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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Painful Sexual Intercourse Followed By Vaginal Bleeding?

I am a 45 year old healthy happy woman. I have been happily married for 25 years. I had a hysterectomy in 1994 after the birth of my son due to endometriosis. In the past couple of years I have begun to have severe pain during sex. Sex has always been important part of our relationship and will continue to be so. My doctor has prescribed a very high dose of estrogen which is great because is gives great lubrication. The sex is sill extremely painful. My husband thought I was screaming in ecstasy instead unbeknownst to him it was screaming in pain. The pain was so bad I cried during the sex we had. I cannot begin to explain how bad the pain was. Afterward I continued to bleed for several hours. It was a bright red blood. I am devestated. I am hurt emotionally and physically. please help
Wed, 13 Jan 2016
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OBGYN 's  Response
Hello, and I hope I can help you today.

There are two main types of pain during sex that need to be evaluated in order to help you.

Pain in your vagina is likely due to the fact that your ovaries (which I assume were left in place) are finally starting to decrease in function and you are having symptoms of atrophic vaginitis (thinning of the skin, and narrowing or chortening of the vagina. It is good that your doctor prescribed some estrogen pills for you, but an estrogen cream you place in the vagina may help with your symptoms better. You can use vaginal estrogen in addition to the pills.

However, if you are having pelvic pain with intercourse, even though your uterus has been removed, endometriosis can recur in your pelvis as long as you have ovaries. So if you are experiencing most of your pain with deep penetration, I suggest you discuss looking into this further with a pelvic ultrasound.

The bleeding you had means there was likely a tear in the skin of the vagina during your last episode of intercourse. You should use an external lubricant every time you have sex, even if you feel lubricated, and go very slowly when attempting intercourse the next time. For now, the area needs to heal so I would recommend waiting 1 week before attempting intercourse again.

I hope I was able to adequately answer your question and that my advice was helpful.

Best wishes, Dr. Brown
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What Causes Painful Sexual Intercourse Followed By Vaginal Bleeding?

Hello, and I hope I can help you today. There are two main types of pain during sex that need to be evaluated in order to help you. Pain in your vagina is likely due to the fact that your ovaries (which I assume were left in place) are finally starting to decrease in function and you are having symptoms of atrophic vaginitis (thinning of the skin, and narrowing or chortening of the vagina. It is good that your doctor prescribed some estrogen pills for you, but an estrogen cream you place in the vagina may help with your symptoms better. You can use vaginal estrogen in addition to the pills. However, if you are having pelvic pain with intercourse, even though your uterus has been removed, endometriosis can recur in your pelvis as long as you have ovaries. So if you are experiencing most of your pain with deep penetration, I suggest you discuss looking into this further with a pelvic ultrasound. The bleeding you had means there was likely a tear in the skin of the vagina during your last episode of intercourse. You should use an external lubricant every time you have sex, even if you feel lubricated, and go very slowly when attempting intercourse the next time. For now, the area needs to heal so I would recommend waiting 1 week before attempting intercourse again. I hope I was able to adequately answer your question and that my advice was helpful. Best wishes, Dr. Brown