Pelvic pain during intercourse?

November 2, 2005 1:19 PM

GirlPartsFilter: pelvic pain during intercourse.

I've been having pelvic pain off and on during intercourse for the past couple of months. I saw a doctor last week and was tested for what seemed to be everything under the sun: urinary tract infection, yeast infection, bacterial infection, and every STD they could think of. The nurse called me today and says that every single test came back negative. What now?

Some facts:

1) Pain started mildly and only occasionally, immediately following a yeast infection a few months ago. In the past couple of weeks its gotten to the point where it's so bad/frequent that we'll stop intercourse and move on to something else.
2) Pain is sharp, located vaginally, and happens more at certain angles than at others, and with moderate or deep thrusting. Its sometimes but not always helped by using extra lubricant.
3) I have no other symptoms, except for a white, very thick, odorless discharge that we noticed for the first time last night during intercourse.
4) I'm on the Pill (went on it around the same time as the pain started) and in my 30s. I've been on the Pill before with no ill effects.
5) The relationship is very positive both sexually and emotionally. (He's got a clean bill of health too, btw, no STD's, etc.) We're monogamous and I'm really comfortable with him (physically and emotionally).
6) I have no history of pain during sex with any other partners.

I'm going to try to get into the doctor's again as soon as possible, but in the meantime I'm starting to freak out a little. Is there a test they might have overlooked?

posted by anonymous to Health & Fitness (17 answers total)

Probably a stupid question, but is he hitting your cervix? I know that's a problem for my girlfriend (and previous girlfriends) in certain positions. For some (most?) women it can be extremely painful if a guy hits the cervix.
posted by KirTakat at 1:32 PM on November 2, 2005

are you on hormonal birth control?
posted by grafholic at 1:52 PM on November 2, 2005

sorry forgot to read #4.
okay you are. and i had THE SAME EXACT thing with one of my ex.
when relationship started - no problem. got on pill - no problem. 3 years later - the mysterious pain that noone was able to figure out until when i got off the pill.

if you are up for it - get off the pill for a bit, and that i mean get off for about 6 months for the effect to fully wear off. then you will know if it's the pill causing the pain.
posted by grafholic at 1:55 PM on November 2, 2005

Your estrogen levels may be too low due to your new Pill. I had similar symptoms last year (no discharge, but mysterious pain during intercourse with no infection or STD) and it turned out my Pill had lowered my hormone levels so far that I had developed menopausal symptoms of vaginal dryness, resulting in pain during intercourse.

My doctor ran all the tests you went through, and ordered an ultrasound for endometriosis besides. I kept going back for more tests, and she kept finding nothing. Finally, I got a second opinion -- and he knew what was wrong right away.

If your doctor can't figure this out -- find another doctor. I wish I'd done that sooner. I used some supplemental estrogen for a few weeks and changed my Pill -
posted by junkbox at 2:04 PM on November 2, 2005

I know you said you've been tested for every imaginable STD, but this sounds exactly like symptoms of chlamydia. Double-check that a test for it was included in the battery of STDs? (I recall that it requires a separate sample, or at least it used to...)
posted by desuetude at 2:12 PM on November 2, 2005

Hm... I had a friend with that problem, she was using Yasmin. Somehow she found out it had to do with the estrogen levels in the pill and to use some sort of lubricating cream that had estrogen in it. I don't know the name, but if you give your doctor a buzz (s)he might know.
posted by idiotfactory at 2:31 PM on November 2, 2005

Pelvic pain during intercourse could be a symptom of endometriosis.
posted by cahlers at 3:07 PM on November 2, 2005

Or an ovarian cyst.
posted by Airhen at 3:11 PM on November 2, 2005

Or pelvic inflammatory disease - go to another doctor.
posted by tristeza at 3:28 PM on November 2, 2005

Constipation can cause pelvic pain during sex. Just thought I'd toss that out as something else to consider.
posted by bonheur at 3:47 PM on November 2, 2005

Anon here, responding via sockpuppet. thanks for the responses so far. just to be clear, the STD tests that were run definitely included chlamydia and PID (also trich, gonnorhea, syphylis, etc.). all of them came back negative. and the pain is definitely vaginal, not anywhere near my cervix (I know what that feels like and it's no fun, but it's a very different pain than this), and not at all related to constipation.

I don't seem to have any other symptoms of endometriosis or cysts, but I will definitely bring that up with the specialist I'm seeing (for the first time) next week - thank you!

given the multiple responses relating pain to the Pill, that connection seems plausible to me. I'm on a low-dose version of the regular (combination) Pill, and other than this (if this is really a side-effect of the Pill) I've never had any bad effects from this particular brand/dose. I've been on abuot 4 or 5 different brands/doses in the past (and have also used the birth control patch), and they all had side effects (mood swings, heavy bleeding, really really painful breasts) that made me switch. Maybe it's time to try the progestin-only Pill?
posted by fizzyliftingdrink at 4:12 PM on November 2, 2005

There could be some degree of secondary vaginismus. That Wikipedia entry goes straight to the really heavy causes, but the discomfort caused by your previous yeast infection may have been enough to induce a bit of trepidation the next time you had intercourse. This can be magnified when future attempts cause pain, and hence more fear of pain, and a stronger vaginismus response.

The fact that you can have intercourse (only, with pain) does not exclude vaginismus. Although it's likely to not be what's causing your pain, if all else comes back negative this may be something to consider.

As other people have mentioned, the cause might be some sort of structural problem rather than infection. Ask your doctor about that. An ultrasound would be a good first step to investigating those.
posted by teem at 4:22 PM on November 2, 2005

Second the vaginismus guess. A gyn should be able to diagnose it.

In most major cities there are "Pelvic Pain Centers." The doctors there have made it their mission to find the cause for any imagineable pelvic pain, and will usually go to the end of the earth to explain what's wrong. Might want to ask for a referral to some place like that.
posted by FortyT-wo at 4:51 PM on November 2, 2005

Not to toot my own horn, but I have a relatively short dick but when I had my ex-wife's knees pressed to her ears, I occasionally hit her cervix and the pain you describe is similar to her description of same.
posted by mischief at 5:32 PM on November 2, 2005

Scar tissue *in* the perineum tissue (might not be visible to naked eye) might be the culprit.
posted by 6:1 at 5:44 PM on November 2, 2005

I had this issue.

Try something simple first: put a pillow under your lower back during intercourse. Saved us :)
posted by dpx.mfx at 7:11 PM on November 2, 2005

once again, the pain is ONLY located vaginally. it is NOT in the cervix (I *know* what that feels like and this is NOT IT) and it is NOT in the perineum (ditto). thanks.
posted by fizzyliftingdrink at 7:11 PM on November 2, 2005