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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 48231
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I was wondering why every time i try to have sex im in sooo

Customer Question

hey I was wondering why every time i try to have sex im in sooo much pain that i have to stop?
JA: The Doctor can help. Just a couple quick questions before I transfer you. How long have you had the pain? Have you used any medication for it?
Customer: ive noticed the pain this week because before ive never thought to have sex and no i haven't taken any medication
JA: Have you seen a doctor about the pain?
Customer: ive never had the chance
JA: Anything else in your medical history you think the Doctor should know?
Customer: ive been a victim of fgm and thats about it really
Submitted: 6 months ago.
Category: Medical
Customer: replied 6 months ago.
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Customer: replied 6 months ago.
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Expert:  Dr. Arun Phophalia replied 6 months ago.

Genital mutilation may be the cause.

Pain during intercourse is called dyspareunia. The main causes are;

1) Inadequate lubrication

2) Deficiency of estrogen hormones; predisposes for inadequate lubrication

3) Urinary tract infection

4) Vulvovaginitis; various infections

5) Vestibulodynia

6) Retroverted or prolapsed uterus

There are a host of other reasons too; infections, vaginal spasm, and inadequate lubrication are one of the commonest out of them One of the main and important causes in women of young age is vulvar vestibulodynia/vulvodynia. Vulvar vestibulodynia can be treated, reduced or prevented with topical xylocaine application. It is available over the counter. You should discuss this possibility with your gynecologist and than discuss various possibilities of the treatment as following (some combination can be determined for the first step of the treatment and if it is less effective, next treatment can be considered);

a) initial treatment of vulvodynia is amitriptyline, nortriptyline. Gabapentin or pregabalin may be considered as adjunctive therapy in addition to these medications.

b) Local provoked vulvodynia ( as in your case; called as vestibulodynia) refractory to other treatments, surgical excision of the vestibule may be considered.

c) In vulvodynia and sex-related pain, pelvic floor muscle dysfunction should be evaluated and treated. Techniques to desensitize the pelvic floor muscles are very helpful. The treatment is following;

1) electro galvanic stimulation,

2) biofeedback training,

3) digital massage of the levator ani muscles

4) sacral nerve stimulation

5) physical therapy for the pelvic floor muscles.

d) Acupuncture may be considered, which is helpful in a significant number of women.

e) For provoked vulvodynia (sexual pain), intralesional injections may be considered.

Please read these excellent authentic resources on painful intercourse (Dyspareunia);

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Expert:  Dr. Arun Phophalia replied 6 months ago.

Wishing you a speedy resolution and all the very best in life.

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