Painful Orgasms - Please help...

[Danimm]

My name is Danielle and I am 32 years old, married with no children. Sometimes I feel bloated, tired and I am experiencing changes in my bowel habits (loose/soft stools). I also have history of abnormal paps (ASCUS) and the HPV exams are always negative and colposcopy results were normal.

Also, since months ago, I am experiencing painful orgasms, cramps like pain that lasts a few seconds after the orgasm. Even without penetration.

What is that? Can it be endometriosis?

Please help. I did a sonogram last week and my doctor said that I had a small cyst that it will go away by it self. She did not see anything else. Regarding the pain, she said that it could be muscle spasms.

Thanks for your help.

[Danimm]

Thanks for your help Dr. J.

I will follow your advice and in two weeks I will get back to you.

Thanks again, Danielle

[Janice M Epp, PhD]

Some women have abnormal paps for years, and then they're normal--and vice versa. If your doc says you're OK, why not just accept it and move on? As long as you have a pap yearly, you can keep tabs on any abnormalities.

Now about the pain: It's possible that you've now created a self-fulfiling prophesy. Short story: A friend of mine had knee pain, had many tests run, and all were negative. Her doc. told her that she should take pain relievers, stretch adequately daily, and accept the fact that there was nothing physiologically amiss--it was just her own eccentric knee. For a time, she couldn't accept this, and she began to limp noticeably in order to avoid putting strain on her knee, and then this affected the strength in her knee, which led to MORE pain, etc. Eventually, she accepted her knee as-is, followed doc's orders, got lots of exercise, etc., and now she lives with some slight pain, but nothing like before. And she no longer limps.

My point is that you're now EXPECTING the pain, so you're contributing to it by tensing up, etc. You're avoiding sex with your husband because of that anticipation.

You also mention feelings of depression. These may be a reaction to your anxiety about pain, or they may indicate some chemical imbalance (clinical depression).

Here's my suggestion: You need to break this cycle of pain/fear/pain. Get back in touch with what's pleasurable about your OWN sexuality and retake control--not with your husband yet--just with yourself. Do some relaxing breathing, conjure up a hot fantasy to override your pain fears, and touch yourself in ways that feel good. If you find yourself anticipating pain, relax, breathe, and think hot thoughts.

Try this regimen for a week or two, and write back to let me know how it's going.

I do have some clinical sexology colleagues in the New York area. After you try the above steps, if you still feel depressed and nothing has changed, we can discuss this further. Hang in there. You've got lots of support. Dr. J

[Danimm]

The STD exam was negative.

Doctor Janice, maybe now I am avoiding sex because I am afraid to feel these cramps that I feel even without penetration. And since I a not feeling like my self for the last 6 months, maybe I am depressed and this makes me avoid sex even more.

I just do not understand why my pap results are abnormal since 2006, and now why I am feeling these cramps. My doc does not know why the results are abnormal; she did std test, colposcopy, sonogram... And regarding the cramps, she said that it is vasocongestion.

I maybe need help. I do not even know if is all in my head. I know that my marriage is not going well because of this. I do not know the cause.

Do you have any colleague attending in NY area?

Thanks for your help. Danielle

[Janice M Epp, PhD]

I am not a gynecologist, so I can't answer your gynecological questions. You really should talk with your physician again to get clear answers. If you're afraid of an STD, why not get thoroughly tested so that you'll know for sure?

Cramping during orgasm is not caused by stress. However, there are many other possibilities, for instance, your husband's penis may be bumping your cervix, causing more cramping. I'm wondering if you're not using this as an excuse to not be sexual with your husband. What else is going on in the relationship? Are there any other reasons you might be avoiding sex?

[Danimm]

Also, because of these abnormal paps, first I thought I had a STD and now I am afraid to have sex and get the pain... So we are not having much of it.

These things are taking a toll in my marriage... My husband thinks I am over reacting, I am concerned about infertility....

I do not know Doctor... Maybe I have something, maybe I need therapy... Can this pain be a result of stress or lack of sex?

[Danimm]

Thanks for the response.

I think I am concerned because of the abnormal paps and now with these cramps during orgasm... Since I heard that PID and Endometriosis are not easy to detect, I though it could be one of these things...

Since they do not know why I am getting abnormal paps, I thought I could have PID and with the cramps during orgasm, which I thought was very very strange, I thought it could be Endo.

When I do the pelvic exam, I feel some discomfort. I do not know if it is pain or just normal discomfort.

[Janice M Epp, PhD]

So your physician told you there's nothing wrong except a small cyst and found nothing else amiss during exam, and yet you don't believe her?

Regarding cramping: The uterus contracts during orgasm as well as during your period. Usually, you don't feel the cramping during orgasm because the pleasure overrides the cramping sensation. Since you have a small cyst, your uterus may be cramping extra hard in order to expel it. Once the cyst goes away, the cramping should abate. If it doesn't see your physician again. Dr. J