PCOS and Pain During Intercourse (Dyspareunia): What’s the Connection?
Polycystic Ovarian Syndrome (PCOS) is a disorder that affects between 5-10 percent of all women and is characterized by a variety of symptoms. One issue associated with PCOS is painful intercourse, which is called dyspareunia. It can be very distressing to have pain during intercourse because this activity is supposed to be enjoyable. Most women will experience painful sex at some time in their life and it is safe to ignore an isolated incidence. But if you start having painful intercourse on a regular basis you need to pursue relief because it could indicate there is a more serious underlying concern. Dyspareunia is not a disease unto itself but might be the result of a medical condition, an emotional issue, or a physical condition associated with the genitalia or sexual organs.
It is important to diagnose the cause of painful sex because relief can often be dependent on managing the underlying cause, such as PCOS. Treating PCOS and conditions such as Insulin Resistance, which can influence PCOS, can minimize the severity of the symptoms of PCOS and increase wellbeing.
Why can Sex be so Painful?
Painful sex is more common with women than men and can be caused by many different factors and conditions. Just feeling stressed or self-conscious can make sex uncomfortable physically.15 Even if dyspareunia starts as a result of a medical condition it can eventually cause stress and affect the intimacy in your relationship. Most women who experience painful sex or pelvic pain have no detectable disease; however, this does not mean there is not a tangible cause for the discomfort.
Some possible causes of dyspareunia include:15,16,17
- Pelvic inflammatory disease
- Varicose veins in the pelvis
- Scars from an episiotomy
- Use of certain medications
- Vaginal dryness
- Vaginal infection
- Ectopic pregnancy
- Insufficient vaginal lubrication
- Thinning and dryness of the vaginal wall
- Bladder or other urinary tract disorders
- Cancer in the sex organs or the pelvic region
- Allergies to spermicides or to latex in condoms
- Sexually transmitted infections
- Intercourse too soon after surgery or childbirth
- Irritable bowel syndrome
- Uterine prolapse
- Uterine fibroids
- Misplaced ovary
- Scars from surgeries in the pelvic area
- Emotional factors
- Diaphragm that does not fit properly
- Ovarian cysts
- Polycystic Ovarian Syndrome
The cause of PCOS is not known conclusively but it is thought to be related to factors such as Insulin Resistance, hormone imbalance, and genetics. Insulin is an important hormone in the body that is released by the pancreas. Insulin assists in the regulation of glucose levels in the blood, and Insulin Resistance is when this process is defective. This means your pancreas has to produce ever-increasing quantities of insulin to prevent your blood glucose levels from rocketing out of control. This type of elevated insulin level can result in numerous medical issues, including Polycystic Ovarian Sndrome.
What Characterizes Dyspareunia?
Most women will experience painful intercourse at some point in their lives. The symptoms associated with dyspareunia can vary in intensity from mild to severe and can present differently with each woman. Symptoms include:14
- Burning, aching, or tearing pain
- Deep pain with thrusting
- Pain during sex
- Pain with every penetration (including nonsexual contact)
- Pain only with certain positions
When you experience pain during sex there will be several steps to diagnosing dyspareunia and then discovering the reason for the pain, such as an existing disorder like PCOS. To diagnose dyspareunia you will be asked about your medical history, sexual history, surgeries, and possible childbirth complications.14 Ordinarily a physical exam will be necessary to look for irritation, infection, and possible physical problems. Your doctor might recommend tests such as an ultrasound to confirm the diagnosis, especially if issues such as ovarian cysts are suspected. Your doctor might need further testing if a disorder such as PCOS is the possible cause of your pain.
Some common symptoms of PCOS can include:1
- Acanthosis nigricans
- Male pattern baldness
- Acrochordons (skin tags)
- Menstrual irregularities
- High levels of certain hormones
- Low levels of SHBG (sex-hormone-binding globulin)
- Ovarian cysts
Is There an Effective Remedy to Relieve Dyspareunia?
The possible remedies recommended for treating painful sex usually revolve around addressing the underlying cause of this distressing symptom. However, there are actions you can take to provide some relief which include:
- Counseling: Individual, couples, or sexual intervention can be very effective when there is a psychological element to your condition such as stress, previous sexual abuse, or poor self-confidence.15
- Changing positions or techniques: Sometimes pain during sex can be due to time of the month, certain sexual positions, or lack of foreplay. Trying a less invasive position can create shallower penetration and minimize the pain.
- Using a personal lubricant.
- Pelvic floor physiotherapy: This is a gentle soft tissue massage in the vaginal and pelvic region designed to teach relaxation and pelvic floor exercises. This can help decrease pain.16
If your dyspareunia is caused by Polycystic Ovarian Syndrome there are many natural remedies that can have a positive impact. Healthy lifestyle changes such as diet, exercise, and taking nutritional supplements can help correct factors like Insulin Resistance, which in turn helps reduce PCOS symptoms such as painful sex.5
One of the foundation remedies for PCOS is a healthy diet.5 Some simple guidelines to follow with respect to diet and PCOS include eating foods low on the glycemic index3, eating six or seven small meals a day to reduce spiking blood sugar, and reducing your alcohol intake. You should make smart choices that highlight a variety of fresh fruits and vegetables, whole grains, lean proteins, and avoiding processed foods and simple sugars.
A regular exercise routine is very important in treating Insulin Resistance. Even a single episode of some sort of moderate exercise done for 30 minutes can significantly increase the rate of glucose removal in your body.5 This important improvement is observed for hours after the exercise is completed. The key to this benefit is regular exercise because it can help remove excess weight and manage Insulin Resistance long-term.
There are quite a few nutritional supplements that can have a positive impact on PCOS and its symptoms. Some good choices include:
- Vitamin D: Has been linked to the normal development of ovarian follicles and improving insulin sensitivity.
- Flax seed: Helps lower testosterone levels in the blood.4
- Licorice root (Glycyrrhiza glabra): Studies have found testosterone secretion is reduced after several months of taking this botanical.4
- Spearmint (mentha spicata): Can increase estrogen levels and decrease testosterone levels.4
- Tulsi (Ocimum sanctum): This botanical can help control obesity by helping to normalize insulin levels.
Is medication a good treatment choice?
Treatment for dyspareunia is ordinarily aimed at improving the disorder at the root of the painful intercourse.17 These types of interventions can take the form of a medication prescribed to treat an infection or use of an alternative birth control method when a latex allergy causes irritation. If your dyspareunia is caused by a physical reason or disorder it stands to reason that treating that medical concern will alleviate the painful intercourse.
If PCOS is at the root of your dyspareunia there are successful medical treatments that can help such as:
- Oral contraceptives: Can regulate and normalize menstruation while minimizing acne and hirsutism.
- Metformin: Can help lower insulin levels, which impacts Insulin Resistance-related issues.8
- Spironolactone and flutamide: These medications can block the action of male hormones, which will help eliminate some symptoms associated with PCOS.
- Clomiphene: This drug is used to stimulate ovulation.2
- About PCOS. Yale PCOS Program. [Online] [Cited: 07 11, 2012.] http://medicine.yale.edu/obgyn/rei/images/PCOS%20Inserts.web_tcm153-13313.pdf
- Clomid. Womens Health. [Online] [Cited: 11 23, 2012.] http://www.womens-health.co.uk/clomid.asp
- Staff. Glycemic Index List of Foods. Lifetime Fatloss. [Online] 2012. [Cited: 07 24, 2012.] http://www.lifetimefatloss.com/glycemic-index-list-of-foods.html
- Herbal Remedies and PCOS. PCOS Info. [Online] [Cited: 07 23, 2012.] http://pcosinfo.com/herbal-remedies-and-pcos/
- Natural Treatments For PCOS (Polycystic Ovary Syndrome). The Healthier Life. [Online] 09 20, 07. [Cited: 09 02, 2012.] http://www.thehealthierlife.co.uk/natural-health-articles/womens-health/natural-treatments-for-pcos-00266.html
- Nutrition for PCOS. Appetite for Health. [Online] 08 12, 2011. [Cited: 07 24, 2012.] http://www.appforhealth.com/2011/08/nutrition-for-pcos/
- Polycystic Ovarian Syndrome (PCOS). American Diabetes Association. [Online] [Cited: 07 18, 2012.] Polycystic Ovarian Syndrome (PCOS)
- Cohen, Dr. Sari. Inflammation, Insulin Resistance and PCOS. PCOSupport. [Online] 12 2007. [Cited: 09 01, 2012.] http://www.pcosupport.org/newsletter/articles/article122707-2.php
- David A. Ehrmann, MD. Defining PCOS. University of Chicago Medicine. [Online] [Cited: 07 23, 2012.] http://www.uchospitals.edu/specialties/pcos/pcos.html
- Steven D. Ehrlich, NMD. Hirsutism. University Of Maryland Medical Center. [Online] 09 02, 2010. [Cited: 07 23, 2012.] http://www.umm.edu/altmed/articles/hirsutism-000081.htm#ixzz21UcLRMdB
- Linda J. Vorvick, MD. Sexual intercourse – painful. Health Central. [Online] 09 11, 2010. [Cited: 11 23, 2012.] http://www.healthcentral.com/ency/408/003157.html?ic=506048
- Polycystic Ovary Syndrome Symptoms. Tree. [Online] [Cited: 11 23, 2011.] http://www.tree.com/health/ovarian-cysts-polycystic-ovarian-syndrome-pcos-symptoms.aspx
- FRCOG, David A Viniker MD. Painful Sex Dyspareunia. 2Womens Health. [Online] [Cited: 11 23, 2012.] http://www.2womenshealth.com/Painful-Sex-Dyspareunia.htm
- Hailes, Jean. Painful Sex – Dyspareunia. Jeanhailes For Women’s Health. [Online] 02 2012. [Cited: 11 23, 2012.] http://www.jeanhailes.org.au/resources/fact-sheets/fact-sheet-by-topic/1360-painful-sex-dyspareunia
- Dyspareunia. Health Scout. [Online] 04 11, 2009. [Cited: 11 24, 2012.] Dyspareunia
- Dr David Delvin, GP and Webber, Christine. Painful intercourse (dyspareunia). Net Doctor. [Online] 04 07, 2011. [Cited: 11 24, 2012.] http://www.netdoctor.co.uk/sex_relationships/facts/painfulintercourse.htm
The Insulite PCOS System is not intended to be medical treatment, nor is information on this website intended to be a substitute for the advice or care of a health-care practitioner. The Insulite PCOS System is a combination of nutritional supplementation and lifestyle programs intended to help individuals better manage their health and wellbeing. Consult a health-care practitioner before beginning the Insulite PCOS System. Because of ongoing research, clinical experience, and the rapid accumulation of information relating to the subject matter discussed on this website, the website’s users are advised to carefully review and evaluate the information on this website and continue to expand and broaden their knowledge of new information as it becomes available on this website and elsewhere. The use or application of the information contained on this website is at the sole discretion and risk of the user.
Since June 2008, Insulite Laboratories and Insulite Health has supported more than 2.4 million women through the Insulite PCOS System, through this website, through emails providing information and support, through consultations with our Consulting & Advisory Team, through telephone conference calls, through online webinars, through published articles, and most recently, through social media community building and support efforts. Insulite Laboratories and Insulite Health are singularly dedicated to improving the lives of women with PCOS and conditions resulting from Insulin Resistance.