Red flags & when to go in person for Dyspareunia (Painful Intercourse) - Triage

Audience: adult

Dyspareunia means pain during sexual intercourse, which can affect many adults. This pain may be caused by physical issues like infections, hormonal changes, or injuries, or by emotional factors such as stress or anxiety. Telemedicine can help by providing education, initial assessment, and guidance on managing symptoms. However, some symptoms require an in-person visit for proper diagnosis and treatment. Knowing when to seek urgent care is important for your health and comfort. This guide explains common red flags, what telemedicine can and cannot do, and how to prepare for a virtual visit. Remember, this information is educational and not a substitute for professional medical care.

Red flags — go in person / ER

• Severe pain during or after intercourse that does not improve or worsens — seek in-person evaluation promptly.
• Unexplained vaginal bleeding or spotting unrelated to your menstrual cycle — see a healthcare provider urgently.
• Signs of infection such as fever, chills, unusual or foul-smelling discharge — require immediate medical attention.

What telemedicine can do

• Providing education about dyspareunia and its common causes.
• Initial symptom assessment and guidance on self-care measures.
• Determining if symptoms require urgent or in-person evaluation.
• Discussing emotional or psychological factors related to painful intercourse.

What telemedicine cannot do

• Performing physical examinations or pelvic exams needed for diagnosis.
• Collecting laboratory tests or cultures to identify infections.
• Prescribing certain treatments that require in-person assessment.
• Managing severe symptoms or complications needing urgent care.

What is Dyspareunia?

Dyspareunia is the medical term for pain during sexual intercourse. It can happen to anyone but is more common in women. The pain may be sharp, burning, or aching and can occur before, during, or after sex. Causes vary and include infections, dryness, injury, or emotional stress.

Common Causes of Painful Intercourse

Pain during sex can come from many sources:

Understanding the cause helps guide treatment.

When to Seek In-Person Care

Some signs mean you should see a healthcare provider in person:

In-person exams and tests may be needed to find the cause.

How Telemedicine Can Help

Telemedicine can:

It is a convenient first step but not a replacement for physical exams when needed.

Preparing for Your Telemedicine Visit

Before your virtual visit:

This helps make the visit effective.

How to prepare for your tele-visit

• Write down your symptoms including when they started and any changes.
• List all medications, supplements, and vaginal products you use.
• Prepare to discuss your medical, sexual, and menstrual history.
• Find a private, quiet place with good internet connection for your tele-visit.
• Have a notepad ready to record advice and next steps.

After your tele-visit

• Follow any self-care advice given during your telemedicine visit.
• Schedule an in-person visit if recommended by your provider.
• Monitor your symptoms and note any changes or new signs.
• Reach out promptly if you develop red flag symptoms.
• Keep a record of treatments tried and their effects for follow-up visits.

FAQs

What causes painful intercourse?

Painful intercourse can be caused by many factors including vaginal dryness, infections, hormonal changes, pelvic muscle issues, or emotional stress. Sometimes more than one factor is involved.

Can telemedicine diagnose the cause of my pain?

Telemedicine can help assess your symptoms and suggest possible causes, but it cannot replace a physical exam or tests needed to confirm a diagnosis.

When should I see a doctor in person?

You should see a doctor in person if you have severe or worsening pain, unexplained bleeding, signs of infection, or if symptoms persist despite home care.

Are there treatments I can try at home?

Yes, using lubricants during sex, avoiding irritants like harsh soaps, practicing relaxation techniques, and maintaining good hygiene may help. Your provider can guide you based on your situation.

Is painful intercourse normal after childbirth or menopause?

It is common to experience some pain due to hormonal changes or tissue healing after childbirth or during menopause. However, persistent pain should be evaluated by a healthcare provider.

Sources

1. Dyspareunia — MedlinePlus | U.S. National Library of Medicine.
2. Painful Intercourse (Dyspareunia) — Mayo Clinic.
3. Sexual Health: Painful Intercourse — Centers for Disease Control and Prevention (CDC).
4. Dyspareunia: Causes and Treatments — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you experience any red flag symptoms or have concerns about your health, please seek prompt evaluation by a healthcare professional in person.