Could my hysterectomy be causing severe pain and spotting during intercourse?

1 answer | Last updated: Oct 05, 2016
Kat17046 asked...

Hi, I had a hysterectomy almost 3 years ago due to endometriosis and andometriosis. I still have 1 ovary and I have been doing well for the most part since surgery. Recently (within 2 months) I have started having severe pain with intercourse and spotting afterwards. I am very scared and when I called to ask the Dr about it they called me back with an appointment in about 10 mins. I don't see them for another 2 weeks but I am concerned at the quickness at getting me in. Could it be something really bad or should I stop worrying?

Expert Answers

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

Painful intercourse, also called dyspareunia, can be difficult to talk about. Many women who experience this problem will feel embarrassed, that maybe they are "crazy", or that they are doing something wrong during sex to give them discomfort. The good news is that there are treatments available for painful intercourse that can help stop or reduce this problem.

Painful intercourse usually happens due to the following:

1) Pain at the entrance of vagina: lack of lubrication (low estrogen levels, medication side effect); can also come from an injury, vaginal skin irritation, or an infection

2) Pain with actual penetration: can be caused by spasms of the muscles of the vaginal wall (vaginismus)

3) Pain from thrusting: can occur from endometriosis, pelvic inflammatory disease, uterine prolapse, uterine fibroids, cystitis, irritable bowel syndrome, hemorrhoids and ovarian cysts. There could also be an infection or scar tissue from surgery. 4) Pain with certain circumstances (different partner, place): Anxiety, depression, fear of intimacy.

Reading your letter, you shouldn't worry. I think you may have issues with lubrication (from low estrogen), which will cause some minor bleeding and pain. You may also have scar tissue that is getting in the way during sex. I think your Gyn is trying to see you quickly to rule out an infection as a cause. I would let them know if there is any increase in bleeding or pain prior to your appointment, but otherwise you should be fine. Good luck!