue lining the uterus) grows outside the uterus.

Problems with the ovaries. Such problems might include cysts on the ovaries.

Pelvic inflammatory disease. The tissues deep inside become badly inflamed and the pressure of intercourse causes deep pain.

Ectopic pregnancy. A pregnancy in which a fertilized egg develops outside of the uterus.

Menopause. The vaginal lining can lose its normal moisture and become dry. It is very important if you do not take hormone replacement that you use a lubricant during intercourse in case you are experiencing vaginal dryness. This is also the reason that foreplay is very important so that your body can prepare for penetration.

Intercourse too soon after surgery or childbirth.

Sexually transmitted diseases. These may include genital warts, herpes sores or other STD

 

Injury to the vulva or vagina. These injuries may include a tear from childbirth or from a cut (episiotomy) in the perenium (area of skin between the vagina and the anus) that is made during labor.Those are some of the physical factors that can cause some women to have pain during intercourse. The  other type of problems that some women experience is entry pain, pain during penetration. This may be associated with a range of factors, including:

Insufficient lubrication. This is often the result of not enough foreplay. Insufficient lubrication is also commonly caused by a drop in estrogen levels after menopause, after childbirth or during breast-feeding. In addition, certain medications are known to inhibit desire or arousal, which can decrease lubrication and make sex painful. These include antidepressants, high blood pressure medications, sedatives, antihistamines and certain birth control pills.

Injury, trauma or irritation. This includes injury or irritation from an accident, pelvic surgery, female circumcision, episiotomy or a congenital abnormality.

Inflammation, infection or skin disorder. An infection in your genital area or urinary tract can cause painful intercourse. Eczema or other skin problems in your genital area also can be the problem.

Vaginismus Involuntary spasms of the muscles of the vaginal wall (vaginismus) can make attempts at penetration very painful. Deep pain usually occurs with deep penetration and may be more pronounced with certain positions. Causes include: • Certain illnesses and conditions. The list includes endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, hemorrhoids and ovarian cysts.

Surgeries or medical treatments Scarring from surgeries that involve your pelvic area, including hysterectomy, can sometimes cause painful intercourse. In addition, medical treatments for cancer, such as radiation and chemotherapy, can cause changes that make sex painful. Emotional factors: Emotions are deeply intertwined with sexual activity and may play a role in any type of sexual pain. Emotional factors include:

Psychological problems  Anxiety, depression, concerns about your physical appearance, fear of intimacy or relationship problems can contribute to a low level of arousal and a resulting discomfort or pain. • Stress. Your pelvic floor muscles tend to tighten in response to stress in your life. This can contribute to pain during intercourse.

History of sexual abuse Most women with dyspareunia don’t have a history of sexual abuse, but if you have been abused, it may play a role. Sometimes, it can be difficult to tell whether psychological factors are associated with dyspareunia. Initial pain can lead to fear of recurring pain, making it difficult to relax, which can lead to more pain. As with any pain in your body, you might start avoiding the activities that you associate with the pain.

Sexual intercourse is an important part of a relationship and it should be enjoyed by both partners. Ladies, it is very important that you communicate with your partner and let them know if you are experiencing any discomfort or pain. It may be something he can do differently or it may be something you need to see a doctor and talk to them to figure out exactly what is the problem and how it can be treated. Rest assured that there is a treatment and you will be cured. If you have any questions please Ask Dr. Renee.

 

Dr. Renee Matthews has appeared on television shows such as “The Oprah Winfrey Show” and WGN’s “People to People”  where she discussed different health topics. She started her media career with her own radio show on ReachMD, a programming source for health professionals. In addition Dr. Renee has been a featured medical correspondent on Sirius XM’s “Sway in the Morning.” 

Dr. Renee earned her undergraduate degree in 1999 and her Medical Doctorate in 2005. She spent the early part of her medical career as an educator for numerous hospitals and attending staff on cord blood. 

Twitter: @AskDrRenee

Facebook.com/AskDrRenee

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