About 30 percent of American women had a nasty surprise the last time they tried to get it on: It hurt. Yet many are embarrassed to share this with their doctor, says Georgine Lamvu, MD, a professor of obstetrics and gynecology at the University of Central Florida and chair of the International Pelvic Pain Society. Even when they do, the doctor might not know how to find the source of their problem. "Women often get very poor care when it comes to the evaluation and treatment of sexual pain disorders," says Andrew T. Goldstein, MD, director of the Centers for Vulvovaginal Disorders in New York City and Washington, D.C. "In my 20,000 hours of ob-gyn residency training, I received 45 minutes on sexual dysfunction." But things are looking up: 59 percent of gynecologists are now female, compared with just 13 percent in 1990, according to the American College of Obstetricians and Gynecologists, and many patients may be more comfortable confiding in a woman. We asked the experts for advice on sexual healing.

Symptoms
Maddening itchiness, irritation, or burning (maybe some discharge, too)

Likely Offender
Most women will experience vaginitis, or vaginal inflammation, at some point. In fact, it's not unusual to have two bouts per year—most commonly, it's bacterial vaginosis (BV) or a yeast infection. BV may involve a fishy-smelling, milky discharge; yeast infection discharge tends to be odorless and white to yellowish. Vaginitis can result from washing with certain bath gels or soaps, douching, using spermicides or antibiotics or having sex with new partners.

What to Do
Don't ignore this. Persistent vaginitis may lead to pelvic floor problems, including chronically tightened muscles. BV can also make you more susceptible to sexually transmitted infections. Talk to an ob-gyn, who will likely write you a prescription for a cream or a pill. And once and for all, ditch the douche.

Symptoms
A red, swollen, raw-feeling, irritated vulva; itchiness; burning pain on contact

Likely Offender
This could be an allergic reaction (or contact dermatitis). Sensitive skin on the vulva can become irritated by soaps, lotions, vaginal washes, spermicides, towelettes, deodorant tampons and pads and even some yeast infection creams, Goldstein says, as well as residue from laundry detergent or fabric softener that lingers on underwear. (Latex, a popular scapegoat, affects only about 1 to 4 percent of the general population.)

What to Do
See if pain subsides after abstaining from the possible culprit. (Are you using a new body wash? What about shaving cream?) And remember that lukewarm water does a fine job of keeping your genital area clean—without getting in the way of your love life.

Symptoms
An acute pelvic pain, like a stabbing sensation, while attempting or having sex

Likely Offender
Genito-pelvic pain/penetration disorder (GPPPD) occurs when muscles at the opening of the vaginal canal contract involuntarily, often prohibiting penetration. In some cases, the agony may lead to a fear of being touched anywhere near the pelvis. Causes of the disorder are unclear, but it may be due to pain from endometriosis, recurrent urinary tract infections, an injury to the pelvic area or psychological factors like a history of sexual abuse.

What to Do
Whatever the cause of your GPPPD, a pelvic pain specialist should be able to help (see one directly or ask an ob-gyn for a referral). She may suggest pelvic floor physical therapy, which involves therapeutic massage and exercises to help ease the pain or possibly resolve the condition altogether—and is often covered by insurance.

Symptoms
A burning or chafing feeling during intercourse (even when you're aroused)

Likely Offender
Vaginal atrophy: This downer of a name refers to an equally disheartening condition: the thinning, drying and inflammation of the tissues of the vulva and vagina, and the resulting discomfort during intercourse. This is most often because of a decrease in estrogen levels that happens during perimenopause, postmenopause or surgical menopause (when ovaries are removed).

What to Do
Lube, lube, lube. Silicone lubrications tend to be more slippery and last longer than water-based products, says Lauren Streicher, MD, a clinical associate professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine. Doctors can prescribe hormonal—namely, estrogen—treatments (creams, pills and more) as well as nonhormonal options to help alleviate the dryness and misery, so you can rediscover the joy of sex.

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