Unfortunately, I often hear women tell me they have tried to talk to their doctor about pelvic or sexual pain, but are dismissed or are told that the pain is normal. In fact, in a 2001 study by Harlow, Wise, & Stewart found that 40% of women who sought treatment for pelvic or sexual pain never even received a diagnosis. If you are having pelvic or sexual pain, you should consult your treating OB/GYNO because pelvic or sexual pain is not normal. Doctors are more often able to help when patients can be specific and clear about their symptoms. In order to make the most of your appointment bring the following information to your appointment:
- Have a Timeline: Identify when the pain started. Think about whether there were any medical or other physical traumas within a year of when the pain started (this may include the birth of a child, a miscarriage, a car accident, a fall, a new diagnosis of a medical condition or worsening of one, new medication or even significant weight loss of weight gain). Also consider whether there were any life stressors within a year of when the pain started as well (this may include the birth of a child, the death of a family member, significant relationship distress, a divorce, a move, being diagnosed with a chronic illness or significant career stress).
- Use a Pain Scale: Use a pain scale from 0 to 10. Zero means no pain. Ten is pain so severe that you must go to the emergency room immediately. Consider 5 as a moderate amount of pain. Note how and when the pain changes. Consider what your baseline daily pain is, versus your pain when you have a flare of symptoms. Also consider whether the pain comes on suddenly and strong, or if it is gradual.
- Type of Pain: Is the pain dull, throbbing, stabbing, sharp, mild, stinging, burning, aching, itchy, etc. Does the main feel more like muscular pain, or nerve pain? Does the type of pain change based on activity or location? Make sure to note these differences and use the pain scale to differentiate the types of pain.
- Location: Identify specifically where the pain is. Does the pain always stay here? Or does it move based on activities you may be doing? Use the pain scale to communicate the differences in severity of pain, especially if there are multiple areas of pain. Use clear and specific language. For instance, “It hurts everywhere down there” is not as helpful as “It hurts around my vaginal opening” or “I have vulva pain.”
- When: When does the pain occur? Is the pain always there? Or do certain activities seem to trigger the pain. “It hurts all of the time” is not as helpful as “The pain is always there, but it is worse after sex.”
Being able to communicate with your doctor clearly about your pelvic or sexual pain will help him/her to make a diagnosis or to make an appropriate referral. Remember, it is always okay to get a second opinion. If you feel dismissed by your doctor or are told that your sexual or pelvic pain is “normal” or “in your head,” it may be time to seek out a OB/GYNO specialist who is familiar with pelvic pain conditions.