Sexual intercourse between my fiancé and me has been painful. My OBGYN said everything appears normal. I was raped from 6-7 years old and when it hurts (and it does about 80% of the time) I have PTSD flashbacks and I start to freak out. I know that painful intercourse is not normal, but I don't know what is wrong. He has been my only sex partner. It is a sharp stabbing like pain, and I don't feel like it is psychological. He is very understanding, but I feel embarrassed and guilty.
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Painful intercourse
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Dypareunia is a complex condition and can be psychological, hormonal, and organic. It seems you have more than one factor involved. You need to distinguish yourself whether you suffer an entry pain, deep pain, or post-sex pain.
Entry pain can be associated with insufficient lubrication, injury, trauma, inflammation, skin disorder (eczema, for example), vaginismum (involuntary spasms of the muscles of the vaginal wall), perineal lacerations
Deep pain commonly occurs due to medical conditions (external or internal endometriosis, cervical erosion, pelvic inflammatory disease, uro-genital infection, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, hemorrhoids, ovarian cysts) and postsurgical complications (bad scarring from pelvic surgery, or unskillful repair of the vaginal rupture or prolapse).
Postsex pain can be related to endometriosis (external - in the Douglas pouch), cervical erosion, vaginosis, vaginitis, uterine myoma, uterine scar after the c-section, and PID.
Psychological factors (with or without history of rape or abuse) are based on both flashbacks (mental, cortical) and body memory (neural, subcortical).
According to the complex causality, both psychological counseling and thorough gynecological exam are required.
Entry pain can be associated with insufficient lubrication, injury, trauma, inflammation, skin disorder (eczema, for example), vaginismum (involuntary spasms of the muscles of the vaginal wall), perineal lacerations
Deep pain commonly occurs due to medical conditions (external or internal endometriosis, cervical erosion, pelvic inflammatory disease, uro-genital infection, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, hemorrhoids, ovarian cysts) and postsurgical complications (bad scarring from pelvic surgery, or unskillful repair of the vaginal rupture or prolapse).
Postsex pain can be related to endometriosis (external - in the Douglas pouch), cervical erosion, vaginosis, vaginitis, uterine myoma, uterine scar after the c-section, and PID.
Psychological factors (with or without history of rape or abuse) are based on both flashbacks (mental, cortical) and body memory (neural, subcortical).
According to the complex causality, both psychological counseling and thorough gynecological exam are required.