Sex: Painful Sex
Q.
I have had extreme pain with intercourse for almost 9 years. Although several doctors have told me I'm fine, I don't think I am. The problem is a bulging feeling at the opening of the vagina. This area is painful after intercourse, and the pain is really bad if I spend a lot of time on my feet. One doctor about 7 years ago suggested a prolapsed uterus as a possible cause. What do you think?
A.
An examination is really necessary in order to make a diagnosis, but I can give you a few ideas. Uterine prolapse (the uterus falling down due to weakness of its supporting structures) is certainly one possibility. Often during intercourse, the penis will impact on the cervix, and this is much more pronounced -- and painful -- if the cervix is sitting low in the vagina. It's also possible that your bladder may be dropping (this is called a cystocele), which can be uncomfortable during intercourse. With each of these possibilities, being on your feet for a long time would make matters worse; in short, gravity takes its toll.
There are many other reasons for painful intercourse, including endometriosis, adhesions (scar tissue), interstitial cystitis (a bladder condition), and ovarian cysts. Infections also can cause discomfort at the vaginal opening.
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