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Gynecology

Acute pain during orgasm

04/24/2006

Question:

I appear to have an idiopathic condition and am getting increasingly despondant. I am a 40 year old female and am happily married. I have one child (18 now), born at 34 weeks gestation followed by a year later by a 13 week gestation miscarriage. I then had a tubal ligation. My husband and I have always enjoyed a healthy, adventuresome sex life until approximately 3 months ago, when I experienced excrutiating pain on my right side (ovary location) right when I orgasmed. It took me completely by surprise and I thought afterwards that it was just an anomoly and nothing to be concerned about. However, I continue to experience this pain every time I orgasm, whether I reach orgasm with or without penetration. In addition I have been experiencing urinary stress incontinance, low back pain, bloating (alot of gas), and have gained 15 pounds. I am 5`2" and 125 pounds and am very health conscious so the weight gain is abnormal also. I went to my PCM and after doing a pelvic exam, pap smear, and abdominal ultrasound, she found a uterine fibroid (very small) and felt this was the cause of my problems. She prescribe BC pills, which I am adverse to taking because of the associated risks. She is a wonderful doctor, however I disagreed with her diagnosis/treatment and asked for a referral to a GYN. This is where it gets worse. He did a pelvic exam and ordered an intravaginal ultrasound and while the sonographer discovered a cyst on my right ovary he made no mention of this in my follow-up visit. I cannot tell him that I know of the finding because I am afraid of getting the sonographer in trouble for telling me. The GYN insinuated that this problem was in my head (he claims he has never heard of a woman having pain during orgasm, only pain during intercourse from penetration), advised me to keep having relations with my husband and take motrin, and has referred me to a urologist. I left his office and came home and cried. I am not prone to hysterics, nor do I have a litany of medical problems, past or present. I do have a family history (maternal and paternal) of breast and uterine cancers. I am desperately seeking validation that this problem is real (not imagined) and that there is a cause and solution. Can you please advise me?

Answer:

I will say that the pain is real if you are experiencing it. Although I haven't seen the ultrasound, the ovarian cyst may very well be normal because at your age, the ovary produces a cyst EVERY month as it prepares an egg for ovulation and makes the female hormones. That may be why he didn't mention the cyst. A urologist may help rule out a condition called interstitial cystitis. This is an inflammation of the bladder that can cause great pain with urination and intercourse. If you don't think you have been given the full consideration of your condition, you should seek a second opinion. You may need a diagnostic laparoscopy to look at your internal organs.

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Response by:

Thomas  A deHoop, MD Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated