Many women come into the office seeking help due to painful intercourse. The complaint may be part of a number of issues involving problems with the bladder, bowel, or vaginal discomfort. Many times they will have been treated for infections or other conditions without success. Pain during sex may have a number of causes, and it is not uncommon to see more than one problem leading to the symptom. For menopausal women, low hormone levels take on average 4-6 years to begin to create significant problems with vaginal dryness and thinning of the tissues. This can lead to abnormal bacterial overgrowth in the vagina which further irritates the delicate tissues. Treatment of atrophy and the changed environment is important in addressing this problem. Vaginal estrogens, Osphena ®, or laser therapy (MonaLisaTouch®) may be effective to treat this problem. In addition, pelvic muscle spasms can be a significant and fairly common (but nearly unknown) cause of painful sex. Normally, the muscles in the pelvis are “silent”, and we are unaware of them. However, certain activities or trauma may lead to spasm of these muscles, which can cause a myriad of symptoms, from frequent urges to urinate, painful urination, or difficulty urinating, to difficulty with bowel movements and pain with intercourse or lower abdominal pain. Identifying this problem is vital in order to obtain relief. Appropriate treatment is aimed at relieving the muscle spasms through physical therapy and modification of activities. We have many skeptical patients who return from a course of physical therapy with joy after finally obtaining relief from their symptoms.
There are other causes of painful intercourse that should be considered and either confirmed or eliminated as possible causes. These conditions include interstitial cystitis, endometriosis, neuropathy, adhesions (scar tissue), and unusual infections, among other less common conditions. When symptoms do not resolve with a simple and straightforward treatment, proper diagnosis is the key to success. If you have experienced this problem and have not had success in finding a solution, you should seek additional help. To schedule an appointment please call 561-701-2841, or visit our webpage: www.drlindakiley.com
Linda Kiley, MD
Dr. Kiley is a Board Certified subspecialist in Female Pelvic Medicine and Reconstructive Surgery, and is also Board Certified in general Obstetrics and Gynecology.