Painful Intercourse is a Common Problem for Women
Channel: BioBalance Healthcast
Date: 2021-02-01

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Painful intercourse is a common problem that OBGYNs diagnose and treat every day, but it is often a very upsetting problem that women don’t like to talk about with their doctor, so they often live with it, silently.  I want to encourage those of you who are experiencing this problem to talk to your doctor about it so you can receive treatment.  It is important for women to ask their doctor about their pain with intercourse so they can have a fulfilling sex life.  

Most causes of painful intercourse are not “in your head” or psychological. I want to concentrate on the physical causes of painful intercourse and not psychological or couple issues, because frankly the psychological causes are not my area of expertise and I always ask my patients to see a counselor or psychiatrist to manage those causes.  There are many physical reasons a woman may experience painful intercourse that prevents them from enjoying the benefits of a good sexual relationship, and today I will discuss the causes and treatments for physical causes of painful intercourse.

At BioBalance Health® I concentrate on the hormonal deficiencies that can cause painful intercourse.   For women before and after menopause, having enough testosterone and estrogen is key to lubrication and skin that is thick enough to have comfortable intercourse. Without these hormones the vagina wont lubricate, the skin “shrinks around the vagina and clitoris and the vagina is no longer stretchy and pliable enough to dilate to accommodate a penis.  The outcome of intercourse without enough estrogen and testosterone (called vaginal atrophy) is lack of orgasm, tearing of the vaginal opening, accompanied by pain and bleeding, and the feeling of being rubbed with “sandpaper” when having intercourse.  Within 3 weeks of replacing testosterone and estradiol with bio-identical pellets brings women back to health in many ways and relieving the pain and agony of sex from low hormone levels brings the joy of sex back to my patients.    

Because of testosterone and estradiol deficiencies many of my patients have stopped having sex because it is too painful. We will talk about menopausal women who have hormone deficiencies first and then we will discuss painful intercourse in pre-menopausal women, what causes this problem and how to remedy this common problem. 

A wonderful example of vaginal dryness that caused painful intercourse was embodied in one of my recent patients who looked at the floor while she told me that she just “could not” have sex because her vagina was too small.  This woman was 59 and she had been divorced for over 10 years by the time she came to my office for the first time.  She had many other symptoms of estrogen and testosterone deficiency, and she had seen her gynecologist to ask for help.  She had given her lubricant first and that did nothing for the size or stretchiness of my patient’s vagina.  She was still unable to have sex.  I don’t know why OBGYNs are afraid of using estrogen cream, estradiol in patch or pellet form or testosterone is any form, but they are!  When she got to me the simplest answer was estrogen cream to put on and in her vagina.  From experience I know that this doesn’t fully bring a woman back to sexual wholeness, so I also gave her estradiol and testosterone pellets, and she was able to stop the cream after one month.  Voila!!  She was healed and her new relationship blossomed into marriage!  With testosterone and estradiol her vagina was once again back to normal premenopausal shape and her sex life was not only possible, but wonderful!
To summarize the effects one by one of replacing both testosterone and estradiol in women with painful intercourse I will list the post-menopausal effects of testosterone and estradiol attributed to each hormone deficiency. 

What Testosterone does for sex:
• Improves Libido
• Brings blood flow to the pelvis
• Makes orgasm possible
• Improves the wetness and stretchy ness of the vagina
• Lengthens the vagina
• Increases the size of the clitoris so it can be stimulated
• Allows the vagina to stretch to accommodate a penis of any size
• Labia around the vaginal opening enlarge and the skin of the whole vulva thickens
• Improves the sensitivity of the vagina, clitoris and G spot

Estradiol’s function in sexual health:
• Increases wetness in the vagina
• Increases the thickness of the vaginal wall and vaginal opening
• Improves the sensitivity of the vulva
• Helps prevent recurrent bladder infections from having sex