Typical evaluations will check for vaginal infections, STDs, and any immediately noticeable problems or injuries to the vagina, uterus, or ovaries. If necessary, medical intervention will be prescribed by the doctor. However, if painful sex continues despite recurring treatment for these issues, insist on finding someone who can make sense of your pain. “Everything we’ve looked at is normal” and “We don’t see any reason for your pain” are not acceptable answers.
80% of the time, triggers for pain in the pelvic region come from bladder and/or bowel function and from gynecological factors alone only 20% of the time. So understand conditions like Interstitial Cystitis (IC or Painful Bladder Syndrome) and Irritable Bowel Syndrome (IBS).
Consider pelvic endometriosis but remember that endometriosis is associated with monthly cyclical pain, not pain that is intermittent and all month long.
Vestibulitis (more accurately Vulvar Vestibulodynia) is the number one cause of vaginal entrance pain in premenopausal women.
Musculoskeletal, ligamental, and nerve related factors can also be heavy influencers in painful sex. Yet they are often overlooked as primary causes. Hypertonic Pelvic Floor Dysfunction (pelvic floor muscles that are clenched or in spasm) and Pudendal Neuralgia are other conditions to be familiar with. See a women’s health physical therapist as they are well equipped in structural matters of the pelvis and determining how this may be influencing your pain.
There are many reasons or “triggers” in the pelvis for persistent pain. Often, these triggers are interrelated; meaning more than one is present. Seek the support of a counselor or sexual health therapist along the way. Painful sex isn’t just an individual problem, it is a relational problem that affects us at the core of our most intimate relationships due to painful sex and intercourse.