Dealing With Pains: Urination, Sexual Intercourse, Menstruation, and Abdominal

Painful Urination

Dysuria is the medical term for painful urination and most of the causes are treatable easily. The common causes include irritated areas that the urine passes over, vaginal infection, sex transmitted diseases (STD), urinary tract infections (UTIs), and alterations in vaginal tissue due to menopause. If you’re sexually active, risks of UTI is higher, while pregnant women also experience infections.

Symptoms of vaginal infection are vaginal discharge, burning, itching, so when urine passes over the infected area, the pain feels like it’s on the outside of the body.  In the case of STDs such as herpes, genital warts, the pain is similar to vaginal infection when urine passes over the infected area. For UTIs, pain feels like it’s inside and there may be blood in the urine And in cases where it comes with fever, back pain, and an upset stomach, it can be a serious kidney infection in which case seeing a doctor should  be immediate.

There are other causes of painful urination but not as common, which include kidneys stones, tumours in the bladder, holding urine for a long period of time, and scarring or narrowing of the vagina. A lab test and a pelvic examination by your doctor can detect a urinary infection.   Antibiotics or anti-infective drugs are used in the treatment of an infection with relief gained fast including improvement in urination within the first day of use.  Flushing the system by drinking lots of water also helps. 

Painful sexual intercourse

Dyspareunia is the medical term for painful intercourse. It’s a burning, ripping, tearing or aching sensation linked with penetration. The pain may be at the opening of the vagina, deep in the pelvis or somewhere in between, in the entire pelvic area and the sexual organs, or may happen only with deep thrusting. Having pain during sex is a very sensitive and emotional problem which several women find hard to discuss with a doctor.  It’s vital to seek treatment if you feel pain during intercourse, and in most cases it can be treated.  

One popular explanation is to have sex without sufficient arousal and lubrication. It’s an experience that repeats itself resulting in a woman fearing intercourse, which in turn makes arousal difficult. For instance women who have had hysterectomy (womb removal) or mastectomy (breasts removal) may have developed arousal problems because of the assumption they have lost their femininity.  Also stress or problems in a relationship can prevent arousal. If the situation is really bad counselling can help address these emotional problems while OTC lubricants can increase lubrication and reduce discomfort.  Consult your doctor or pharmacist.

Another popular explanation is thinning and drying of the vaginal tissue as menopause starts, due to the body producing less and less of the estrogens that are needed to maintain moist vaginal tissue.  The vagina becomes dry, itchy and painful, as the vagina’s ability to make its own mucus declines, leading to discomfort during intercourse.  If this is a problem with you, estrogens creams and lubricating gels can help restore moisture. However, this isn’t a problem with all menopausal women, it’s an individual thing.

Yet another explanation is involuntary muscle spasms of the thighs, pelvis, and vagina which make penetration impossible.  It’s a condition called vaginismus, which can develop along with any of the other causes of painful intercourse, already mentioned, or as a consequence of emotional factors. A traumatic sexual experience like rape or an absurd fear of genital injury can lead to vaginismus.  Seeking counselling help can work.  Other causes of painful intercourse include:

·         Infection of the vagina, pelvic, cysts or boils, or herpes.

·         Anything that narrows the vagina like scars, tumours.

·         Endometriosis.

·         Unbroken hymen in virgins.

·         Problems of surgery.

·        Diseases which hinder physical process of arousal or orgasm, such as and multiple sclerosis and diabetes.

Painful Menstruation

Dysmenorrhoea is the medical term for painful menstruation.  It’s frequently severe enough to cause absence from work, college lectures, or inability to do other tasks.  Symptoms include lower abdominal cramping, headache, nausea, vomiting, during menstruation.

There are two types of painful menstruation. The first called primary dysmenorrhoea inclines to affect about half of all young women soon after their first menstruation.  Painful contractions may occur as the uterine walls release natural substances called prostaglandins.  Psychological factors may play a role.  Primary dysmenorrhoea can be treated with ibuprofen, which helps block production of prostaglandins.  In some situations, birth control pills or other medications containing hormones may help. In addition, exercise, good nutrition, and avoiding stress are also crucial.

The second called secondary dysmenorrhoea develops after years of normal menstruation and consequences of diseases of the uterus, fallopian tubes or ovaries.  Among likely causes are tumours, pelvic infection, uterine cancer, and endometriosis.  Endometriosis is a serious disease that can cause infertility.  It's best to see your doctor who will ask you about your periods and the timing and severity of the pain.  A pelvic examination will be done along with any other additional tests necessary, as treatment for secondary dysmenorrhoea is determined by its cause.

Painful Abdomen

This symptom is pain in the abdominal area, stomach region, or belly.  Abdominal pain is a non-specific symptom that may be associated with a multitude of conditions.  Some do not occur within the abdomen itself, but cause abdominal discomfort.  Several abdominal pain can be associated with mild conditions, such as gas, while mild pain or no pain may be present with severe and life threatening conditions such as cancer or the colon or early appendicitis.

The causes of abdominal pain are extensive: toxins, infection, liver disease, bladder infections, menstruation, ovulation, ulcers, pancreatic disease, hernias, trauma, metabolic diseases etc.  Since abdominal pain is non-specific, the doctor will require much more information regarding the time of onset, duration of pain, location of pain, nature of pain, severity of pain, and relationship to normal functions (such as menstruation and ovulation).  The location of the pain and its time pattern may also be helpful in suggesting its cause.  In addition the doctor will try to relate the abdominal tenderness to other general symptoms such as fever, fatigue, general ill feeling, nausea, vomiting, or changes in stool.

A likely emergency is needed when abdominal pain:

·    Comes with nausea and fever which may point to appendicitis, infected gall bladder or  complications of diverticulitis.

·         Comes with nausea, and bloating or constipation which may point to bowel obstruction.

·     Comes with a stiff, ‘board like’ abdomen which may point to an infection spreading in the   abdominal cavity or to a hole in the stomach or intestine.

·         Comes with bloody stools, vomiting blood or gastrointestinal bleeding from any cause.

·         Is consistent in the upper abdominal and comes with vomiting may point to inflammation of the pancreas.

·         Is followed by nausea and vomiting and fever may point to appendicitis.

Home Treatment

For mild pains, drink water or other clear fluids.  Shun solid food.  Antacids may provide some relief, but shun narcotic pain medications and aspirins unless prescribed by the doctor.

Consult a doctor immediately if:

·         Pain is really unbearable.

·         There was an injury to the abdomen in the last 2-3 days.

·         Pain develops during pregnancy, or possible pregnancy.

·         Pain continues for a long period of time.

·         Pain comes with fever, nausea, or not being able to keep food or liquids down for many days.

·         Pain comes with nausea, fever, and bloating or constipation.

·         Pain comes with vomiting blood or there are bloody stools.

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