THE REASONS OF PAIN WITH INTERCOURSE IN WOMEN
Endometriosis. This condition occurs when the tissue lining the uterus (the endometrium) dislodges from the uterus and becomes implanted in other areas of the pelvis or other areas of the body. Even though this tissue is no longer part of the uterus, it continues to respond to hormonal changes just like the endometrium, and it bleeds monthly. This bleeding irritates the structures where the tissue has become implanted, causing pain, usually with the menstrual cycle. Because of this irritation, intercourse, especially with deep penetration, may be painful. The best way to diagnose endometriosis is through a procedure called a laparoscopy, during which a special tool called a laparoscope is inserted through a small incision into the abdomen so the surgeon can view these pieces of implanted tissue. The typical treatments for endometriosis involve medications or surgery.
Estrogen deficiency. Women who are going through or who have gone through menopause and who do not receive estrogen replacement therapy (ERT) may develop thinning of the vaginal tissues (atrophy) and therefore increased susceptibihty to tearing with intercourse. This is true whether a woman’s menopause is natural (brought about by a decline in the amount of estrogen produced by the ovaries, which occurs for most women around the age of fifty) or due to surgical removal of the ovaries (such as with a total hysterectomy, which may be performed for various reasons). ERT after menopause will help to prevent these changes and can reverse atrophy when it has occurred. The decision to start ERT is an individual one, and all the pros and cons must be discussed with your health care provider.
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