Pain During Intercourse: Causes and Solutions for Women

Q: Pain During Intercourse: Causes and Solutions for Women

Hello, Xiao Hong： 1. RU-486 generally does not cause thinning of the vaginal wall; this is mostly congenital. If this were the cause of the symptoms, it would likely have been evident earlier. 2. Clinically, phimosis should not cause these symptoms; urologists a

There is a persistent issue of pain during the process of intercourse?

Hello Dr.
Chang, my wife and I have been married for over ten years.
Throughout this time, my wife has experienced pain during intercourse (the pain primarily occurs inside the vagina, not at the vaginal opening), which has led to a significant decrease in her interest in sexual activity.
Recently, we visited both a gynecologist and a urologist for relevant examinations, but I still have some questions I would like to ask you.
1.
After an internal examination by the gynecologist, it was found that my wife has a relatively thin vaginal wall, but there were no significant organic issues.
I recall that my wife had taken RU486 for abortion three times during her previous relationship (she did not mention this to the gynecologist).
Could the thinner vaginal wall be a result of self-induced abortions? Are women with thinner vaginal walls more likely to experience pain during intercourse?
2.
I personally have a mild curvature of the penis and phimosis.
After examination by the urologist, he informed us that the degree of curvature is quite mild and is unlikely to be the cause of the pain.
The gynecologist also simulated the curvature during testing and found no pain, only discomfort under heavy pressure, which does not occur during intercourse.
Therefore, we initially ruled out curvature as a factor.
Could the pain be related to phimosis (where the foreskin does not retract past the coronal sulcus, creating a ring of tissue)? My wife's previous boyfriend did not have this issue, so she did not experience pain with him.
However, the urologist mentioned that he has not encountered such cases in his clinical practice and could not guarantee that a circumcision would improve the situation.
Dr.
Chang, have you encountered similar cases in your clinical experience?
3.
A few days ago, we tried the suggestions provided by the doctor, which included using ample lubricant and elevating the hips.
After trying this, the pain was reduced by half.
I would like to ask if there are any other methods to improve this issue besides these two approaches? Additionally, if lubricant is not cleaned off immediately after use, could it cause any adverse effects on the body?
Thank you, Dr.
for patiently reading through my questions.
I hope you can provide answers and suggestions for someone who is filled with confusion.
Thank you very much.

Xiao Hong, 30~39 year old female. Ask Date: 2010/04/29

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, Xiao Hong:
1.
RU-486 generally does not cause thinning of the vaginal wall; this is mostly congenital.
If this were the cause of the symptoms, it would likely have been evident earlier.
2.
Clinically, phimosis should not cause these symptoms; urologists are more likely to encounter this issue.
3.
Generally, legally approved lubricants should not have adverse effects.
I recommend using a third method combined with slow, gradual steps (patience leads to perfection) along with psychological relaxation and support, as this is more likely to resolve your issue.
Thank you!

Reply Date: 2010/04/29

More Info

Understanding pain during intercourse is a multifaceted issue that can stem from various physiological and psychological factors. In your case, it seems that your wife has been experiencing vaginal pain during sexual intercourse for an extended period, which has understandably affected her interest in sexual activity. Let's address your questions one by one.

1. Thin Vaginal Walls and Past Abortions: It is indeed possible that the history of multiple abortions, especially if they were performed without proper medical supervision, could contribute to changes in the vaginal wall. The vaginal wall can become thinner due to hormonal changes, trauma, or scarring from previous procedures. A thinner vaginal wall may lead to increased sensitivity and discomfort during intercourse. Women with thinner vaginal walls may experience more friction and less elasticity, which can result in pain. It’s essential for your wife to discuss her full medical history, including her past abortions, with her healthcare provider to ensure that all potential factors are considered in her treatment plan.

2. Penile Curvature and Phimosis: You mentioned having a slight penile curvature and a condition known as phimosis (where the foreskin cannot be easily retracted). While the curvature is mild and not likely to cause pain, phimosis can sometimes lead to discomfort during intercourse if it causes friction or if the foreskin does not retract properly. However, as your urologist indicated, this is not a common cause of pain for most couples. If the foreskin is causing discomfort, a circumcision may be beneficial, but it is essential to have a thorough discussion with your urologist about the potential benefits and risks of the procedure.

3. Improving Intercourse Comfort: It’s great to hear that using lubricant and elevating the hips has helped reduce the pain. In addition to these methods, there are several other strategies that may help:
- Communication: Open dialogue between partners about comfort levels, preferences, and any pain experienced during intercourse can help create a more relaxed environment.

- Foreplay: Engaging in extended foreplay can enhance arousal and natural lubrication, which may help alleviate discomfort.

- Different Positions: Experimenting with different sexual positions may help find one that is more comfortable for your wife.

- Pelvic Floor Exercises: Strengthening the pelvic floor muscles through exercises like Kegels can improve vaginal tone and potentially reduce pain.

- Therapy: If psychological factors such as anxiety or past trauma are contributing to the pain, consulting a therapist who specializes in sexual health may be beneficial.

Regarding the use of lubricants, they are generally safe for use during intercourse. If left on the skin, they typically do not cause harm, but it is advisable to clean the area afterward to prevent any potential irritation or infection, especially if the lubricant contains certain chemicals or fragrances.
In conclusion, addressing pain during intercourse often requires a comprehensive approach that considers both physical and emotional aspects. It is crucial for your wife to continue working with her healthcare providers to explore all potential causes and treatments. Encouraging her to be open about her experiences and feelings will also help in finding effective solutions. Thank you for your thoughtful questions, and I hope this information provides clarity and guidance for both you and your wife.

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