Expert Answers Factual Answers to Your Sexual Health Questions

Anonymous on September 16, 2011

My partner and I have been having great sex for many years…but now, my vagina is extremely sensitive and intercourse is painful. Why?

My partner and I are in a monogamous relationship, and we’ve both been tested for HIV. We’ve been having great sex for a number of years without a problem...but now, intercourse is painful. The entrance to my vagina has become extremely sensitive and intercourse feels like being rubbed with sandpaper. I’ve noticed small sores in the area, too. My doctor was quick to say they’re herpes, but the test he did on one of the sores was inconclusive. What do you think?

answered by
Lisa Oldson, MD on September 16, 2011

Thanks for your detailed description of your symptoms. I’m happy to offer you some ideas for your consideration, but I would encourage you to see your doctor again (or get a second opinion from another doctor) to identify the root cause of your discomfort.

First, what is herpes? The virus that causes herpes comes in two types: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Both viruses can cause oral or genital herpes...although the majority of oral herpes cases are caused by HSV-1. These days, new herpes infections are just as likely to be HSV-1 (usually from oral sex) as HSV-2.

Herpes can live in your body for a while without causing any symptoms. In fact, the majority of people infected with HSV-2 don’t even know it. Unfortunately, people who don’t know they have herpes are the most likely to spread it. And, you don’t have to have a herpes outbreak to spread the virus...that means you or your partner could have been carrying the herpes virus for a long time before you started to get outbreaks.

What do herpes sores look like? Herpes sores are usually small and, most of the time, they start off looking like little blisters. But the blister stage doesn’t last long, so most people don’t even notice it.

It’s most common to find herpes sores clustered together in a group. Usually an outbreak will clear up within two weeks...but that doesn’t mean you’re cured. Instead, the virus becomes dormant, or inactive, for awhile. After the first outbreak, some people will never have another one, but other people might have herpes outbreaks often without medication.

How do you test for herpes? There are two ways to test for herpes. If you have open sores, your doctor can use a cotton swab to take a sample from the sore and test it for HSV. Another way we can test for herpes infection is to look at your body’s immune response to the virus. In other words, we check to see if your body has built up antibodies against HSV-1 or HSV-2.  

Do you have herpes? It’s possible. But since your herpes test result was inconclusive, it probably makes sense for you (and your partner) to get tested again.

In fact, if you and your partner haven’t been tested for a full array of common STDs, you may both want to get tested across the board...just to be on the safe side. For example, painful intercourse could also indicate a chlamydia or gonorrhea infection.

And if one or both of you does have an STD, there are treatments available to either cure or manage the infection(s), and to reduce the risk of developing more serious complications from untreated STDs down the road. There’s more to learn about STD symptoms, testing and treatment in our Expert Guide to STD Basics.

That said, it’s also possible that you’re experiencing symptoms of a harmless skin condition...for example, you might be having an allergic reaction to a new soap, detergent or shampoo, or perhaps to a new lubricant. There are also a number of other skin conditions that a dermatologist or doctor can help you identify. You could even have discomfort from excessive friction with inadequate lubrication.

I hope this information is helpful to you, and that you’re soon able to resume comfortable sexual activity with your partner.

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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