31 Jul When to see the doctor about painful sex
I don’t often share personal stories but this feels important for the women reading my stories. It’s really several stories woven together; a failed relationship and what we look for when we embark on dating post-divorce or the loss of a spouse. And then there is the side story of dating a widow or widower, to be shared another time.
Back in January I met a man. We went through the initial period of getting to know each other and after I convinced him to get his STD tests, as I had done, we had sex. I was stunned to find that it was uncomfortable. Was it because I hadn’t had sex in over 6 months? Or a size issue?
I felt a sharp searing pain with the beginning of intercourse that diminished a bit as we got going. Afterwards I had some slight bleeding. I decided it must be a factor of thinning vaginal tissues combined with inactivity. So, I didn’t worry about it. But then it happened again, and again. Each time with a bit of bleeding.
I decided to see a gynecologist. Post-menopausal with no issues, I hadn’t seen a gynecologist in a number of years; my Internist was performing pap smears and exams. I knew I wanted a specialist and I knew wanted a woman doctor. I found a menopause specialist at our Midlife Health Center and made an appointment.
We talked about my experience and went over my sexual health history. My last pap smear had been normal and there was no sign of HPV; according to standard procedure I wasn’t scheduled for one in five years (coincidentally at the end of this year). She did a Pap test, which came back as abnormal and showed the presence of HPV. The HPV itself was not the issue as it’s very common and can come and go in people. But the abnormal results, combined with the bleeding, was a warning sign of problems—the worst being possible cervical cancer.
The doctor prescribed a topical estrogen to use on my introitus (the opening to the vagina) to help with the atrophy, which is hormonal-related, that was causing the discomfort during penetration. And, she scheduled a colposcopy to look at my cervix and take a biopsy—this was done in the office with only mild pain meds. Based on what she’d seen, before the biopsies even came back, she indicated I would need a further procedure to biopsy and treat suspicious cells on my cervix. This procedure, called LEEP, was to be done in her office. After the biopsy results came back she instead decided to refer me to a surgeon who would do more involved procedures along with the LEEP.
So, I went off to Mexico knowing I’d have surgery in mid-July—uncertain as to how bad the suspicious cells were and how much tissue they might need to remove. And not knowing whether sexual desire and sensation would be impacted. And the growing realization that my new boyfriend wasn’t showing the kind of support or concern I wanted, or felt was warranted, given the possible ramifications.
I had general surgery on July 17, in an outpatient surgery center. They removed much of my cervix using the LEEP procedure, took samples from the endometrial lining of the uterus and did a D&C. The results came back last week and there is no cancer. No endometrial abnormalities, just a chronic inflammation of the cervix. I am still healing but greatly relieved at this point. I have a few questions which I’ve written down for my follow-up visit this week. The relationship ended a couple of weeks before surgery, hastened by the realization he’d forgotten all about my health issues.
I am grateful for this failed relationship in allowing me to discover an otherwise non-symptomatic issue that could have been quite severe. I’m glad I chose to go to a specialist rather than “tough it out”. If I had not had problems during intercourse I would not have seen a specialist. If that bleeding had been a symptom of pre-cancer it would still be undetected at this point. So, that’s the positive side of this experience.
Women who experience painful sex often don’t talk about it. There may be feelings of shame or embarrassment. Women may be reluctant to see a doctor, often not realizing that it might be a simple treat-able condition. In my case the pain was the result of atrophied vaginal tissues caused by the lack of estrogen (I never took any treatments or used supplements during menopause). And more importantly this doctor took all the steps to diagnosis my abnormal bleeding.
If sex is painful for you please don’t dismiss it. And buy yourself a good lube, it always helps with sex. Talk to your partner so they know you’re feeling discomfort—the two of you can explore other options for pleasure that do not include penetrative sex. Dealing with pain in silence can damage your relationship, cause you to dread or avoid sex, and, as was the case for me, mask possible health problems.
Go see a doctor.
Know when you need to see a doctor about painful sex. I can’t urge this strongly enough: make an appointment with a doctor. Not your GP. Not the family doctor. Find a gynecologist, preferably one specializing in midlife health or menopause. If you need help finding a doctor in your area, the website menopause.org can help.
I know that many women are uncomfortable talking about sex, as are some doctors. But the more you can talk about your sexual health needs the easier it becomes. Gynecologists should be more at ease than general practitioners in discussing the topic and can explain how aging tissues and hormonal changes affect your body. If you get a doctor who dismisses your pain or doesn’t do follow-up exams, get a different doctor.
The more important of my stories here has a happy ending. I don’t have cervical cancer. And, with the application of the estrogen I should begin to see some relief from the atrophied tissues and hopefully little or no discomfort when the time comes for me to contemplate that specific sexual activity. I took charge of my own health because having a healthy, pain-free sex life is important to me. I shared that with the doctor and did some research on residual effects of cervical surgery and told her what I had read. I even sent her a link to the article. We have a right to be our own medical advocates.