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In young women, pelvic pain during sex can be caused by psychological or physical issues, such as endometriosis. In older women, pain may be caused by other problems, explains Elizabeth Poynor, MD, PhD, a gynecologist-oncologist in New York City.
For younger women, the basis of pelvic pain with intercourse can be due to psychological issues, can be due to actually Endometriosis is classic for causing pelvic pain with intercourse for younger women. That can be alleviated by treatment of the Endometriosis or some newer therapies called pelvic floor physical therapy which actually can result in elevating pelvic pain with intercourse. For older women that pain with intercourse usually is due to vaginal atrophy or thinning of the vagina which can be supplemented and corrected with a little bit of tropical vaginal estrogen, so important to realize that all pain with intercourse is due to vaginal atrophy, subclinical yeast infections or other types of vaginal infections can also contribute to pain during intercourse.
Like in Sclerosis which is not a common issue but yet an issue as we age, which is a thinning of the outside of the vagina or the vulva can also lead with pain with intercourse, so not all pain with intercourse is due to vaginal atrophy and lack of estrogen. That's why it's important to bring it up to one's physician, it can can also be corrected quite nicely with lubricants also with that in addition to hormones.
Elizabeth Poynor, MD, PhD, FACOG is a gynecologic oncologist and pelvic surgeon. Her solo practice focuses on the care of woman at elevated risk of cancer based on abnormal Pap smear, medical history, or family history of cancer.
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