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Nearly 75 percent of women report having pain during intercourse at some point in their lives, according to the American College of Obstetricians and Gynecologists ACOG. Women can experience pain with sex at any age and for a variety of reasons, from clinical conditions like endometriosis to the decrease in estrogen associated with menopause and the postpartum period.
Sometimes, the causes are less self-evident.
Take irritable bowel syndromefor example, which can cause shifts in the pelvic-floor muscles and lead to pain during sex, says Amy Stein, DPT author of Heal Pelvic Pain and coauthor of Beating Endo. Now, she says, that timeline is down to seven or eight years.
It makes me wonder how many women did accept it.
Pain during intercourse can lead to low or no sexual activity, which can contribute to feelings of anxiety and depression, negative body image, relationship problems, and diminished quality of life. We asked experts to explain some of the top causes of pain during intercourse for women and how to address them:.
This painful condition is the result of endometrial-like tissue growing outside the uterus in such places as the fallopian tubes and ovaries. This alone can cause pain with sex, but it can be especially painful if endometrial tissue implants in and around the vaginal canal. The in-and-out motion is very painful.
But note that some medications prescribed Women want sex Burnt Ranch endometriosis can lower estrogen and cause other problems related to pain during sex. More on low estrogen and painful sex, below. It can also be worth consulting with a functional-medicine provider, or another trusted holistic practitioner, because lifestyle strategies — like shifts in nutrition — may help ease symptoms of endometriosis when used with other strategies. Vulvodynia is marked by chronic pain, burning, or irritation around the vulva that has no identifiable physical cause.
Vaginismus is the spasming of the muscles around the vagina during sex or when inserting a tampon, and it also has no identifiable, physical cause. If you suspect you have either of these conditions, first ask your doctor to run some tests to exclude other possible diagnoses, like yeast or bacterial infections.
Treatment options for both conditions can include pelvic-floor physical therapy and local anesthetic creams. Biofeedback therapy has shown promise in helping with the symptoms of vulvodynia.
Doctors may also recommend other medications for vulvodynia, including anticonvulsants, antidepressants, antihistamines, and nerve block injections. Every area of the human body that comes into contact with the external environment has a microbiome. That includes the gut, of course, but also the lungs, skin, eyes, and vagina. When the balance of good and bad bacteria in the vagina gets thrown out of balance, it can lead to itching, irritation, and discomfort during sex.
Have your doctor test for bacterial vaginosis or a yeast infection.
Antibiotic pills and antibiotic and antifungal creams can be prescribed for vaginal dysbiosis. And like gut dysbiosis, an imbalance of bacteria in the vagina can be helped by lifestyle interventions, including reducing or eliminating sugar from the diet, taking a high-quality probiotic, and staying hydrated. Soaps with perfumes and synthetic fragrances can irritate the delicate skin in the vulva and cause contact dermatitis.
Douches present the same problem, as well as wreaking havoc on the vaginal microbiome. Experts recommend never using a douche whether you have pain with sex or not and switching to unfragranced, natural soap. Estrogen is the hormone responsible for keeping the walls of the vagina thick, elastic, and lubricated. Without it, the vaginal walls can become thin and less flexible, and vaginal dryness can be a problem.
Vaginal dryness can be addressed by anything that brings blood flow to the vagina, says Mary Jane Minkin, MD, a practicing gynecologist Women want sex Burnt Ranch a clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University. That includes foreplay, vibrators, and sex itself. It is a protective mechanism. Vaginal atrophy, which Women want sex Burnt Ranch experts now refer to as the genitourinary syndrome of menopause or GSM, has other safe and effective treatment options.
Different bodies will react to different ingredients, and it might take a few tries to find the best products for you. Data does not show an increased cancer risk for women who have a history of breast cancer who also use vaginal estrogen, according to ACOG, but the organization still advises women who are currently in treatment for breast cancer or who have a history of breast cancer to try non-hormonal remedies first.
Certain medications change the tissue integrity at the vaginal opening, says Stein, and that includes hormonal birth control. The pill fosters a high-progesterone, low-estrogen environment in the body — and, as with perimenopause and menopause, less estrogen is correlated with vaginal dryness, thinner vaginal walls, and less vaginal elasticity. IUDs tend to have less of this effect though they still can lead to symptoms for some women. If you think HBC might be contributing to pain during intercourse, talk to a d healthcare provider about alternative birth-control methods.
Women who have a history of estrogen receptor-positive breast cancer may be prescribed drugs like Tamoxifen that block estrogen from being absorbed by the body. Women with endometriosis are sometimes prescribed drugs that block the pituitary gland from stimulating the ovaries to produce estrogen these drugs are called gonadotropin-releasing hormone agonists or GnRH agonists.
These are important treatments for serious conditions, but they can result in the overall lower estrogen that contributes to vaginal atrophy. If you take one of these drugs, consult your oncologist or gynecologist or both about strategies for addressing pain during sex. Estrogen plummets after giving birth and during breastfeeding and can lead to perimenopause- and menopause-like symptoms.
Hormone replacement therapy and local hormone treatment can be considered during the postpartum period. Extreme exercise can lead to lower estrogen levels, says Drummond. If you suspect overtraining is contributing to symptoms of vaginal atrophy and pain during sex, work to add more rest days into your routine. If intense exercise has become part of your routine and you find it hard to give up for any reasonconsider working with a counselor or therapist to explore your relationship with exercise.
Same with people who have alternating constipation and diarrhea: They may reflexively tense and strain all the local muscles when their gut is giving them trouble. Pelvic-floor physical therapy can be a tremendous help when the cause of pain during sex is muscular or skeletal. As with GI pain, lower-back pain can cause sufferers to reflexively tense all the muscles in the lower part of their torso, including the pelvic-floor muscles, and that can lead to pain during sex.
Again, a pelvic-floor physical therapist can help address painful sex when the cause is musculoskeletal. Scar tissue can build up after a pelvic or abdominal surgery and contribute to pain during sex.
Any surgery can cause this for any woman, but it is especially common for transgender women who have had gender-confirmation surgery. This can be caused by nerve damage from a new or old injury, say hitting the crossbar of a bike on a recent ride or when you were a.
Physical therapy can help with clitoral pain if the musculoskeletal system is involved as it often is with injuries. Women with clitoral pain should also consult with their gynecologist or other trusted healthcare provider. Working with a good therapist can be a key part of healing emotional and sexual trauma. City and state are only displayed in our print magazine if your comment is chosen for publication.
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There are many reasons why women chronically experience pain during intercourse. Here are some of the top causes — and what to do about them. Thoughts to share? Leave a Comment. More Like This. Functional Medicine General Health. How to Support Your Vaginal Microbiome.
Functional-medicine doc and hormone expert Aviva Romm, MD, talks to us about the health effects of hormonal contraception — and what to do about it.Women want sex Burnt Ranch
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