How to manage intense pain during sexual intercourse?

Question

Hello doctor,

I need some advice on an ongoing problem that has my doctor stumped. I am experiencing intense pain during sex, to the point that it often entirely prevents intimacy. This has been going on for about 12 months. The pain is consistently in the same spot, just behind my hymen to the right. It is not cervical or abdominal, does not shift, and is not linked to any vaginal contraction.

It is worse immediately upon penetration. I am a lady with a very high pain tolerance, but initial penetration has me screaming/throwing my partner off me at the moment. If I am able to battle through the first minute or two, it starts easing. I am not generally intensely sore (beyond the usual little ache) after sex.

Whatever it is does not usually make itself known outside of sex (even when I sit down hard or use the bathroom), although there have been perhaps four to five little twinges over the past 12 months when I have been walking around.

I have had two doctor appointments about this previously. First, I went through full STD testing to eliminate a disease or infection, but all tests came back clear, including BV. On the second appointment, I went in for a Pap smear and visual inspection of the spot. Pap smear was negative, and the doctor was only able to say that she could see a 'pink irritated area' in the location.

I described the pain as being centered, with no cysts, polyps, tumors, notable textural difference, cuts, scarring, or injury to my hymen. I am self-lubricating relatively normally and using lubricant when I do not. I am not experiencing any contractions upon penetration.

The painful spot is consistent whether I am with a partner/using a sexual aid/touching it with my fingers. It does seem to ease somewhat when it has been seven or more days since I have had a sexual encounter, but every time after the first time following a break, it is as painful as ever.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

What you seem to be suffering from is vaginismus, where the pain is related only to the initial penetration and not due to any organic cause. The cause of vaginismus is either that the vaginal muscles are too taut, or you are not sexually excited enough before the act. And also, the vaginal opening may be slightly small.

So, I suggest using alternatives to widen the opening before penetration is practiced. This problem generally goes away after delivery when the vagina is stretched. So, the same can be mechanically applied in privacy, and I am sure you would benefit.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.