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Pain Disorders Affecting Sexual Health

Sexual disorders fall into several categories, including libido or desire disorders, orgasm disorders, arousal disorders, psychological disorders, and more. This page will focus on pain disorders related to sexual health.

Pain disorders that affect sexual health are unique in that they cause pain during sexual intercourse or pain related to sexual intercourse. Pain may be experienced in different ways and at different times during or after intercourse. For example, you may have pain:

Only upon entry/penetration

With each penetration, which could include something as simple as putting in a tampon

Only with certain movements, such as deep penetration

Pain may be burning, aching, or throbbing, and it may last only a short time, or it could last many hours after intercourse. 

Common pain disorders related to sexual health include:

  • Vaginismus 
  • Dyspareunia (painful sexual intercourse) can be caused by:
    • Atrophic vaginitis
    • Vestibulodynia (vulvar vestibulitis syndrome)
    • Interstitial cystitis (painful bladder syndrome)
    • Pelvic floor hypertonus
    • Vulvar dermatologic conditions
    • Endometriosis
  • Vulvodynia (chronic vulvar pain)
  • Vaginal dryness
  • Peyronie's disease 

How are pain disorders related to sexual health diagnosed?

Painful intercourse is often the most prominent symptom in all conditions that can cause pain during sex. To get to the root cause of the problem, doctors will start ty taking a thorough medical and sexual history, which will involve asking you a lot of questions about your health, your sexual history, and your symptoms. A pelvic exam will likely be part of the diagnosis process as well, and your doctor may order tests, like an imaging test or blood tests, to help diagnose the underlying cause of pain.

What are the tests to diagnose pain disorders?

Once your doctor has an idea about what may be causing your pain, he or she may order tests to help get a definitive diagnosis. Tests that can help diagnose pain disorders include:

  • Physical and visual exams to check pelvic floor function and look for obvious physical causes of the pain
  • Lab tests, such as a blood test, urinalysis, or tests to check for sexually transmitted diseases or yeast infections
  • A transvaginal ultrasound
  • An MRI or CT scan of the abdomen and pelvis
  • X-rays

How do pain disorders happen? Can they be avoided?

There are many possible causes of pain disorders that can cause pain during sex. There are a few general causes of painful sex, including:

  • Vaginal dryness – When the vagina isn’t well lubricated, it can lead to painful intercourse. There are many reasons women experience vaginal dryness, but fortunately, there are also many lubricants that can help. 
  • Vaginal infections and sexually transmitted diseases often cause the vagina to be irritated and itchy. The friction of intercourse can further irritate the skin and cause pain. Urinary tract infections and yeast infections can be cured with medications, and many sexually transmitted infections can be cured or treated, making them manageable. 
  • Vaginismus is a pain disorder that involves involuntary contraction of the muscles in the vagina during penetration. It can be caused by either physical problems or psychological trauma. To effectively treat vaginismus, your doctor will have to have a clear understanding of the cause.
  • Atrophic vaginitis, also known as vaginal atrophy – Some women experience inflammation, drying, and thinning of the vaginal walls as estrogen levels drop in the body. This can lead to painful intercourse. It tends to occur in women after menopause.
  • Vulvodynia – This is a condition that causes chronic pain in the vulva and sometimes elsewhere in the pelvic area. It can be localized or generalized. Most women who have vulvodynia experience what is called provoked vestibulodynia (PVD), which is pain when pressure is applied around the vaginal opening.
  • Pelvic floor hypertonus is a condition characterized by constant contraction of the pelvic floor muscles, which can make intercourse difficult and painful.
  • Allergic reactions can cause irritation that may be painful. You may be allergic to soaps, detergents, the maxi pads you use, or even the condoms (which is often a latex sensitivity). 
  • Psychological causes – Some pain disorders related to sexual health, like vaginismus, can sometimes be caused by psychological conditions or trauma. Anxiety, depression, and a history of abuse can all contribute to sexual pain disorders.
  • Other health conditions, such as endometriosis can cause painful intercourse, as can hemorrhoids. 

Some pain disorders may be preventable. For example, if women treat vaginal infections or irritation promptly, pain related to those infections may be preventable. Vaginal dryness can cause sexual pain, and if it does, the pain can often be prevented by using plenty of lubrication during intercourse. Pain disorders that are related to an underlying medical condition, such as endometriosis, may be prevented by treating the underlying condition promptly. Some pain conditions related to sexual health are caused by a lack of estrogen. Those conditions could possibly be prevented with hormone replacement therapy. Pelvic floor physical therapy may also help prevent some causes of pain during intercourse. Women who have experienced sexual abuse may be able to prevent sexual pain disorders by working with a therapist to address their past and the trauma related to the abuse. 

Who is most likely to experience pain disorders related to sexual health?

Women of any age can experience pain disorders. Men can also experience pain disorders (such as Peyronie’s disease). Disorders related to lack of estrogen, such as atrophic vaginitis, most likely occur in women who have experienced menopause. 

What do treatment plans look like?

Treatment plans for sexual pain vary greatly depending upon the cause of the pain. Before any treatment can be prescribed, your doctor will have to understand what the underlying cause of the pain is. To gather that information, your doctor will talk to you about your medical and sexual history and will do a physical exam. You may also need to have tests to get a proper diagnosis.

Your treatment may involve the use of lubricants, medication (such as antibiotics to treat infections), hormone replacement therapy, pelvic floor physical therapy, Kegel exercises, vaginal dilation exercises, surgery, and mental health therapy.

What types of doctors treat pain disorders related to sexual health?

There are a few types of doctors that treat pain disorders. Which doctor is right for you will depend on your condition and the cause of the pain during intercourse. If your condition is related to dysfunction of the pelvic floor muscles, seeing both a urogynecologist and pelvic floor physical therapist may be best for you. Some causes may be treatable by an OB/GYN. If psychological trauma or mental health conditions are the root cause of your pain disorder, you may also want to work with a psychologist or licensed therapist who has experience treating your specific condition. 

If you have questions about which type of doctor you should see, you’d like to make an appointment with a Beaumont specialist, or you need a referral, call 800-633-7377 today.