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Heavy bleeding after sexual relations
I am a 27 y/o woman with two children. I have no significant
gynecological problems, except for an abnormal Pap smear 5 months
ago, which was atypical squamous cells of unknown significance.
For the past month and a half, after intercourse, I experience
heavy bleeding. The bleeding is thin and (pardon the graphicness)
runs down my legs afterwards. I am taking the pill (Demulen). I
have no pain during intercourse or while bleeding, and it isn't
particularly rough sex. This bleeding will go on for three or
four days, last month, it was as if I had my period for an entire
month. Any insight would be greatly appreciated.
Atypical squamous cells of unknown significance (ASCUS) is often
due to an inflammation or irritation of the cervix. The bleeding
after intercourse is also often a sign of
irritation/inflammation. Cervical polyps will often cause the
type of bleeding you are describing. A pelvic exam is needed to
see if you need any treatment for a cervicitis or any cervical
lesion.
Will hysterectomy alter orgasm?
The Board Certified gynecologist that I went to says a
hysterectomy is the answer for my pain problems. I have all my
children and I am 39 years old. I would love to not have anymore
pain and constant bleeding but I keep hearing about total
hysterectomies causing orgasm problems and decreased desire.
Also, bladder problems and they call it being castrated. I am
scared and don't know what is true! I have a wonderful sex life
now when I am not in pain which is about 2 weeks out of every
month! I also have powerful and fulfilling orgasms and I am
scared that this will change after hearing and reading about
Hysterectomies. Please help me as I am really scared. Some say,
you will be so glad you did it and others say, DON'T DO IT NO
MATTER WHAT! What is the truth??
There is no truth and no answer that applies to all situations.
For every woman it is a trade-off of symptoms (i.e., pain in your
case) versus possible change in orgasmic response.
The physiology of female orgasm is comprised of two events
basically: release of blood vessel engorgement (which
accumulated during arousal phase) and uterine, vaginal and some
say, clitoral contractions. After hysterectomy there are no more
uterine contractions with orgasm. There are still vaginal and
possibly clitoral contractions. Some women perceive all of these
while many only perceive some, it varies. As far as the vascular
response there probably are less blood vessels to get engorged
over time because they are not having to supply the uterus any
more.
The most common thing physicians hear from women concerning
orgasm after hysterectomy is that it is different but still
present and pleasurable. There are some women, however, who say
that orgasm is gone. I suspect those women were very sensitive to
the uterine contractions part of orgasm. Other women will also
admit to problems with sex but it is really because of decreased
libido (desire) or decreased arousal.
Removal of the ovaries can affect decreased desire but if
estrogen is replaced, that can account for most but, not all of
the decrease.
Everything you hear is correct but the proportion is not equal,
at least from a physician's view. The majority (let's say 75-85%)
of women having a hysterectomy have a substantial net improvement
in their daily lives. The rest don't and some feel worse off than
before.
Decreased libido and orgasm on Paxil®
I am a 58 y.o. woman post hysterectomy 25 years ago. Recently
due to a sudden onset of panic attacks, I have been perscribed to
take 10 mg Paxil® 1x a day. This has caused a sudden lack of
interest in sex as well as the inability to reach orgasm. What
can I do about this? Is there any remedy while I am on Paxil
which will be for about another 6 months if I go panic attack
free for that time. Any suggestions would be helpful.
Paxil usually has less effect on libido than other mood
altering meds but it can have the effects you describe. Right now
I don't know of any way to counteract that problem except make
sure you are taking your dose in morning or as far removed in
time from when you are likely to have sexual relations. Are you
sensitive to normal doses of other medicines or weigh less than
120; maybe half the Paxil® dose will keep the panic attacks in check
and not suppress sexual desire so much. Be sure to keep up
an exercise program. Restricting calories usually picks up energy
levels if that's a problem.
I haven't heard of Paxil® affecting orgasm. I would more
likely suspect blood pressure meds for that.
Some day we may know that Viagra helps this problem but at
that it's only a temporary solution. I don't think androgens will
help counteract this libido depression unless you are menopausal
or you take high doses that might end up causing masculinization
side effects. The truth is we do not really know and this
subject has not been studied much at all.
Premenopausal vaginal dryness and decreased libido
I am 23 years old and married. I have been having a problem
for the last year or so with vaginal dryness during intercourse.
We have stocked up on K-Y jelly and the like but I am a bit
worried because it has been ongoing. In addition to the dryness
and the pain (irritation) that it causes during sexual
intercourse, I seem to have lost my sex drive (which has always
been quite strong). I don't know if the low sex drive is
psychological because sex is uncomfortable or if it is perhaps
hormonal. I have mentioned the above to my doctors but they just
blame it on my busy lifestyle and stress.
I have my life under control, the sex part is stressing me
out though!! Please help, all of the books that I have looked at
seem to be aimed at menopausal women.
Vaginal dryness can play a role in the cause of decreased libido.
As you say, you begin to fear pain with relations because of
the lack of lubrication and that in turn "turns" you off. There
are other causes of vaginal dryness. Decreased estrogens from
anovulation. Reaction of the vagina to spermicides, condoms, even
sometimes K-Y jelly doesn't help it.
Fear of pain with relations, anger at one's spouse or
something else, can also suppress lubrication at the time of sex.
Certain medications, dietary ingestions can also affect lubrication.
Several questions: Are your menses regular? Are you on any
hormones, medications, dietary supplements? Is the dryness just a
problem at the time of having sexual relations or does it seem to
be a problem in between or all of the time? Are you concerned
about your husband's lovemaking skills, hygiene, verbal or
physical threats or possible extramarital behavior?
Thanks for your quick response. Let me try to answer some of
your questions... My menses used to be very regular, when I was
on the pill, but now they are more erratic. I stopped taking the
pill in January of this year because I thought that the hormones
might be causing the dryness and low sex drive as well as skin
problems. I have been on OrthoNovum 7/7/7® (acne),
Demulen® (severe
mood changes, depression, loss of sexual appetite), and most
recently Ortho TriCyclen®. I was fitted for a diaphragm, hoping
that by using a contraceptive that was not hormonal, everything
would go back to normal. It hasn't.
Diet: I have been lacto-ovum vegetarian since high school
(1991). Dryness: The dryness isn't bothersome on a day to day
basis (although I can tell a difference from how I used to be).
It is mainly a nuisance when we try to make love. Sometimes we
can't even finish. I don't think it has anything to do with my
husband because even when I have tried to make myself wet by
masturbating I am unsuccessful. I used to get wet just thinking
about sex. We are in a monogamous relationship; I have absolutely
no fears that he is unfaithful to me. He is also very sympathetic
and understanding, not at all abusive. We do not use condoms any
more, but I don't think I ever had a problem with being sensitive
to them or to spermicides of any sort. The only major thing that
happened in the last 1 1/2 years was that I had an abnormal pap
smear and was told that I had cervical dysplasia due to HPV. I
had a colposcopy and went back for repeated pap tests which have
in the last 6 months been normal. Could HPV be the physical
reason for the dryness as well as a mental reason for my lack of
interest in sex? I think that this might have something to do
with it but I don't think that it is the whole story. What else
could it be and is there anything besides k-y jelly that would
help make sex fun again?
HPV isn't known to decrease vaginal lubrication on a
physiological basis. As to whether it is a mental reason, that's
possible. It depends on what thoughts you have about HPV. What do
you think are the consequences of HPV? How do you think you got
HPV? If you don't really think about those questions on a
conscious or a subconscious basis, then it shouldn't be having a
mental effect.
The physiological "wetness" with sex comes during arousal when
the blood vessels are congested and excess fluid "weeps" thru to
the vagina. As you said, just thinking about it can cause wetness
if you are aroused. That response is not happening in you. "Why"
is not clear. Remember there is some natural decrease in sexual
arousal as marriage progresses from its early stages to more
familiarity with each other and more tasks of just getting a
family unit operational for the long run. Some of that has to be
taken into account but as you say, its probably not the entire
answer.
From what you've said so far, it's difficult to say what the
cause might be. The end result is a lack of arousal which in turn
produces a lack of lubrication. Since you are not on any
medicines and since the dryness predated the diaphragm use, I
would suspect that there are some mental barriers that are adding
to the problem. The exception is the menstrual irregularity. You
could still be somewhat estrogen deficient and that could
contribute. I would suggest one alternative would be to ask your
physician to prescribe an Estring®. This is and estrogen
impregnated silicone ring that you wear in the vagina all of the
time. It will help increase your overall lubrication which is at
the base of your problem. Very little is absorbed systemically
into your blood stream so you will not have any other effect from
it. It might help you with this.
With a vaginal hysterectomy, will cervix removal affect sex?
I am scheduled for a hysterectomy next week because of
uterine prolapse and related bladder/rectal difficulties. My
doctor is doing this vaginally and is taking out my cervix. He
says there is no reason to leave it in and it won't affect my sex
life. Friends have told me that I should keep my cervix to keep
full sexual enjoyment after the surgery. Who is right?
There's not any scientific right or wrong answer to this. In
general, women with prolapse have the cervix removed with the
uterus. It has to be in order to have a vaginal hysterectomy. In
order to not remove it, you would have to have the procedure done
abdominally.
There can be some differences in sexual response after
hysterectomy. The uterus undergoes contractions with orgasm as
does the vagina, but the uterine contractions are more prominent.
Leaving the cervix in place may preserve some of those
contractions. Arousal should be the same in both cases because it
is primarily due to congested blood vessels just like a male
erection. The blood vessels are still there after hysterectomy.
Most patients I have had will tell you that sexual response
after hysterectomy (removing cervix too) is slightly different,
but no less enjoyable. Many women with prolapse have discomfort
or pain with sex and fixing the prolapse makes such a positive
difference that they wish it had been done earlier. Your friends
are correct though, that some women have a negative change in
sexual response with hysterectomy but it is not known if that
would change if the cervix was left in.
What kind of physician do I see for a decreased sexual desire?
I am a 32 yr old mother of 3 boys (5 yr old twins, and 7 yr
old). I've been married 9 years to my DH and we have a great
relationship. What we don't have however is sex. Now he's okay
with it, and I am somewhat okay with it.. although I'd like to
improve it. Here's my problems..I have chronic yeast infections
and anything can set them off from beer to sex. I get bacterial
infections really easy (example oral sex). I also have absolutely
NO sex drive. I mean none. I use to like to masturbate and I
still can occasionally, but not half as much as I use to. Even if
I do.. its just not very exciting. My question I guess I'm asking
is I don't know which doctor to go see. I mentioned to the OBGYN
once about my low sex drive, and basically the answer I got was
very humiliating (seduce your hubby etc..) I'm wondering do
endocrinologists test hormone levels?? OR should I just check
with my family doctor first?? Or some kind of sex therapist?? I
really am not sure who to turn to to help me straighten all this
out. Any insight?
This isn't an easy question. Decreased sexual desire is a
complex subject. See our news article about libido at:
Sexual
desire
The best physician to find is a gynecologist who has an
interest in or specializes in sexual therapy. There's not a
comprehensive list anywhere that I know of. The next person
might be a Gyn endocrinologist. If medical diseases and hormone
levels measure out as normal, a psychologic counselor/therapist
who specializes in women's problems would be next. That person
could examine to what degree feelings play a role. These
types of problems are never 100% hormonal nor are they 100%
emotional.
Pain with sex or full bladder or bowel movement
For the last 4 years I have experienced pain during
intercourse. When I first told my doctor about it, he sent me for
an ultrasound, it came out "negative". I figured it was all in my
head (I was going through a divorce.) One year later, a new
partner and no health insurance, I went to planned parenthood for
my annual & BCP. I mentioned the still occurring pain to the
nurse, she said my partner was hitting my cervix and to try
different positions. So I did, but still had the pain, the next
year was the same thing. This year I went back to my original
doctor, let him know the pain was still there and getting worse.
He sent me for two more ultrasounds; one on the lower right
(where the pain is) then another one of my entire abdomen. Both
were fine. My doctor is a general practitioner and he seems
reluctant to send me to a gynecologist. I get the same pain when
my bladder is full, having a bowel movement, and after a pelvic
exam, or just pushing on the area. Since the ultrasounds are fine
should I simply live with the pain or are there other tests? My
paps come out normal, but I'm not sure what they are testing. I'm
27 years old. Thank you so much, I don't know where to go from
here.
This is the type of question that is very difficult to answer
without an exam. A pelvic exam by a gynecologist could quickly
confirm what the health department nurse mentioned which is a
degree of uterine prolapse. In that condition the uterus has
lost its support and has dropped lower in the vagina and can
undergo painful movement during sexual relations. Since you are
having pain all of the time with relations and, I assume, this is
interfering with your ability to have a physical relationship
with your partner, I would keep pursuing trying to figure out
what is causing it until all possibilities are ruled out.
The fact that the pain is similar to when the bladder is full
or having a bowel movement tells me there is likely to be either
adhesions in the pelvis (scar tissue) or bowel or bladder disease
such as irritable bowel syndrome or interstitial cystitis,
assuming uterine prolapse has been ruled out. If you
are not having urinary frequency during the day and having to
urinate at night more than once or twice, that is against
interstitial cystitis.
Therefore, I would ask your G.P. if irritable bowel syndrome
is likely. If so see a gastroenterologist. If not, you need to
see a gynecologist. It's likely that a laparoscopy will be
recommended. It may be positive or negative for a cause such as
adhesions or endometriosis, but at least you'll know.
Thank you for taking the time to answer my questions. I will
ask my doctor about this
Painful sex and pelvic adhesions
My doctor said I have adhesions in the pelvis an will
require a 3 hour laparoscopy to free them. In addition I was
wondering if adhesions causing pain get worse over time? The pain
I'm experiencing is getting worse and is suddenly very painful
during sex.
Adhesions do tend to get "thicker" or more dense over time.
Pain can increase due to adhesions up to about one year then
stays the same.
Vulvar redness and itching with condom use
Each time my husband and I use a condom to prevent
pregnancy, I end up with redness and itching (about 12 hours
later). Could this be an allergic reaction to the condom? I am
not allergic to latex gloves. The condom was free of spermicide
but did have a lubricant. HELP !! I was going to the doctor next
month to get a diaphragm, but aren't those latex?
Yes. You are probably having a contact allergy. Most often it
is the lubricant and not the latex. You have to be your own
detective to determine which brand is the problem. There are
unlubricated condoms you can try and then add Replens as a
lubricant. You may want to try the Replens first to make sure you
don't react to it but it is one of the least reactive ones to
try.
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