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Sexual pain Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Sexual pain. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. How long have you had the sexual pain?

    Why: to determine if acute or chronic and to determine if the sexual pain is related to first penetrative sexual intercourse.

  2. Is the person with the sexual pain male or female?

    Why: Some possible causes of sexual pain for men include an unlubricated partner, penile skin infection, penile Candida infection, genital herpes, Peyronie's disease and prostatitis.

  3. If the person with sexual pain is female, is the sexual pain superficial

    Why: (i.e. around the vulva and vagina on penetration) or deep in the pelvis? - If pain is superficial, this usually suggests a vulval or vaginal origin such as bartholinitis, vulvitis, vulval dystrophy, cystitis (bladder infection), urethritis and urethral caruncle. If pain is deep, this may suggest salpingo-oophoritis (infection of the ovary and tube), retroverted uterus, endometriosis or ovarian cyst.

  4. Was the sexual pain during the first ever penetrative sexual intercourse?

    Why: the cause may by psychological or due to local trauma (such as tears to the hymen, laceration of the vaginal opening or bruising of the urethral opening). After these injuries, painful superficial ulcers may develop. Other causes include inadequate lubrication (usually due to improper or insufficient foreplay), irritation due to improperly fitted condom or inadequately lubricated condom, allergic reaction to the contents of contraceptive foams or an abnormality of the genital tract (such as congenital septum or a rigid hymen).

  5. If the person with sexual pain is male, is the penis pain unrelated to erections or passing urine?

    Why: must consider kidney stones, appendicitis, anxiety, chancroid and herpes simplex. If the penis pain is mostly during erections must consider Peyronie's disease or priapism. If the penis pain occurs mostly with urination, this may suggest urethritis (due to Chlamydia or gonorrhea), cystitis (infection of the bladder), bladder stone, prostatitis, urethral stricture, bladder cancer, anal fissure or hemorrhoids.

  6. Age of person with sexual pain?

    Why: e.g. Menopause may be associated with a dry vagina, atrophic vaginitis (dryness and thinning of the vaginal walls) and increased risk of Candida infections which may all cause sexual pain.

  7. History of sexual abuse as a child or adult?

    Why: may suggest vaginismus or sexually transmitted infection as cause of sexual pain.

  8. History of an episiotomy (surgical incision of the vulva to prevent laceration at the time of delivery of a baby or to facilitate a surgical delivery of the baby) or vaginal repair?

    Why: A painful episiotomy scar or vaginal repair may cause sexual pain.

  9. Has your genital area been exposed to any new agents lately to explain a possible contact dermatitis?

    Why: e.g. hygiene products, laundry detergents, soaps, latex condoms.

  10. Past history of sexually transmitted diseases?
  11. Past medical history?

    Why: e.g. many medical conditions can predispose to Candida infections including diabetes, obesity, AIDS, Sjogren's syndrome, Severe combined immunodeficiency (SCID), Wiskott-Aldrich syndrome, polyendocrine deficiency syndrome type 1 and bone marrow transplant; priapism may be associated with leukemia, metastatic cancer, sickle cell anemia or spinal cord injuries; Peyronie's disease may be associated with Dupuytren's contracture of the hand and premature atherosclerosis (hardening of the arteries).

  12. Medications?

    Why: some medications may predispose to Candida infections such as corticosteroids, cancer cytotoxic drugs, antibiotics and oral contraceptives.

  13. Known skin allergies?

    Why: e.g. soaps, laundry detergents, hygiene products, latex allergy from latex condoms.

  14. Lack of vaginal lubrication?

    Why: Dryness of the vagina may cause sexual pain. Vaginal dryness may be due to inadequate foreplay, poor sexual technique, sexual anxiety, menopause, recent childbirth (due to both reduced libido and physical vaginal injuries), breast feeding (due to reduced hormone levels), Sjogren's syndrome and scleroderma.

  15. Menopausal symptoms?

    Why: e.g. palpitations, hot flushes, night sweats, lightheadedness, dry skin, dry vagina, mood change. The estrogen withdrawal in menopause causes atrophic vaginitis (thinning and dryness of the vaginal skin) which predisposes to vaginal candidiasis and genital itch.

  16. Vaginal discharge?

    Why: may suggest pelvic inflammatory disease (may be an offensive, pus-like vaginal discharge), Candida vaginal infection (usually white curd like vaginal discharge), trichomoniasis vaginal infection, Chlamydia or gonorrhea vaginal infections.

  17. Pain with urination?

    Why: may suggest urethritis (due to Chlamydia or gonorrhea) or cystitis (infection of the bladder).

  18. Genital ulcers?

    Why: usually suggest herpes simplex virus 1 or 2. Less common causes of genital ulcers include syphilis (primary chancre of treponema pallidum often painless), chancroid (Haemophilus decreyi, usually painful), donovanosis (granulomona inguinale due to calymmatobacterium granulomatis, relatively painless) and lymphogranuloma venereum (due to Chlamydia trachomatis, usually painless).

  19. Fever?

    Why: may suggest acute pelvic inflammatory disease or cystitis (bladder infection).

  20. Symptoms of pregnancy?

    Why: e.g. missed menstrual periods, breast enlargement, breast tenderness, urinary frequency, nausea - If associated with sexual pain must consider ectopic pregnancy.

  21. Symptoms of vaginismus?

    Why: e.g. involuntary tightening of the muscles that surround the vaginal opening and lower part of the vagina which prevents intercourse. Most cases are due to psychological causes such as inadequate or faulty sex education, sexual assault during childhood or due to a painful initial experience of sexual intercourse.

  22. Symptoms of endometriosis?

    Why: e.g. pelvic pain which may start 1-2 weeks before the period and then reduces with the onset of the period. Also associated with pain with intercourse, infertility or subfertility, heavy periods and non-specific pelvic pain.

  23. Symptoms of malignant ovarian tumor?

    Why: e.g. ache or discomfort in lower abdomen or pelvis with a sensation of pelvic heaviness. May be associated with menstrual period dysfunction, pain with intercourse and/or pain with menstruation.

  24. Symptoms of pelvic inflammatory disease?

    Why: e.g. fever (if acute infection) , mild to severe lower abdominal pain, pain with intercourse, painful heavy or irregular periods, bleeding in-between the periods, abnormal and perhaps offensive pus-like vaginal discharge, painful or frequent urination.

  25. Symptoms of a ruptured ovarian cyst?

    Why: e.g. sudden onset of pain in one or the other sides of the pelvis. Usually occurring just prior to ovulation (just prior to day 14) or following sexual intercourse. There may be associated nausea and vomiting. The pain usually settles within a few hours.

  26. Symptoms of Bartholin's gland abscess?

    Why: e.g. red, tender swelling within the posterior (back part) of the labia majora (the large rounded fold surrounding the vagina). May be due to non-sexually transmitted infection with E.Coli or Staphylococci bacteria; or a sexually transmitted infection with gonorrhea.

  27. Symptoms of genital herpes?

    Why: e.g. with the first attack there is a tingling or burning feeling in the genital area, then a crop of small vesicles appear and then burst after 24 hours to leave small red painful ulcers which then form scabs and heal. The glands in the groin can become swollen and tender and the person may feel unwell and have a fever. May have difficulty or pain with passing urine. With recurrent attacks, symptoms usually become milder.

  28. Symptoms of vaginal candidiasis?

    Why: onset often abrupt, usually the week before the menstruation and symptoms may recur before each menstruation. Symptoms may include genital itch, vaginal discharge, vaginal soreness, vulvar burning, painful intercourse and stinging of the urine.

  29. Symptoms of Diabetes?

    Why: e.g. frequency of urination, excessive thirst, weight loss, fatigue, increased infections - Diabetes is a major risk factor for vaginal candidiasis.

  30. Symptoms of Sjogren's syndrome?

    Why: e.g. dry eyes, dryness of the mouth, skin or vagina. This syndrome may be associated with many systemic conditions such as Raynaud's phenomenon, difficulty in swallowing (as seen in systemic sclerosis), painful joints (like that seen with systemic lupus erythematosus), thyroid disease, myasthenia gravis, primary biliary cirrhosis, chronic active hepatitis, renal diabetes insipidus, renal tubular acidosis and vasculitis.

  31. Symptoms of Peyronie's disease?

    Why: e.g. pain and crooked deformity of the penis with erections; abnormal curvature of the erect penis.

  32. Symptoms of Priapism?

    Why: e.g. prolonged painful erection occurs, usually not associated with sexual stimulation. May be associated with leukemia, metastatic cancer, sickle cell anemia or trauma. In most cases, the cause is unknown Symptoms of paraphimosis? - e.g. foreskin is retracted, tight, swollen and painful. Typically occurs when the penis is erect.

  33. Symptoms of prostate cancer?

    Why: e.g. pain with urination, weak urine stream, urinary retention (unable to urinate), urinary tract infection, erectile difficulty, pain with ejaculation, symptoms of metastases (weight loss, bone pain, numbness or weakness in legs).

  34. Symptoms of cancer of the penis?

    Why: e.g. blood stained or foul smelling discharge from a lesion on the penis. The lesion is usually a nodular warty growth or an ulcer which may be painful especially if it is infected. There may also be enlarged lymph nodes in the groin. Cancer of the penis is rarely seen in uncircumcised men.

Conditions listing medical symptoms: Sexual pain:

The following list of conditions have 'Sexual pain' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Sexual pain or choose View All.

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Conditions listing medical complications: Sexual pain:

The following list of medical conditions have 'Sexual pain' or similar listed as a medical complication in our database.

 

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