How can my doctor tell what is causing my pain?
Your doctor may ask you to describe your pain, where it is located and when it began. He or she may also ask you to describe what you have tried in the past. For example, have you tried a sexual lubricant or more foreplay? Is it painful every time you try to have sex? Are there other problems associated with sex? These are some of the questions that your doctor will need to discuss with you. Your doctor may want to examine your genital area or give you a pelvic exam.
What will the exam be like?
During the exam, your doctor may apply a cotton-tipped swab to the area to see if the area around the vagina is painful. A gentle exam of the vagina and cervix is done with a speculum, similar to the way you get a Pap smear. For some women, this part of the exam may be painful. Your doctor may use a smaller speculum to decrease the discomfort. Or, your doctor may delay the exam until the pain has decreased.
It is important to let your doctor know if the exam becomes too painful. Discuss this with your doctor ahead of time. Many women find it useful to hold a mirror during the exam to see the appearance of their genital structures.
During the final part of the exam, your doctor will feel your uterus and ovaries with one hand on the abdomen and one finger in your vagina. This is similar to exams performed during a pelvic exam.
Will I need any tests?
If your symptoms and exam suggest an infection, tests may be needed done to check for yeast or bacteria. If there is no infection, your doctor may do some other tests, such as urine or allergy tests.
Evaluation and Differential Diagnosis of Dyspareunia by Lori J. Heim, LTC, USAF, MC (American Family Physician April 15, 2001, http://www.aafp.org/afp/20010415/1535.html)
Written by familydoctor.org editorial staff