PCOS & Pain During Sex:
Causes, Treatments & How to Talk to Your Doctor

Women suffering from PCOS often experience pain during sex. If this is a current problem, learn more about how to alleviate your pain and improve your quality of life!

Learn the two major causes and how you can begin enjoying your sexuality to its fullest.

Dyspareunia refers to pelvic pain one suffers during or after sexual intercourse. There can be a number of causes for dyspareunia however with patience on both your and your partner's part, a wonderfully fulfilling sex life is possible.

If the cause of your pelvic pain is from a trauma (injury, surgery, child abuse, or sexual assault) you've likely worked very hard on your emotional, spiritual, and physical healing. The good new is, your sexuality need not suffer any longer; you are entitled to feel loved and precious.

If sexual intercourse is painful or if you suffer from spasms of the muscles that support the pelvic region you may be suffering from one of several common disorders. Sex is likely painful and confusing, possibly even affecting the intimacy you share with your partner and may lead to frustrating and involuntary celibacy.

For the purpose of this article, I am addressing two common causes of pelvic pain due to internal injuries, adhesions and vaginismus:

Adhesions

Adhesions are scars from inflammation following trauma that adhere to internal organs. These adhesions lead to difficulty in movement, pain and discomfort. When these adhesions occur around the ovaries, fallopian tubs, uterine tubes, or uterus, you may experience infertility in addition to pain.

Adhesions can form due to blows you received during trauma, objects that may have been inserted into the vagina, a sexually transmitted disease contracted during the trauma, or an abortion if one was performed as a result of the assault.
Inflammation is the body's natural response to tissue damage and as healing takes place, these tissues begin to shrink, as would any other scar. Internal adhesions are particularly painful because of their propensity to attach to organs, muscles and nerves around the area of the scarring.
If you underwent surgery for your injuries following your trauma, you're at a greater risk for forming adhesions as studies have shown that at least 55% of women form adhesions following gynecological surgery.

Your doctor may have diagnosed you as having PID (Pelvic Inflammatory Disease), endometriosis, or vaginitis.

Treatment

Non-surgical treatment includes the stretching and strengthening of muscle groups by means of physical therapy and is designed to minimize pain and increase movement. Physical therapists use a manual form of treatment in which sustained, gentle stretching is applied to the areas of the body where scarring is being experienced.

Surgical treatments are an option when the desired results are not achieved by non-surgical means.

Vaginismus

Vaginismus is not uncommon in women who have experienced trauma such as child abuse or rape. It refers to an involuntary spasm surrounding the musculature called the pubococcygeus (or PC muscle group) of the vagina, closing it as penetration is attempted. Intercourse is painful and in some cases impossible.

The size of what can be inserted in the vagina varies. Some women are able to undergo gynecological exams, others are unable to insert anything as small as a finger or tampon and are placed in separate diagnostic classifications as show below:

Primary Vaginismus means that the woman has not had been able to have sexual intercourse or had a gynecological examination; nothing has entered the vagina.

Secondary Vaginismus occurs following a trauma or surgery in a woman who previously enjoyed a sexual relationship. All physical concerns were resolved.

Apareunia is present when the woman is able to insert a finger or tampon and can complete a gynecological exam, but is unable to accomplish penetration of a penis.

Treatment

Treatment for vaginismus is best achieved by enlisting a qualified sex therapist and your health care provider. Successful resolution often consists of education, counseling for issues that may arise in the relationship, and muscle relaxation/contraction techniques such as Kegel exercises.

Vaginal dilators, typically formed of hard plastic and in progressively larger sizes are also utilized with great success in vaginismus. These are typically prescribed by your physician and used in conjunction with a sex therapist.

Discussion Points for You and Your Physician and/or Sex Therapist

Many women have found that it's helpful to be prepared with an overview of present symptoms and past history when discussing sexual issues.
You may not have discussed your pain or trauma with your physician or other professionals, but you deserve an amazing, enjoyable sex life, and the first step is to become pain free.

Think about the following and prepare your answers prior to your appointment:

My symptoms began to develop:
_____________________________________________________________________________

Intercourse is painful when:
_____________________________________________________________________________

Pain has {always} {sometimes} {never} been a problem during sex:
_____________________________________________________________________________

Pain occurs when my partner:
_____________________________________________________________________________

My pain is located in my:
_____________________________________________________________________________
(Try to be as specific as possible using words such as vagina, labia, pelvic area, etc.)

The pain feels like:
_____________________________________________________________________________
(Try to use words such as burning, stinging, stretching, etc.)

I have experienced a trauma in the past:
_____________________________________________________________________________
(I know this question may be difficult, but if you try to supply as much information as possible, your physician and therapist are better able to provide the care you require.)

I have tried to make myself more comfortable during intercourse by:
_____________________________________________________________________________
(Supply any methods you may have used such as lubrication, etc.)

Medications I'm taking include:
_____________________________________________________________________________

Other symptoms I'm having include:
_____________________________________________________________________________

Treatment for sexual issues relating to trauma takes time and patience on the part of both partners, however the rewards are great.

The process of recovery when shared with someone we love and trust can be insightful and add enormously to the depth of the relationship. Like all of us, you're a sexual being deserving of an exciting, sensual sex life, pain free.