### Patient: Doctor, I have been experiencing severe pain and discomfort during sexual intercourse. It feels like my vaginal muscles are contracting and it's becoming difficult to have sex.
### Doctor: Based on your symptoms, I would recommend a pelvis exam to check for any abnormalities in your reproductive organs. I would also suggest an examination of your breast to rule out any possibilities of breast cancer. Additionally, a urinalysis will help us test for any underlying infection. An ultrasonography (ultrasound) will also help us identify any structural abnormalities in your pelvic region. A rectal examination can further assist us in identifying any issues in your rectum or surrounding muscles that may be contributing to your discomfort. Lastly, a complete physical skin exam will be performed to rule out any other skin diseases. Based on your age and medical history, I may also suggest a mammography (mammogram) as a precautionary measure.