VERIFIED CONTENTConsultation: dr Tadeusz Oleszczuk, gynecologist-obstetrician
Probably each of us at least once in our life ignored the pain that appeared in the intimate area. These ailments may have various causes, but we should never ignore them. Why? We asked the expert Dr. Tadeusz Oleszczuk about it.
Patrycja Pupiec: Is pain during or immediately after sex a disorder?
Tadeusz Oleszczuk:Of course. Pain is a symptom, it is always a symptom of a pathology, sometimes a disease. This is a signal that something is wrong in the body, so you need to find its cause as soon as possible. We cannot act in such a way that we take painkillers that only relieve the symptoms and do not find the cause of the problem.
Many women still feel that it can, and even has to, hurt at times. That's the wrong approach, isn't it?
You can wave your hand like a person has a headache, or take a painkiller, because while this may be due to the increase in pressure and there is a risk of a stroke, it just happens, for example due to a change in weather, but in the event of intimate pain, such behavior is irresponsible. Pain will make you fear more sexual intercourse, and this further reduces physiological hydration and increases pain. The spiral of the vicious circle starts to spin faster and faster, so find the cause, not underestimate the pain.
Why not ignore this problem?
Yesterday a young girl came to see me. She has always had painful intercourse for many months since her cesarean section due to a twin pregnancy. It turned out that she had a problem with getting pregnant. She received support from a fertility clinic, but never had an ultrasound scan of the thyroid gland in her life. It turned out that he had hypothyroidism resulting from inflammation that began with an incorrect diet. While performing an ultrasound of the reproductive organs, I found a large amount of free fluid.
This is a picture of chronic inflammation. While answering this question, I will give another example of many women over 45 years of age. The perimenopausal period is the time when there is less estrogen in their body, and the mucosa is not so moisturized. Drynesscauses pain when trying to have intercourse. It can lead to a woman avoiding intercourse precisely because of pain. Since it hurts her, she avoids intercourse. Stress causes even more dryness and discomfort. The vicious circle begins to spin.
This means?
Lack of hydration can cause more inflammation, and then even more pain, and even more stress and anxiety. Therefore, finding the causes of soreness should be a priority in pain management, as only proper treatment can bring relief. Breaking the vicious cycle allows you to return to your full quality of life.
Is it easier to talk about painful problems thanks to the increased awareness of women and the exchange of experiences?
Easier and as a doctor I am very happy that the topic is raised, not disposed of.
Dyspareunia, or painful intercourse, is a common problem? Do your patients often complain of painful intercourse?
Here a certain division should be made, because women after menopause or during menopause are about 20 percent. Some of them say they feel pain, but more often I have to ask about it. Younger women, on the other hand, come with rather painful inflammations, and then the topic of painful intercourse arises. The reasons are therefore different for each group, although of course they can overlap.
Gynecologists rarely ask about painful ailments related to intercourse.
If the specialist decides that everything is fine during the examination and interview, and the patient does not report any complaints related to pain, this question does not arise. Agree, the doctors do not ask about it. Although I honestly admit that they should. The quality of coexistence affects the quality of life and is included in the definition of he alth presented by the WHO.
Where to look for the causes of pain?
Very often the causes of pain should be found in the way we eat, because what we eat matters. About 20-30 percent. people have food intolerance disorders, and many people do not even know they have it. These problems manifest themselves, for example, with the Irritable Bowel Syndrome. The patient eats something that her body cannot tolerate.
Let's add a huge amount of pesticides in the vegetables and fruits that we eat, because they are he althy. Unhe althy, contaminated food causes inflammation, and it gets worse from year to year, until the intestines begin to produce fluid, which can be seen in the abdomen. It, in turn, irritates the area of the bladder and small pelvis, and then there is pressure on the bladder and more frequent urination.
Sometimes the doctor recognizes inflammationappendages, and in fact it is the fault of food intolerance. The cause of pain can be anatomical changes, but also inflammation. He alth is also influenced by external factors, stress and immune resistance.
In this case, it is enough to change your lifestyle and start eating properly?
Yes, and after 2-3 weeks you will see an improvement. You should change your habits, introduce physical activity and eat properly, preferably by eating organic products. Check the composition of intimate hygiene products, because allergic reactions also happen.
Sometimes pain is in a woman's head, isn't it?
Absolutely, pain in the intimate area can have a mixed background, including mental and emotional. Partner relationships or previous traumatic experiences influence the perception of pain.
Excitement is definitely very important.
Of course, without excitement, there is no proper hydration. Vaginal dryness is a very common cause of pain. Of course, there are preparations that can be used and that will help you deal with this problem. There is also a mechanism to note here, because a woman who is afraid of pain has a pattern in her head that intercourse is associated with pain.
She is afraid of him at the very beginning, so her stress level increases, and the vagina becomes drier and even more difficult to get aroused, because if she is afraid, how is she supposed to get excited? There is a vicious cycle, and vaginal dryness can cause infections, including painful ones. Mucosal abrasions are an open gate for pathogens.
Vulvodynia is another painful ailment that, according to experts, affects 5 to 16 percent of people. women in the world. This is a really common problem.
Yes, that's true. Feeling painful, burning, free from inflammation, but as with other pain conditions, diet may be too much. A diet is closely related to immunity, hormonal balance and the condition of the sheaths of nerve fiber endings. They send pain signals.
Scientists have found that the risk of vulvodynia is three times higher in women suffering from depression and anxiety disorders.
Yes, that's true. The efficiency of the entire nervous system is of the greatest importance. This has to do with stress, but also because depressive disorders can be responses to pain, especially when it is long-term. Vitamin and mineral deficiencies can play a role. Vitamin B12 in particular is responsible for the condition of the myelin sheaths of nerve fibers. Its deficiency is more often found in people with depression. Also depressedthe pain threshold is lowered.
Why is it like this from a medical point of view?
It's a vicious cycle. With depression, the joy and desire to have intercourse decreases, we are not even attracted to them, vaginal dryness appears, it is hard to get excited. Suppose a couple tries to have intercourse and the pain arises again, so the resentment grows. In addition, stress, she thinks that sex is associated with pain, and that the depressive background increases the reluctance even more. In such a case, it is necessary to implement treatment, preferably pharmacology on the one hand, and on the other hand help from a psychologist, psychiatrist, gynecologist, physiotherapist.
Are surgical treatment methods of last resort?
Yes, these are sophisticated approaches to solving the problem, a rather rare last resort. It all depends on the cause. There are cases where partners get together in such a way that a woman has a narrow vaginal opening and her partner is generously endowed and their relationship may turn out to be painful. Anatomical problems are repaired surgically, so a narrow vaginal opening requires surgery.
What to do to avoid pain?
If pain occurs, first find the cause. A great deal is due to inflammation, dryness, and this can be successfully de alt with in many different ways. Remember about proper nutrition, use of moisturizing preparations, if necessary, and not ignoring the symptoms of mycosis, viral or bacterial infections or allergies.
You can use probiotics preventively, also vaginally, but most of all take care of your he alth, avoid sweets, take care of foreplay, relationships with your partner, physical activity. Pain in the intimate area is a serious problem, it cannot be taken lightly, and if it is not resolved at an early stage, it is easy to fall into a vicious circle.
Pain in the intimate area may also affect women in puerperium and those who have had a difficult delivery. Is it a separate group and is it treated differently?
Yes, a distinction should be made between these groups here, as the pain itself can result from an incision birth. Sometimes it is also the case that a woman who has just given birth, tired and overwhelmed by caring for a child, may be afraid of another pregnancy and again this psychological basis appears, which, driven by fear, fear that it will hurt her, affects her intimate life. The entire muscular apparatus of the small pelvis also changes. Here, physiotherapy also comes in handy.
Neoplasms of the reproductive organs do not cause pain at the initial stage, and how is it later?
Advanced cancerovarian cancer is very painful, but cervical cancer, for example, may not show painful symptoms, even when invasive. Uterine fibroids can also be very painful. Yesterday I was examining a patient who had several fibroids, each of them about 4 cm. In fact, that's more than the diameter of a newborn's head.
The examination itself was painful for her. We also didn't mention ovarian cysts or inflammation of the appendages, which can also cause pain. That is why you always have to look for the cause, do tests and check what is happening, because it is simply not worth risking a permanent loss of your own he alth. You cannot leave it without treatment, grit your teeth and give up on relationships, because it is also a deviation the other way.
And endometriosis? It is diagnosed more and more often.
This condition can worsen and cause pain over the years, especially during intercourse. When we are diagnosed with endometriosis, we are now able to treat it effectively. The methods vary depending on the level of advancement. Therefore, it is worth finding out what is causing the pain as soon as possible, so as not to allow the appearance of further outbreaks of endometriosis.
What tests should be performed? Can you self-medicate?
No, you definitely need to go to a gynecologist who has to examine and see what kind of pain it is, what kind of pain it is, what is really the cause, perform a gynecological ultrasound. After that, blood tests are performed, depending on the problem, sometimes it is necessary to extend the diagnosis.
Each case should be treated individually, but the cause of the pain must be found. Pain is a symptom of a disease or problem, but it can be effectively de alt with.
gynecologist-obstetrician Tadeusz OleszczukGynecologist-obstetrician with over 30 years of experience. Author of the books "What the gynecologist will not tell you" and "Calm your hormones".
www.tadeuszoleszczuk.pl
fb.com / drtadeusz
Read other articles from the StrefaKobiety series:
- First visit to the gynecologist: what can you expect?
- Ignorance or maybe ignorance? Why do women die of cancer?
- 20 percent couples deal with infertility. Mostly not the fault of the woman
- Last menstruation and menopause. How to prepare for it?
- A woman must be he althy before starting contraception
- How to take care of intimate hygiene to avoid infections?
- Allergies - where do they come from? Allergy to semen and condoms
- Gynecologist on the prohibition of abortion: Let us not condemn women to suffering at the risk of losing he alth andlife
- Sexually transmitted diseases. How to take care of your safety?
- Polycystic Ovary Syndrome (PCOS), or when the body and mind suffer
- Gynecological visit during a pandemic. What has changed?
- Breasts. What about their appearance should worry us?
- Are you pregnant and afraid to vaccinate against COVID-19? Expert explains why it is worth doing this
- Why is it so long to be diagnosed with endometriosis?
- Endometrial cancer, i.e. a cancer in which lifestyle is important
- Why are uterine fibroids mostly only monitored?
- Gynecologist: People are afraid to name the basic elements of the reproductive system, let alone know what the physiology of the cycle looks like