Extremely painful sex for years

Dear Ask The Doctor: I have been having sexual intercourse for three years now. In the beginning it was extremely painful. I assumed this would get better with time and tried to ignore it. It is still an extreme issue for me. I am in love with my boyfriend and really wish we could have sexual intercourse without pain. As soon as he enters me I have a strong pain and burning sensation inside my vagina and outside. I try to continue the sex for him, but the pain continues. Afterwards, I am usually swollen and throbbing in my genitals. This has become a very embarrassing problem for me and I know it upsets my boyfriend as well. I have been tested and know that it is not an std. I would appreciate any suggestions that you have. If you have any idea what could be wrong with me or know anything that might help with my problem, please let me know.

Dear Rena: There are different causes for dysparenuia ( painfull intercourse) . Some of the conditions which you may be having are

1) Endometriosis: The inner lining of the uterus is present in other tissue outside of the uterus leading to dysparenuia, extremly painfull periods and infertility

2) Vaginismus: vaginal spasms and tightening which can be relieved by slowly dilating the vagina prior with a finger or increased foreplay prior to penetration

3) Pyschological

4)inadequate lubrication

5) pelvic inflamatory disease due to STI's / vaginitis - inflammation of the vagina

You first need to see a gynecologist to rule out organic causes that may be leading to this situation. Also sometimes use of lubricant jelly and increasef foreplay may be useful.