[30F] Experiencing sharp pain during deep sexual intercourse

Patient Description

A 30-year-old female reports experiencing sharp pain deep inside, approximately 4 inches below the belly button, during deep thrusting in sexual intercourse. The pain is described as a 6 on a scale of 1-10 and is followed by discomfort when sitting post-coitus. The patient has a history of severe menstrual cramping and has had some painful ovarian cysts. She underwent tubal ligation 4.5 years ago and has had three full-term pregnancies. There is a family history of endometriosis and ovarian fibroids; the patient's mother underwent a hysterectomy due to these conditions. The patient is not currently on any medications and has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Endometriosis: This is a condition where tissue similar to the lining of the uterus is found outside of the uterus. It can cause pain during sex, especially with deep penetration, and heavy, painful periods. Given your family history of endometriosis, this could be a possibility.

    • Treatment options typically include hormonal medications, pain relievers, and in some cases, surgery.

  • Uterine fibroids: These are noncancerous growths of the uterus that can cause pain during sex and heavy menstrual bleeding. Your family history of fibroids also makes this a possible diagnosis.

    • Treatment options can range from watchful waiting to medications or surgery, depending on the size and location of the fibroids and your symptoms.

  • Ovarian cysts: You mentioned a history of painful ovarian cysts. Some types of ovarian cysts can cause pain during sex.

    • Most ovarian cysts resolve on their own, but if they're large or causing symptoms, treatment may be necessary.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to perform a pelvic exam or other tests to help determine the cause of your pain.

  2. Keep a symptom diary. Note when you have pain, its severity, and any activities that make it better or worse. This can help your healthcare provider in diagnosing your condition.

  3. Over-the-counter pain relievers, such as ibuprofen, may help with your pain. However, you should still seek medical attention to find out what's causing your symptoms.

What you should look out for

If you experience any of the following symptoms, seek medical attention immediately:

  • Severe or sudden pelvic pain
  • Pain along with a fever
  • Difficulty or pain when urinating
  • Unusual vaginal discharge

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago

People Also Ask

What is endometriosis and how can it affect sexual intercourse?

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus. It can cause pain during sex, especially with deep penetration, due to inflammation and irritation of the surrounding tissues.

How do uterine fibroids cause pain during sex?

Uterine fibroids are noncancerous growths in the uterus that can cause pain during sex by pressing against other pelvic organs or causing inflammation. The pain can vary depending on the size and location of the fibroids.

Can ovarian cysts cause pain during intercourse, and how are they treated?

Ovarian cysts can cause pain during intercourse if they are large or located in a position that is irritated during sex. Most cysts resolve on their own, but treatment may include pain management or surgery if they are persistent or problematic.

What are the treatment options for painful menstrual cramps?

Painful menstrual cramps can be treated with over-the-counter pain relievers like ibuprofen, hormonal birth control to regulate or reduce periods, and lifestyle changes such as exercise and heat therapy. In severe cases, a healthcare provider may recommend other medications or surgical options.

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