Menstrual Changes and Painful Intercourse: A Guide for Women

Q: Menstrual Changes and Painful Intercourse: A Guide for Women

Hello, <br>1： The duration of my menstrual period has decreased from 7 days to 5 days, and now it lasts only 3 days, with a heavier flow on the first day and light spotting on the second and third days. <br>What could be the cause and how can I improve this? <br>Answer： This may

Menstruation and Sexual Intercourse

1: The duration of my menstrual period has decreased from 7 days to 5 days, and now it is only 3 days, with a heavier flow on the first day and light spotting on the second and third days.
What could be the cause and how can I improve this?
2: I experience pain during intercourse every time, although the doctor has performed a pelvic exam and found no pain, stating that there is no issue.
What could be the reason?
3: Can CIN 1 with HPV type 58 be treated simultaneously with infertility treatment? (All infertility tests are normal.) My current doctor requires two normal Pap smears before proceeding with artificial insemination, but I am currently 35 years old.
If my Pap smears continue to be abnormal and considering my age, what should I do?

I'm sorry, 30~39 year old female. Ask Date: 2009/08/20

Dr. Lü Lizheng reply Obstetrics and Gynecology

Hello,
1: The duration of my menstrual period has decreased from 7 days to 5 days, and now it lasts only 3 days, with a heavier flow on the first day and light spotting on the second and third days.
What could be the cause and how can I improve this?
Answer: This may be related to ovarian function or issues with the uterus itself.
It is recommended to have blood tests to check hormone levels and undergo an ultrasound to identify the underlying cause before proceeding with treatment.
2: I experience pain during intercourse every time.
The doctor has performed a physical examination but found no pain and stated that there are no issues.
What could be the reason?
Answer: Common causes include vaginal inflammation, endometriosis, and pelvic adhesions.
A thorough examination by a physician is necessary to determine the exact cause.
3: Can I undergo infertility treatment while having CIN 1 with HPV type 58? (All infertility tests are normal.) My current doctor requires two normal Pap smears before proceeding with artificial insemination, but I am currently 35 years old.
If my Pap smears continue to be abnormal and my age is a concern, what should I do?
Answer: CIN 1 with HPV type 58 indicates a higher risk of cervical cancer compared to the general population.
It is important to engage in regular exercise, ensure adequate sleep, wear breathable clothing, and actively treat any vaginal inflammation to strengthen your immune system against the virus.

Wishing you health and safety,
Dr.
Lu Li-Cheng, Attending Physician, Department of Obstetrics and Gynecology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2009/08/20

More Info

Understanding menstrual changes and painful intercourse can be quite complex, as they often involve a combination of hormonal, anatomical, and psychological factors. Let's break down your questions and provide some insights based on medical knowledge.

1. Changes in Menstrual Duration and Flow: It's not uncommon for women to experience changes in their menstrual cycle as they age. A decrease in the number of days of menstruation from 7 to 3 days, with only the first day being heavier, can be attributed to several factors. Hormonal fluctuations, particularly changes in estrogen and progesterone levels, can lead to lighter periods. Other potential causes include stress, changes in weight, exercise habits, or even the onset of perimenopause, which can start in the mid-30s to early 40s. To improve your menstrual flow and duration, consider maintaining a healthy lifestyle, including a balanced diet rich in iron and vitamins, regular exercise, and managing stress levels. If the changes are concerning or accompanied by other symptoms, consulting a gynecologist for further evaluation is advisable.

2. Painful Intercourse (Dyspareunia): Experiencing pain during intercourse can be distressing and may stem from various causes. Since your doctor has performed a physical examination and found no issues, it may be worth considering other factors. These can include insufficient lubrication, which can be common, especially if hormonal changes are affecting vaginal moisture. Psychological factors such as anxiety or past trauma can also contribute to painful intercourse. It may be beneficial to explore options such as using water-based lubricants, engaging in more foreplay, or even discussing the issue with a therapist specializing in sexual health. If the pain persists, seeking a second opinion or further evaluation from a specialist in sexual medicine may provide additional insights.

3. CIN1 and Infertility Treatment: Cervical Intraepithelial Neoplasia (CIN) refers to changes in the cells on the surface of the cervix, and CIN1 is considered a low-grade lesion that often resolves on its own. The presence of CIN1 does not typically preclude fertility treatments, but your healthcare provider may have specific protocols in place. The requirement for two normal Pap smears before proceeding with artificial insemination is a precautionary measure to ensure that any potential cervical issues are resolved. If you are concerned about the timeline due to your age (35), it is crucial to communicate openly with your healthcare provider. They may consider your overall health, fertility status, and the urgency of your situation. If your Pap smears continue to be abnormal, further evaluation, such as a colposcopy or biopsy, may be warranted to rule out any significant issues.
In summary, menstrual changes and painful intercourse can be influenced by a variety of factors, including hormonal changes, psychological aspects, and underlying medical conditions. It is essential to maintain open communication with your healthcare provider, seek second opinions if necessary, and advocate for your health and well-being. Regular check-ups and screenings are vital, especially as you navigate fertility concerns and any changes in your menstrual cycle.

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