1. Polycystic Ovarian Syndrome (PCOS): It is estimated that 6-12% of women have PCOS, which impacts women during their childbearing years. The ovaries of women with PCOS produce an abnormal quantity of androgens, which in some cases disrupt ovulation. Symptoms of PCOS can vary but may include cystic ovaries, irregular periods, insulin resistance, excess body hair, weight gain, acne and thinning hair. Some women with PCOS may experience pelvic/sexual pain if they have cystic or large ovaries.
2. Vulvodynia: Roughly 8.3% of women have vulvodynia, a condition which causes chronic vulvar pain (Reed et al., 2012). Symptoms include a burning, raw, sharp, stabbing or tearing feeling at the entry of the vagina when pressure is applied (Moyal-Barracco & Lynch, 2004; Henzell, Bersins & Langford, 2017). Many of my clients with vulvodynia have experienced pain so significant that they find it difficult to wear pants, let alone engage in penetrative sex.
3. Endometriosis: Endometriosis is found in about 10-15% of women in childbearing ages, and makes up 70% of women that report chronic pelvic pain (Parasar, Ozcan, & Terry, 2017). This condition causes endometrial tissue to grow outside of the uterus and adhesions may spread to other organs and ligaments in the pelvis which can cause chronic pain, painful sex, and infertility. Symptoms vary and may be dependent on where the endometriosis has grown. For instance, some women have no physical symptoms and only become aware of a possible endometriosis diagnosis when struggling with infertility. Common symptoms of endometriosis include painful periods, spotting or bleeding in between periods, bleeding after intercourse, pain with bowel movements, pain with urination, nausea and other GI distress, general pelvic pain, fatigue, and nerve pain in the legs (Parasar, Ozcan, & Terry, 2017; Endometriosis Foundation of America). Pain with sex is another very common symptom of endometriosis. In fact, an online study that surveyed 638 women with endometriosis in several countries, including the United States, found that 70% of women found sex unpleasant due to high levels of pain. Half of the respondents had pain that lasted 24 hours or more after sex (Witzeman et al., 2020).
4. Interstitial Cystitis (IC): IC is also known as painful bladder syndrome. It is estimated that 2.7-6.53% of women have IC. Common symptoms include pelvic pain, bladder pressure and pain, and urinary urgency or frequency (Berry et al., 2011). Endometriosis and IC are also commonly seen together (Paulson & Delgado, 2007). Women with IC can experience their symptoms as restrictive and plans suddenly center around bathroom accessibility.
5. Uterine Fibroids: Uterine fibroids are benign tumors in the uterus that appear during childbearing years. Roughly 5-21% of women have uterine fibroids, with higher rates occurring in African American women. Common symptoms include heavy bleeding during periods, spotting in between periods, irregular periods, bladder pressure, pelvic pain, and pain during sex (Zimmermann, Bernuit, Gerlinger, Schaefers, & Geppert, 2012). Similar to endometriosis, pain experienced with sex will depend on where the fibroids are located, and can range in severity (Fibroids and Sex).
6. Lichen Sclerosis & Other Vulvar skin disorders: A range of disorders can cause vulvar skin issues including dermatitis or skin irritation caused by an allergy, lichen planus, lichen sclerosis, psoriasis and Paget’s disease. Common symptoms of vulvar skin disorders include tearing of the skin (especially from intercourse), burning, stinging or itching sensations, dry skin, and skin lesions. Vulvar skin conditions may cause pain with intercourse due to the skin irritation, skin thinning, and narrowing of the vaginal opening from scar tissue (Doyen et al., 2014).
By: Heather Davidson
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Counseling can help women and their partners better cope with a diagnosis causing pelvic/sexual pain. Better Being Main Line specializes in individual, couples and sex therapy. We offer appointments both in-person and virtually at flexible times including the mornings, daytime, evenings and weekends. Please contact us for more information or to make an appointment.
Disclaimer: The information provided in this blog is for educational and informational purposes only and is not intended to replace professional psychological, medical, or mental health advice, diagnosis, or treatment. Reading this blog does not establish a psychologist/therapist-client relationship.
