Sex Pain: Your Questions Answered

For many women, sexual intercourse is an unbearable experience. The women profiled by "20/20" suffered in silence: They did not feel pleasure from sex. Instead, they said they felt excruciating pain.

The vaginal pain extended beyond sex to everyday activities like walking, and even light contact from wearing blue jeans can be too agonizing to bear. But all the women said what's almost harder than the physical pain is the emotional toll of suffering from such a mysterious condition without a clear diagnosis. Click here to watch.

Dr. Andrew Goldstein, who runs the Center for Vulvovaginal Disorders in Washington, D.C., and is a pioneer in the new field of sexual pain disorders, said 20 million U.S. women will suffer from sexual pain disorders at some point in their lives.

Goldstein said the No. 1 cause is birth control pills, followed by tight pelvic muscles and an overabundance of nerve endings at the opening of the vagina.

Click here for Goldstein's frequently asked questions about sex pain and how to treat it.

Your Sex Pain Questions Answered

Whitney of Alberta, Canada, asked: I started taking the birth control pill called Yasmin in May 2008 and four months later I could no longer have sex with my fiance, the pain and dryness around my vulva was so great. I quit that pill in December, even though my doctor did not believe that my pain, extreme dryness and itchiness had any connection to the pill. I regained a small amount of natural lubrication, but I have not been able to have pain-free sex since. What can I ask my doctor to prescribe me? I have always felt that my hormones have never recovered from the use of this pill. Would it be better to try taking the tricycle pill I had successfully taken in the past, or ask for an estrogen and testosterone cream (Estradiol 0.03 percent andTestosterone 0.1 percent). I would like to have my interest in sex as well as my pleasure restored. My fiance has been very patient and supportive, but I would like to enjoy our wonderful sexual connection again. Thank you so much for your help!

Goldstein answered: I frequently see women with sexual pain and low libido because of Yasmin. This OCP (oral contraceptive) contains a combination of hormones that lowers estrogen and testosterone. Unfortunately, just stopping the Yasmin may not fix the problem. Frequently, a topical cream that is made at a compounding pharmacy that contains estrogen and testosterone can be used after stopping the Yasmin. It is important to go to a physician who knows how to monitor these hormones.

Physical Therapy May Be a Solution

Emily of Greensboro, N.C., asked: I experience sexual pain and therefore rarely -- really never -- engage in intercourse with my boyfriend of two years. I am 26 years old. I chronically worry about anything and everything and not on purpose. I think that has something to do with it. In March of this year, my doctor injected a steroid onto my cervix. Is that the same thing as a vestibulectomy? He said it would help the pain for at least six months. It did a little at first, but when we tried, it seemed to hurt some more. I tighten my pelvic muscles because I anticipate the pain. Do Kegel exercises help? He suggested dilators for therapy, but I don't think I could do that at all. I don't think this problem will ever go away. We don't plan on children, but I still would like to be normal and enjoy it.

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