Dyspareunia is genital pain during or after sexual intercourse. Internally in the vagina, uterus, or pelvis as well as outwardly on the vulva, painful sex can be felt. Sexual activity can be uncomfortable due to things like infections or underlying medical issues. Usually, the underlying source of the discomfort is found and treated.
Dyspareunia (dis-puh-ROO-nee-uh) is the medical name for painful sex and is characterized as persistent or recurrent genital pain that happens just before, during, or after sex. If you’re having painful sex, consult your doctor. Treatments minimize or decrease this widespread issue by concentrating on the underlying cause.
Women are more likely than men to have dyspareunia. Although there are numerous potential causes, it is treatable. It’s a widespread disorder that may have detrimental psychological and emotional implications. Couples may experience pressure in their relationship or loss of intimacy in addition to physical suffering.
Based on your symptoms, your healthcare practitioner can suggest the best course of action and identify the underlying cause of your discomfort.
Symptoms of Dyspareunia
If you have painful sex, you might experience:
- Deep pain when thrusting
- Burning pain or hurting pain
- Throbbing pain, lasting hours after sexual contact
- Pain with a feeling of stabbing pain, similar to menstruation cramps
- Pain with tampon use
- Pain exclusively with specific partners or circumstances
- Pain only at sexual entry (penetration)
Causes of Dyspareunia
Depending on whether the pain is felt at entry or with deep thrusting, there are different physical causes of painful intercourse. Many different kinds of uncomfortable sexual encounters may be influenced by emotional considerations.
Entry pain
There are many potential causes of pain during penetration, including:
- Inadequate lubrication. This frequently happens when there isn’t enough foreplay. Drops in estrogen levels following menopause, childbirth, or breastfeeding are further potential causes.
Certain drugs are known to alter arousal or sexual desire, which can reduce lubrication and make sex uncomfortable. These include birth control drugs, sedatives, antihistamines, high blood pressure meds, and antidepressants. - Ailment, trauma, or injury. This includes wounds or irritation from accidents, pelvic surgery, female circumcision, or a birth canal-enlarging cut (episiotomy).
- Skin disease, infection, or inflammation. A painful genital infection or urinary tract infection might affect how you have sex. Your vaginal area’s eczema or other skin conditions may possibly be the issue.
- Vaginismus. These uncontrollable contractions of the vaginal wall’s muscles can make penetration uncomfortable.
- An issue that exists from birth. Dyspareunia may result from the absence of a completely formed vagina (vaginal agenesis) or the growth of a membrane that closes the vaginal opening (imperforate hymen).
Deep pain
Deep penetration frequently results in severe agony. In some positions, it might be worse. Some of the causes are:
- A few diseases and disorders. Endometriosis, pelvic inflammatory disease, retroverted uterus, uterine prolapse, uterine fibroids, cystitis, irritable bowel syndrome, pelvic floor dysfunction, adenomyosis, hemorrhoids, and ovarian cysts are among the conditions on the list.
- Operations or other medical procedures. Hysterectomy scarring and another pelvic surgery scarring can make sexual activity uncomfortable. Chemotherapy and radiation therapy for cancer can alter the body in ways that make sex difficult.
Emotional factors
Emotions may contribute to sexual pain since they are intricately linked to sexual behavior. Emotional factors include:
- Psychological concerns. These are an example of emotional factors. A low level of arousal and the ensuing discomfort or suffering can be attributed to anxiety, melancholy, worries about your physical attractiveness, fear of intimacy, or relationship issues.
- Stress. When you’re under stress in your life, your pelvic floor muscles usually become more rigid. This could make it more painful when having sex.
- Past sexual assault. Although not every person with dyspareunia has experienced sexual abuse, it can be a factor.
It can be challenging to determine whether emotional factors contribute to dyspareunia. Initial discomfort might cause dread of future discomfort, which makes it challenging to relax, which can result in further discomfort. If you start to equate sex with pain, you can begin to avoid it.
Risk Factors of Dyspareunia
- take medications that cause vaginal dryness
- have a viral or bacterial infection
- are postmenopausal
Prevention
Generally speaking, there isn’t much you can do to lower your risk of dyspareunia. You frequently have no control over it. To lessen the possibility of experiencing pain during sexual activity, however, you can:
- Use a water-soluble lubricant when vaginal dryness is an issue.
- Use proper hygiene.
- Get proper routine medical care.
- Prevent sexually transmitted diseases (STDs) by using condoms or other barriers.
- Encourage natural vaginal lubrication with enough time for foreplay and stimulation.
- After childbirth, wait at least six weeks before resuming sexual intercourse.
Diagnosis
Typically, a medical assessment for dyspareunia entails:
- A complete medical background. Your doctor might inquire as to when your discomfort started, where it aches, how it feels, and whether it occurs with every sexual partner and in every position. Your healthcare professional might also ask you about your past with sexual activity, surgery, and childbirth.
Don’t let embarrassment keep you from providing an honest response. These inquiries offer hints as to the origin of your discomfort. - A pelvic examination. Your doctor can look for indications of skin irritability, infection, or structural issues during a pelvic exam. By lightly pressing on your genitalia and the muscles in your pelvis, he or she may also try to pinpoint the source of your discomfort.
There may also be a visual examination of your vagina using a speculum to separate the vaginal walls. Some women who experience painful erections also experience pain during a pelvic check. If the exam is extremely uncomfortable, you might request to discontinue it. - More tests. Additionally, if your healthcare professional detects a particular cause of painful erections, he or she can advise a pelvic ultrasound.
Treatment of Dyspareunia
Depending on the source of the discomfort, different treatments are available.
Medications
If an infection or other medical condition is the cause of your discomfort, treating the underlying issue may provide relief. Changing prescription drugs that have been linked to lubrication issues may potentially get rid of your symptoms.
Low estrogen levels in many postmenopausal women result in insufficient lubrication, which leads to dyspareunia. Topical estrogen that is given directly to the vagina is frequently effective in treating this.
Ospemifene (Osphena), a medication licensed by the Food and Drug Administration, is used to treat moderate to severe dyspareunia in females who have issues with vaginal lubrication. On the lining of the vagina, ospemifene has estrogenic effects.
The medication has drawbacks, including the potential for hot flashes and the risks of stroke, blood clots, and uterine cancer (endometrium).
Prasterone is yet another treatment for uncomfortable sexual encounters (Intrarosa). You ingest a pill daily through the vagina.
Other treatments
Other non-pharmacological treatments for dyspareunia include:
- Therapy for desensitization. You pick up pain-relieving vaginal relaxation techniques.
- Sexual treatment or counseling. Even after treatment, you might still have negative emotions when being stimulated sexually if sex has been traumatic for you in the past. You may also require assistance with repairing your relationship with your spouse and reestablishing sexual intimacy if you and your partner have shied away from intimacy due to unpleasant sexual experiences. These problems can be resolved by speaking with a therapist who specializes in sex.
Positive thought patterns and behaviors can be modified with the use of cognitive-behavioral therapy.
Lifestyle and home remedies
You and your spouse might attempt one of the following to ease pain during sex:
- Try moving into different positions, such as being on top, if you experience severe pain when thrusting. You might be able to control penetration from this position to a depth that feels comfortable to you.
- Communicate. Discuss what works for you and what doesn’t. Tell your companion to go slowly if you require it.
- Don’t hurry. Longer foreplay may encourage your body’s own lubrication. Delaying penetration until you’re completely aroused may help you feel less pain.
- Apply lubrication. Sex can be more comfortable when using a personal lubricant. Up till you find one you like, try out various brands.