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Up to 60% of women experience discomfort For 36-year-old Amy, sex with her husband had transformed from an intimate expression of love into a painful activity to be endured. For years, each time she had intercourse with her husband, Amy experienced severe vaginal burning and sharp pain. Sex between the couple – once a fun and spontaneous activity – became increasingly infrequent after the onset of the mysterious pain, which made it impossible for Amy to be the kind of wife she wanted to be. “Painful intercourse robbed my husband and me of the enjoyment of being one,” she says. “It affected my relationship greatly.” Like thousands of women across the United States, Amy suffers from dyspareunia, the medical term for painful intercourse. The condition is more common than most think. Studies indicate that up to 60% of sexually active women can suffer from varying degrees of painful intercourse at some point in their lifetime. Unfortunately, many women suffer in silence for years, never realizing there is treatment. Why does it hurt? “Painful intercourse can be caused by a number of reversible medical conditions of the female reproductive tract” says Dr. Felicia Lane, a urogynecologist at the UCI Women’s Health Care Center at UCI Medical Center. Unfortunately, many women diagnosed with dyspareunia are often bounced from doctor to doctor before a cause is uncovered. Indeed, in Amy’s case, she had visited five doctors before Dr. Lane diagnosed the underlying causes of her problem. For practitioners, uncovering a cause – or causes – of the condition is oftentimes akin to detective work. Amy’s pain was the result of a number of contributing factors. First, she suffered severe spasms of her pelvic floor muscles stemming from a difficult childbirth. Additionally, she experienced a marked decrease in estrogen at certain times of the month. Indeed, her drops in estrogen corresponded with an increase in her sexual pain. Oftentimes, the pain was so excruciating that she was unable to wear tampons during her period or to sit comfortably. On top of all that, Amy was prone to vaginal yeast infections, which exacerbated her dyspareunia. Help is available The good news is that a number of treatment options exist to lessen and even break the pain cycle for women with dyspareunia. The first step involves finding the right physician who understands the problem. Try to locate a urogynecologist or a pelvic floor physical therapist who specializes in treating painful intercourse. Getting the correct diagnosis and treatment from the right practitioner can put you on the road to recovery. A specialist might prescribe one or more treatments, depending on the diagnosis. Among the treatments are: lubricants, medication for infections or nerve pain, hormone replacement therapy, biofeedback to re-educate and relax pelvic floor muscles, internal electrical stimulation, self-treatment using vaginal dilators, an exercise program directed by a physical therapist, psychotherapy or sex therapy, and in some cases surgery. In Amy’s case, her treatment regimen includes: 1) weekly pelvic floor physical therapy at UCI to release and lengthen her pelvic floor muscles; 2) an estrogen patch worn a week before her period to help prevent the extreme hormonal drop to which she is prone; and 3) preventive medication to fight off yeast infections prior to having sex. For the first time in years, Amy is having pain-free sex. “It feels amazing to experience fully what it means to be a woman,” she says. Julie Sarton, DPT, and Patty Morita-Nagai, PT, are physical therapists specializing in pelvic floor problems at UCI Medical Center, Orange County’s only university hospital, which has been named one of the nation’s best hospitals for gynecology by U.S. News & World Report. Information: www.ucihealth.com or call toll free 714.456.2911 Why it hurts Some of the most common causes of dyspareunia, or painful intercourse, are: • Insufficient lubrication • Hormonal changes (common during menstruation and menopause) • Decreased arousal • Thinning of vaginal tissues • Surgical scar tissue • Childbirth/improperly healed episiotomies • Infections • Allergic reactions to lubricants or condoms • Vaginismus - Involuntary spasms of the vaginal muscles known as the pelvic floor. In severe cases, penetration is not possible. • Physical trauma – Falls onto the hip, back or tailbone. • Emotional trauma – A history of abuse or religious/cultural restrictions. • Chronic constipation • Fibroids and endometriosis • Retroverted (tilted) uterus • Bartholin’s gland cysts – Growths on ducts from glands in the genital area. • Vulvodynia/vulvar vestibulitis – Inflammation of tissues surrounding the entrance to the vagina. • Dermatologic conditions such as lichens sclerosis |
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