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Doctor talking with patient

Sexual health issues are a topic that many women are hesitant to discuss, even with their doctors. Know that sexual dysfunction is quite common among women, and receiving appropriate treatment is a necessary step toward improving quality of life. In some cases, problems such as painful sexual intercourse could indicate an underlying health problem, such as endometriosis. Women who take the first step by talking to a urology provider are being proactive patients.

Vaginal Atrophy

Vaginal atrophy typically occurs after menopause, when a woman has a drastically reduced amount of estrogen. This hormonal shift causes the vaginal walls to become thinner, less lubricated, and inflamed. In addition to painful sex, women with vaginal atrophy may experience urgent, painful urination, urinary incontinence, genital itching, and frequent urinary tract infections (UTIs).


Vaginismus is the involuntary contraction or spasm of the vaginal muscles when penetration is attempted. It can occur when attempting sexual penetration or tampon insertion. In some cases, vaginismus is believed to stem from past sexual abuse.


Normally, the tissue that lines the uterus is shed each month during a woman’s menstrual cycle. In women with endometriosis, uterine tissue grows outside the uterus. This displaced tissue also attempts to shed each month by growing thicker, breaking down, and bleeding. However, the tissue can’t be expelled. Displaced endometrial tissue can cause significant irritation and inflammation, along with the formation of scar tissue, adhesions, and cysts. Women with endometriosis commonly suffer from pain during or after sex, as well as intense pain during menstruation.

Uterine Fibroids

Uterine fibroids are abnormal growths attached to the uterine wall. These are not cancerous, but they can cause medical problems like pain during sex. Fibroids can range widely in size. Some women have just one, while others have many. In some cases, fibroids don’t cause symptoms. Large fibroids can cause painful sex, along with infertility, pelvic pain or pressure, and heavy, prolonged menstruation.

You’ll find sensitive, confidential care for sexual dysfunction in Tennessee at the Women’s Institute for Sexual Health (WISH). WISH, available at Urology Associates, P.C., takes a multidisciplinary approach to coordinate each patient’s care. Call us at 888-656-0667.