If you need to urinate with
alarming frequency and it’s extremely painful, bacteria, in the form of a
urinary tract infection, might be to blame.
The area “down there” doesn’t always behave the way you’d expect it
to. And sometimes, trouble can crop up at the most frustrating or
embarrassing times—like intimate moments with your partner. But however
ill-timed these interruptions may seem, your body is trying to tell you
something important. “During sex is when many women first notice pain in
their genitals, or rashes, bleeding and other potential signs of health
trouble,” says Michele Curtis, MD, a professor of obstetrics and
gynecology at the University of Texas at Houston. “And though you may
feel awkward discussing these symptoms, it’s essential to see your
doctor right away and describe where the problems are located and how
frequently they occur.” While most pain can be linked to treatable
conditions, such as those stemming from infection and ovulation, other
sources of problems can be chronic and much more serious, which is why
it’s vital to monitor your body and communicate with your doctor. Read
on to learn about seven common symptoms you should never ignore—and what
they mean for your health.
1. Vaginal Discharge
“When you ovulate in the middle of your menstrual cycle and your body
is most fertile, your vagina secretes clear to slightly cloudy fluid
that is more copious than at other times of the month,” says Sandra
Reed, MD, a spokeswoman for the American Congress of Obstetricians and
Gynecologists who is based in Thomasville, GA. While this type of
vaginal discharge is perfectly healthy, other types are cause for
concern. For example, if the fluid is clotted, clumpy and white, like
cottage cheese, the problem is likely a yeast infection. This is the
result of an overgrowth of a fungus called candida, which is always
present in the vagina. Stress, illness, taking drugs like antibiotics
and steroids, and sometimes, health problems such as diabetes can cause
the overgrowth. Yeast infections affect three out of four women at some
point in their lives, and can be passed between sexual partners if not
treated immediately. Vaginal discharge can also signal a sexually
transmitted infection (STI), including gonorrhea (marked by
greenish-yellow fluid), trichomoniasis (in which the discharge is
usually frothy), or Chlamydia (which can cause excessive, clear-to-white
discharge). “Make sure to treat STIs right away, as they can be
dangerous for you and your partner, especially if they spread and their
symptoms worsen,” says Leandro Mena, MD, an infectious disease
specialist at the University of Mississippi Medical Center in Jackson
and a spokesman for the American Social Health Association.
2. Itchy Rash
If your genital area is inflamed and itchy, you likely have some form
of vulval dermatitis, which is an allergic reaction to an irritant that
could be anything from shower gel to synthetic underwear fibers.
“Sometimes rashes manifest after sex because women may be allergic to
latex condoms, lubricants or spermicidal creams,” says Dr. Curtis. “They
can even be allergic to their partner’s urine, sweat or sperm.” A rash
could also signal herpes, an STI causing sporadic outbreaks that usually
begin with a tingling sensation and then erupt into small red bumps or
white blisters. “Herpes affects 16 percent of people, but 80 percent of
carriers don’t realize they have it because they have no visible signs,
and symptoms can vary from person to person,” says Dr. Mena. “If you or
your partner has herpes symptoms, abstain from intercourse and see your
doctor right away.” It’s crucial for pregnant women to get herpes
treatment because they can transmit the infection to infants during
childbirth. It’s also important to get continued treatment to prevent or
minimize future herpes outbreaks; herpes is most contagious during
visible outbreaks, even though those outbreaks may change and become
less severe over time. Another possible cause of itchy rash is lichen
sclerosus, a rare skin condition that causes patchy white skin mostly on
the genital and anal areas. The condition causes skin on those areas to
thin out and tear more easily, sometimes leading to scarring. Prompt
diagnosis and treatment (usually with cortisone creams and ointments) is
essential. Left unchecked, lichen sclerosus can cause the genitals to
become malformed, making it painful to have sex and difficult to
urinate.
3. Burning Sensation
If you need to urinate with alarming frequency and it’s extremely
painful, bacteria, in the form of a urinary tract infection, might be to
blame. “Frequent intercourse can boost your risk of UTIs, and can
increase the pain that they cause,” says Dr. Curtis. “Sex can also move
the infection up to your bladder, causing a more serious infection
called cystitis.” In rare cases, burning sensations are a sign of
vulvodynia, chronic pain in the vulva that can be caused by infection
(such as repeated yeast or candida outbreaks), trauma (such as pelvic
surgery that damages the nerves and causes them to feel continued pain)
or an unidentifiable trigger. This condition, which affects 1 percent of
U.S. women, can cause pain not just during sex but also while a woman
is walking, using the bathroom or even just resting. Most often,
vulvodynia is treated with medication, biofeedback therapy or local
anesthetics. In some cases where localized vulvodynia is present surgery
is performed as a last resort to remove inflamed nerves.
4. Muscle Spasms
Do your genitals regularly clench or clamp down when you’re touched
or trying to have sex? If so, Dr. Reed points to vaginismus as the most
likely cause. Vaginismus affects 6 percent of women and causes
involuntary spasms of the vaginal wall muscles, making penetration
painful. Dr. Reed says the cause of such spasms and pain is not fully
known—and sometimes there is no identifiable cause. Most often, however,
the root of the condition is emotional, such as past sexual trauma or
anxiety about intercourse. Treatment can involve counseling, the use of
vaginal dilators and physical therapy to retrain muscles and prevent
them from spasming during sex.
5. Sour Smell
If your usual scent turns fishy or sour, that’s a telltale sign of
bacterial vaginosis (BV), an inflammation resulting from the overgrowth
of bacteria (usually gardnerella) normally found in the vagina.
“Smoking, frequent douching and frequent sexual activity can all trigger
BV,” says Dr. Curtis. Women usually notice BV’s smell most strongly
right after their period or after sex. Treatment typically involves a
course of antibiotic medication. In rare cases, a foul smell may be
caused by a tampon that is left in the vagina longer than the
recommended eight hours to prevent bacterial infection and toxic shock
syndrome (a severe disease caused by staph bacteria). “If you’ve left
your tampon in for more than a day, you may need to see your MD to
remove it and get medication to treat infection,” says Dr. Reed. She
adds that leaving in a tampon for a few extra hours will not likely
cause toxic shock syndrome, however if you do and are experiencing a
high fever, contact your doctor immediately.
6. Bleeding
The cause of spotting or light bleeding can be traced to varying
factors depending on your age and health. Menopause or a hormonal
imbalance can cause your uterus to shed blood and tissue at unexpected
times, leading to spotting. Light bleeding can also happen if you’re
using a brand of birth control pill that doesn’t agree with your body;
it can cause your uterine lining to shed before the phase when you take
placebo pills. If bleeding only happens right after sex—and not at any
other time—Dr. Curtis says it could be an issue with your cervix. “The
cells there may be sensitive or inflamed for some reason, such as an HPV
infection or even the beginnings of cervical cancer.” Other causes of
vaginal bleeding could include endometrial cancer, uterine fibroids
(which are benign growths), pelvic inflammatory disease (bacterial
infection that spreads to the upper genital tract) or an ectopic
pregnancy (which takes root in the fallopian tubes instead of the
uterus). If you’re pregnant, bleeding could be a sign of a miscarriage.
If that’s the case, Dr. Reed recommends calling your doctor and heading
to the emergency room right away.
7. Pain During Sex
Nearly 22 percent of women experience dyspareunia, or painful
intercourse, at some point in their lives, reports the World Health
Organization. The cause is usually a matter of physics—a need to avoid
deep thrusting or finding a position that’s pleasurable for you. If pain
persists, there could be many causes: ovarian cysts, infections of the
uterus or fallopian tubes, scar tissue from old infections or surgeries,
endometriosis (in which menstrual tissue grows in the abdominal cavity)
or fibroids (benign uterine growths). If you experience any sustained
pain when you have sex, talk with your physician. “Pay attention to
where the pain is,” says Dr. Curtis. “Note whether it’s sharp or dull,
constant or sporadic, and describe it in detail to your doctor.”
