Common Gynecological Concerns: Pain, Infections, and Treatment Options

Distressing questions?

Hello doctor,
1.
Every time I engage in sexual intercourse with my boyfriend, I experience intense pain inside my vagina at the beginning, as if I am being cut by a knife.
After a while, the pain subsides.
Even with lubrication and my boyfriend being very careful, the pain persists.
Could this be due to a bacterial infection?
2.
A long time ago, when I visited a doctor, they mentioned that vaginal pain during intercourse could take a long time to heal on its own and suggested treatment with electrocautery.
However, after seeing the pictures, I found it very frightening and did not proceed with the treatment.
Is electrocautery very painful?
3.
Since childhood, I have had my menstrual period only once every 2-3 months, lasting about 5-7 days, and I do not experience any discomfort during this time.
Is this normal?
4.
I take oral contraceptive pills daily for birth control.
Will this cause infertility in the future or increase the risk of breast cancer?
5.
I received the cervical cancer vaccine when I was 28 years old.
Is this vaccine a one-time treatment for life?
6.
Is one of the causes of cervical cancer recurrent urinary tract infections during youth?
7.
I usually have vaginal discharge without any odor, and when I see a doctor, they prescribe medication for a few days, but the symptoms recur after a while.
Is the discharge due to an infection? I take hygiene very seriously and have only one sexual partner, who also maintains good hygiene, yet the issue persists.
I am very afraid of visiting a gynecologist, which makes me very distressed.
I have many questions, and I would greatly appreciate your responses.
Thank you very much.

kina, 30~39 year old female. Ask Date: 2013/03/21

Dr. Lin Wenbin reply Obstetrics and Gynecology

1.
The body's naturally secreted lubricant is a natural vaginal protectant that helps prevent friction injuries during intercourse.
However, infections, endocrine disorders, or insufficient foreplay can reduce the production of this lubricant.
A medical examination is necessary to determine the underlying cause.

2.
It is unclear what you are referring to; electrocautery is not used to treat vaginal pain.

3.
This indicates a prolonged menstrual cycle, which may suggest an absence of normal ovulation.
If you plan to conceive soon, treatment is necessary.
If there are no discomforts, you can discuss with your physician whether treatment or observation is appropriate.

4.
Whether contraceptive pills cause ovarian function decline varies from person to person.
Long-term use of contraceptive pills may lead to ovulation disorders.
If you plan to have children in the future, the best contraceptive method is condoms, not contraceptive pills.
The former provides localized effects and can also prevent infections, while the latter has systemic effects and does not prevent infections.
Long-term use of contraceptive pills should be monitored for an increased risk of breast cancer.

5.
The cervical cancer vaccine is not a panacea.
It can only prevent about 80% of high-risk HPV infections.
The duration of its preventive effect is still undetermined.
The best way to prevent cervical cancer, besides receiving the vaccine, is to use condoms (unless you are timing intercourse for conception during ovulation; condoms should be used every time otherwise).

6.
Cervical cancer is associated with the sexually transmitted human papillomavirus (HPV) and is not related to bladder or urethral infections.

7.
The causes of increased vaginal discharge are primarily due to poor immunity, lack of sleep, antibiotic use, colds, etc.
Frequent sexual activity can also lead to increased discharge, and it does not necessarily indicate issues with the sexual partner or a lack of hygiene.
Using condoms helps maintain the vaginal acidic environment and reduces the risk of fungal infections.

Reply Date: 2013/03/21

More Info

When it comes to common gynecological concerns, many women experience a range of symptoms that can be both confusing and distressing. Your questions touch on several important aspects of women's health, including pain during intercourse, menstrual irregularities, the use of contraceptives, and concerns about infections. Let’s address each of your questions in detail.

1. Pain During Intercourse: Experiencing sharp pain during intercourse, even with lubrication, can be indicative of several issues. It may be related to vaginal dryness, which can occur for various reasons, including hormonal changes or stress. However, it could also be a sign of an underlying infection, such as vaginitis or vulvodynia, which is chronic pain in the vulvar area. It’s essential to consult a healthcare provider for a thorough examination to rule out infections or other conditions like endometriosis, which can also cause pain during intercourse.

2. Electrosurgery Treatment: Electrosurgery, or cauterization, is a procedure that uses electrical currents to remove or destroy tissue. While it can be effective for certain conditions, it can also be painful. The level of discomfort varies from person to person, and local anesthesia is typically used to minimize pain during the procedure. If you have concerns about the pain associated with this treatment, discussing them with your healthcare provider can help you make an informed decision.

3. Menstrual Irregularities: Having menstrual cycles that are spaced 2-3 months apart can be a sign of an underlying condition, such as polycystic ovary syndrome (PCOS) or hormonal imbalances. While some women naturally have irregular cycles, it’s important to monitor any changes and discuss them with your healthcare provider, especially if you are concerned about fertility or other health issues.

4. Oral Contraceptives and Fertility: The use of oral contraceptives is a common method for preventing pregnancy and can regulate menstrual cycles. There is no evidence to suggest that taking the pill will lead to infertility in the long term. However, some studies suggest a slight increase in the risk of breast cancer, particularly in women who have a family history of the disease. It’s crucial to discuss your personal risk factors with your doctor to make the best choice for your health.

5. Cervical Cancer Vaccine: The HPV vaccine is typically administered in a series of three doses, but there are now vaccines that require only two doses for certain age groups. Once you complete the vaccination series, you are generally considered protected against the strains of HPV that the vaccine covers. However, it’s important to continue regular cervical screenings as recommended by your healthcare provider.

6. Cervical Cancer and Infections: While recurrent urinary tract infections (UTIs) are not directly linked to cervical cancer, persistent infections can lead to inflammation and other complications. HPV, a sexually transmitted infection, is the primary cause of cervical cancer. Regular screenings and vaccinations can significantly reduce your risk.

7. Vaginal Discharge: Having a white discharge without odor can be normal, especially if it changes throughout your menstrual cycle. However, if you notice changes in color, consistency, or odor, it could indicate an infection. If you are experiencing recurrent infections despite maintaining good hygiene and having a single sexual partner, it may be worth exploring other factors, such as hormonal imbalances or sensitivities to certain products.

In summary, it’s essential to maintain open communication with your healthcare provider about your symptoms and concerns. Regular check-ups, screenings, and honest discussions about your sexual health can help you manage these issues effectively. Don’t hesitate to seek medical advice, as early intervention can often lead to better outcomes and peace of mind.

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