Do you have pain with intercourse? Is this affecting your relationship with your partner? Sexual pain problems can be caused by an array of conditions and can be very disruptive to your quality of life.
Pain with intercourse can include: endometriosis, infections, problems with involuntary tightening of the vaginal muscles (vaginismus), vulvar and vaginal skin conditions such as vulvodynia or vestibulodynia amongst many other types of disorders.
The causes depend on the type of condition and are usually a combination of physical, chemical, and psychological factors. This is why it is important to take an integrative and holistic approach to find out the causes of your condition.
An examination for sexual pain should include a 360 degree evaluation including a medical and psychosocial assessment, a validated sexual pain questionnaire, a physical examination, a vulvoscopy (taking a close look at the vulva and vagina with a special lens), sensation tests involving a Q-tip to identify the tender areas, and a hormonal evaluation via a blood test if indicated.
An integrated treatment plan is then discussed and can include the following: compounded or conventional hormonal/nonhormonal treatments, pelvic floor physical therapy, neurobiofeedback, sex therapy, acupuncture, heart rate variability training, lubricants, moisturizers, meditation/mindfulness training, laser treatments, and herbs where appropriate. It should be noted that surgery is normally reserved as the last option.
I will be discussing specific conditions and their possible treatments in future blog posts.