Got a new hit related to POIS, regarding a female case:
Clinical Conundrum: A 33-Year-Old With Pain Post-Orgasm and a History of Endometriosis
Sci-hub doesn't seem to unlock this one in contrary to the article in French:
Raisonnement clinique : Une femme de 33 ans avec ant?c?dents d'endom?triose ?prouvant des douleurs apr?s l'orgasme
Copying text from the article and putting them into a translator doesn't work well, punctuation marks aren't properly depicted when pasting.
Can someone get a hold on the full english version of the article or wanting to translate it to english?
Hi Muon, I suggest you use a newer online translator which is far better than any others: DeepL (
https://www.deepl.com/translator ). Almost no punctuation problems with DeepL ( they are managed before translation, by erasing them automatically). Here is the first 5000 characters with DeepL ( free online DeepL works with 5000 max at a time), with no correction :
"THE CLINICAL PICTURE
Referred by a tertiary care centre in
sexual medicine, a 33 year old woman
presented with post-orgasm pain.
She had a history of dysmenorrhea and had
underwent laparoscopy about ten years ago plus t^ot for
treat probable endometriosis that was likely to be affected by
minimal to light. Thereafter, she remained under
continuous treatment with oral contraceptives and was
amenorrheic. She didn't present any history.
of dyspareunia. The patient was reaching orgasm,
which was pleasant and painless in itself, through the stimulation
of the clitoris and/or penetration with a partner
male. However, immediately after orgasm..,
she was suffering from cramps similar to dysmia.
enorrhea for approximately 30 minutes; these cramps
were also sometimes accompanied by vaginal bleeding.
Other symptoms included sweating,
occasional nausea and exhaustion. His
medical histories included a
resection at the diathermic loop to treat CIN1;
subsequent Pap test results were normal.
The patient reported a history of anxiety,
but she scored low on the questionnaire
on Generalized Anxiety Disorder GAD-7 (Generalized
Anxiety Disorder-7).
Clinician's comment: Pelvic pain after orgasm
are a little-studied phenomenon1. It would be important
to perform a speculum examination of the cervix, being
gives antecedents of post-coital bleeding and
treatment of CIN1 by diathermy loop resection.
Pelvic examination and imaging to detect the
the presence of endometriotic lesions, in particular of an endometriotic
deep endometriosis or ovarian endometriomas, would be
also instructive. It would also be useful to
imaging exams of the uterus itself to detect
the presence of adenomyosis, since the pain was similar to
is dysmenorrhea. The pelvic floor should also be examined, as pelvic floor dysfunction is a common cause of
pelvic floor would be a potential cause of pelvic floor pain.
moment of arousal, penetration or orgasm.
Finally, an examination of the vulva is recommended.
in all patients who experience pain during the course of
sexual intercourse.
THE DIAGNOSTIC PROCESS
On examination, the vulval skin and anatomy were
and palpation of the vulvar vestibule at the
with a cotton swab caused no pain.
Speculum examination revealed a cervix of the uterus.
appearance and the presence of a very good looking
small polyp on the external os. The results of
pelvic floor examination proved to be very helpful.
normal events and did not indicate any pain or
no sign of vaginismus. Pelvic exam, palpation...
of the uterus has allowed us to observe
a sensitivity, which was not the case with the bladder,
the pelvic floor, appendages or cul-de-sac, and
uterosacral ligaments. No nodularity was observed.
Detective. The endovaginal ultrasound revealed an
sensitivity to the cul-de-sac, both ligaments...
uterosacral and right ovary. On ultrasound, the uterus
showed a decrease in the demarcation
between the myometrium and endometrium, but otherwise, he's
was normal. The endometrial layer measured 5 mm.
and both ovaries were normal. A sign of the
positive slip between the uterus (cervix) and the c^olon a
e été observé, mais aucun signe echographique n'a pu
confirm the presence of nodules in the compartment
posterior.
Clinician's commentary: Given the sensitivity of the uterus
on bimanual palpation, it was issued as hypoth--
The uterus could be a factor in the origin of the
pain after orgasm. The elements that support this
are post-coital bleeding, which is diagnosed as post-coital bleeding.
could indicate a metrorrorror from the uterus,
and the ultrasound signs of adenomyosis (even though the
diagnosis cannot be confirmed due to the absence of
other echographic signs)2. However, the patient
was amenorrheic while she was using birth control.
oral, suggesting sufficient inhibition of
Uterine activity. The differential diagnosis includes the
recurrence of endometriosis; no sign of endometrioma
ovarian or deep endometriosis has been observed, but the
sensitivity to endovaginal ultrasound may be observed.
It is indicative of superficial peritoneal endometriosis3.
It is plausible that superficial endometriosis
may contribute to the post-orgasm pain, but it
would not be the direct cause of the bleeding, which indicates
a uterine cause. The differential diagnosis always holds
pelvic floor account, since the results of the
clinical examinations do not always correspond to the dysfunction.
of the pelvic floor in a sexual context.
We've considered increasing inhibition of the activity
uterine by administration of a progestin superimposed on the
oral contraceptive. A huddle... "
Sorry but due to the work overload linked to the pandemia I do not have time to do the rest for now, or to edit this first part, but it is already very good as it is.
I am sure some dedicated member could do the rest !
( However - and there is a "spoiler" ahead - I have done a very rapid survey of the article, since I am French speaking, and the solution found in this case study is centered on controlling the endometriosis and the pain associated with it, so this will not apply to men, as I understand it after my very partial reading ).
