Hi, I’m Doctor Rich — board-certified urogynecologist, OB/GYN, and passionate advocate of women’s healthcare. Today we’re gonna talk about the infectious causes for sexual pain. We’re gonna talk about two bacteria, one protozoa, and a virus. Click on our Patreon link to join our team to help spread important women’s health education around the world.
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Have you ever had pain with sex?
Well you’re in good company! 75% of women report sexual pain at some point during their life, and up to 18% of women have persistent sexual pain. Today we’re gonna break down the causes, and stick around to the end to find out about the wide differential of causes for sexual pain. Let’s get into this!
So chlamydia is a very common sexually transmitted infection. How common? Well for women aged between fourteen and twenty-four, it’s estimated that 5% have chlamydia. The symptoms of chlamydia include a green or gray foul-smelling discharge, and the inflammation caused by this infection can create sexual pain. So if you have any of these symptoms, you need to go check it out with your doctor and get treated. Fortunately, it can be treated relatively easily with antibiotics, but what happens if you don’t get treated?
Well this bacteria can worsen — it can go up into the uterus and your pelvis and can create pelvic inflammatory disease. In rare cases, it can result in abscesses requiring surgery (even a hysterectomy), and in rare cases — it can be life-threatening. So don’t delay! If you have these symptoms, go see your doctor right away.
Second on the list is gonorrhea. Although not quite as common, it causes very similar symptoms and can result in the same consequences. And the long-term effects of untreated gonorrhea and chlamydia can result in adhesions around the tubes — and lead to infertility. So if you have these symptoms, get treated.
Next up, we have a single cell protozoa (or a parasite) called trichomonas. This is also a sexually transmitted infection. It can cause a kind of gray, frosty discharge that usually doesn’t have as much of an odor. But if you’re noticing these persistent symptoms, you should see your doctor right away.
Next up, we have herpes (or HSV). So this is a viral infection that’s spread through sexual contact — and can cause painful blisters on the vagina, around the clitoris, even around the anus. Although there’s not a cure, there are medicines that can help reduce the intensity, the pain, and the duration of the symptoms.
Syphilis is a sexually transmitted condition — this time bacteria that causes painless ulcers. Also, go see your doctor right away.
What about HIV? Can that cause painful sex? Not directly, but HIV is a viral sexual infection that can cause immunosuppression (or your body to have a weakened immune system). And you can get frequent and severe yeast infections. So if you’re noticing that you have yeast infections more commonly or more severe — go see your doctor and get worked up for this condition.
Now today we’ve talked about sexual infections that cause sexual pain. But just be aware that there are many different conditions of the vagina, the vulva, the cervix, the uterus, and the pelvis, and systemic conditions that can also cause sexual pain. Commonly for the vagina in menopausal women is atrophy. As many as 60% of women complain of sexual pain — just due to dryness from the lack of hormones and menopause.
There are other conditions:
- lichen conditions of the vulva,
- infections of the cervix,
- cervical cancer,
- conditions of the uterus (including adenomyosis and fibroids),
- and endometriosis.
And then systemic conditions like fibromyalgia and other nerve problems and chronic bladder symptoms (like interstitial cystitis and irritable bowel syndrome).
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