Pain with Sexual Activity

Do you have pain with sexual activity?  You are not alone; pain with sex is more common than you’d think, and it can occur in women of all ages.

Sexual pain can result from decreasing estrogen levels as we get older. This can cause vaginal dryness that makes intercourse painful.  Vaginal dryness and sexual pain often cause women to avoid sexual activity.  Many women who report decreased libido have pain as the cause.  Vaginal dryness can also occur in women who use hormonal birth control, such as pills, patches, or rings.  There are non-hormonal vaginal moisturizers and sexual lubricants that can help with dryness and pain.  If these do not provide satisfactory relief, then low-dose vaginal estrogen treatment is very helpful.

Another cause of pain with intercourse is involuntary pelvic floor muscle spasms. When there is fear that intercourse will be painful, the mind-body connection can cause tense and painful contractions of the pelvic floor muscles.  This pain is like the pain caused by spasms in other muscles, like your back or your calf muscles.  Fortunately, there are women’s health physical therapists that can help you overcome this.

Dr. Clark has helped many women overcome sexual pain. The process starts with a comprehensive history and physical examination, followed by laboratory testing if needed, and then appropriate treatment can be started.  If the vaginal lining is thin and dry, then biologically identical (bioidentical) vaginal hormone therapy can be prescribed.  If pelvic floor muscle spasm is the problem, she will refer you to a women’s health physical therapist.  Some women have both vaginal dryness and pelvic floor muscle spasm, and a coordinated team approach is needed.

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