A patient may complain of deep pain upon thrusting during intercourse and you have ruled out infections, fibroids, ovarian cysts or other potential causes. Next steps to consider include:
The key diagnostic clue that will guide management is the determination that the pain is in fact deep upon thrusting and not more proximal involving the vulva. In the case of deep pain, the cause is related to the length of the partner’s penis, which is longer than comfortably fits into the woman’s vaginal canal. The discomfort experienced by the patient is a result of the penis hitting the cervix. This pain can be replicated in the physician’s office, gently using a dilator.
Physical therapy management of female chronic pelvic pain: Anatomic considerations
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