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Date of last update: 10/14/2017.
Forum Name: Gynecology
|buggs24 - Mon Sep 05, 2005 9:42 pm||
Hi, I am 21 years old and have been with the same boyfriend for over a year now. Lately I have been having pain in the right side of my vagina during intercourse. It feels close to my right ovary, but I am not sure. This only occurrs depending on the position. I have also had sore breasts and a bit of an upset stomach lately. Do you have any idea what may be wrong? I won't be having my period for two more weeks so I am not sure if a pregnancy test would even show up positive if I were pregnant... hopefully you can help.
Thank you so much for your time! :)
|Dr. Tamer Fouad - Tue Jan 10, 2006 12:26 pm||
Dyspareunia refers to sexual dysfunction manifested as painful or difficult sexual intercourse. Although this problem can affect men, it is more common in women. For women, the genital pain can occur with penetration or during or after intercourse. True dyspareunia is recurrent and associated with a disruption of normal functioning.
Common causes include: vaginal dryness and atrophic vaginitis (eg, due to menopause); side effects of drugs such as antihistamines and tamoxifen and endometriosis. It can also result from an allergic reaction to clothing, spermicides or douches. Vulvar vestibulitis which is an inflammation of the area surrounding the vaginal opening or skin diseases affecting the vaginal area (eg, lichen planus and lichen sclerosis) can cause severe genital pain. Urinary tract infections, vaginal yeast infections, or sexually transmitted diseases can also lead to dyspareunia. Finally, psychological trauma, often stemming from a past history of sexual abuse or trauma.
Pain with deep penetration can be caused by several conditions including diseases of the bowel (eg, inflammatory bowel disease, irritable bowel syndrome). This may also explain your bowel symptoms. Other causes include chronic pelvic inflammatory disease, endometriosis, enlarged uterus from myoma or adenomyosis; fixed retroverted uterus and inadequate sexual arousal. Pelvic conditions can also result in pain with deep penetration, this can result from pelvic masses or pelvic relaxation.[1,3]
Women may have pain in the vagina, clitoris or labia. Women with dyspareunia may feel superficial pain at the entrance of the vagina, or deeper pain during penetration or thrusting of the penis. Some women also may experience severe tightening of the vaginal muscles during penetration, a condition called vaginismus.
The most sure method is to exclude pregnancy using a pregnancy test. The highest possible screening sensitivity for an hCG-based pregnancy test conducted on the first day of a missed period is 90 percent, as 10 percent of women may not have implanted yet. It was estimated that the highest possible screening sensitivity of a home pregnancy test by one week after the first day of the missed period is 97 percent.
1. Smith RP. Gynecology in primary care. Baltimore: Williams & Wilkins, 1997:537-48.
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: Am Psychiatric Assn, 1994:511-3.
3. Meana M, Binik YM, Khalife S, et al. Dyspareunia: sexual dysfunction or pain syndrome? J Nerv Ment Dis 1997;185(9):561-9.
4. Allen J. Wilcox; Donna Day Baird; David Dunson; Ruth McChesney; Clarice R. Weinberg. Natural Limits of Pregnancy Testing in Relation to the Expected Menstrual Period. JAMA. 2001;286:1759-1761.
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