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I’m uncomfortable, unable or it hurts to have sex

Conditions that affect all genders

Both women and men, and people with female and male genitals, can experience symptoms or have conditions that interferes with their sexual enjoyment or performance.

Skin disease (lichen sclerosus)

Lichen sclerosus is a skin disease that causes itchy and painful patches of thin, white, wrinkled-looking skin.

Lichen sclerosus is treated with cortisone ointment first for both female and male genitalia. If this doesn’t work, however, then surgery to remove the affected skin is required.

Pain during intercourse (dyspareunia)

Dyspareunia is the medical term for painful intercourse. It can occur in the pelvic area or vagina for females and males. If you have symptoms consistent with this condition, please visit your family doctor for further advice. You can also visit a pelvic floor physiotherapy to discuss exercises that can help reduce this pain.

Learn more about dyspareunia

Ep. 47 - Pain with intercourse: Looking beyond the pelvic floor muscles with Dr. Lori Brotto

Ep. 48 - Using dilators to address painful penetration with Dr. Amanda Olson

Persistent genital arousal disorder

Also called restless genital syndrome, this disorder results in spontaneous, persistent and uncontrollable genital arousal. This arousal occurs, with or without orgasm or genital engorgement, and is unrelated to any feelings of sexual desire.

Learn more about persistent genital arousal disorder

Conditions affecting those with female genitalia

Symptoms of menopause

Menopause can bring about changes to female genitals, including the vulva, vagina and lower urinary tract. This is known as genitourinary syndrome of menopause.

Symptoms can include:

Dryness, burning and irritation
Sexual issues like lack of lubrication, discomfort or pain, and impaired function
Urinary symptoms, including urgency, dysuria and recurrent urinary tract infections (UTIs)

Ep. 54 - Vulvovaginal hormone therapy with urologist Dr. Rachel Rubin

Pelvic organ prolapse

When one more of your pelvic organs bulges or herniates into or out of the vagina, this is known as pelvic organ prolapse.

Symptoms include:

A heavy dragging feeling in the vagina or lower back
Feeling of a lump in the vagina or outside the vagina
Urinary symptoms such as slow urinary stream, a feeling of incomplete bladder emptying, urinary frequency or urgent desire to pass urine, and urinary stress incontinence
Bowel symptoms, such as difficulty moving the bowel or a feeling of not emptying properly, or needing to press on the vaginal wall to empty the bowel
Discomfort during sexual intercourse

Learn more:

Conditions that affect those with male genitalia

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Erectile dysfunction (ED)

Erectile dysfunction (ED) is the persistent inability to get and keep an erection of the penis that is firm enough for satisfactory sexual activity.

Learn more about ED

Premature ejaculation

This is ejaculation that occurs sooner than a person with a penis or their partner would like during sex.

Pelvic and genital pain (prostatitis)

Prostatitis is pelvic and or genital pain or discomfort that may also include urinary and sexual problems.

Learn more about prostatitis

Curvature of the penis (Peyronie’s disease)

Peyronie’s is a disease that curves the penis due to dense formation of scar tissue.

Learn more about Peyronie’s disease

Where to get help

Although it might feel embarrassing, share your concerns with your current health-care provider: family doctor, nurse practitioner, physiotherapist and/or occupational therapist. They can discuss treatment options with you or refer you to another health-care provider. Your family doctor who may refer you to a specialist urologist, gynecologist or urogynecologist.

Physiotherapists
For some of these conditions, physiotherapists can help assess your symptoms and offer treatments.

To find a physiotherapist in your area:

Go to Find a Physiotherapist in British Columbia on the Physiotherapy Association of BC website
Under “By Areas of Practice” select Pelvic Floor and/or Women’s Health

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