Dear doctor;

I feel a lot of pain during intercourse, which has made me lose interest in sex. I used to think it was my ex-boyfriend but two others down the road and the pain has not subsided. How do I seek help?

Phionah, 27.

Dear Phionah,

At your age, the most common cause for painful intercourse is a pelvic inflammatory disease. The pain may be felt during penetration or during deep thrust. It may be associated with pain in the lower abdomen, with or without vaginal discharge. Infection may be acquired through poor menstrual, sexual hygiene or may be sexually acquired  from an infected partner. 

It may be a bacterial, viral or fungal infection. Infections of the urinary bladder can also result in painful intercourse. Conditions with reduced immunity like diabetes, HIV infection, etc. make one more prone to it.

Dyspareunia can also occur due to inflammation of the inner lining of the uterus, uterine myomas endometriosis, ovarian cysts and even skin problems of vagina like eczema or fungal infections.

Tightening of the vaginal muscles as happens due to stress also causes painful intercourse. Pain during intercourse can also occur due to any injury or surgery to the vagina. Intercourse done immediately after childbirth can be painful. Ectopic pregnancy(where embryo is implanted outside uterus), though a rare condition but when it occurs causes dyspareunia.  

You need to get the first morning sample of urine and vaginal discharge(if any)  examined in a pathology laboratory. If positive for infection, suitable antibiotics will help to cure it. Improve on menstrual hygiene and hygiene after intercourse. If the partner has any sexually transmitted disease, say no to sex or insist on a condom. Drinking plenty of water also helps in clearing body of germs particularly of urogenital system, hence is useful.