What is dyspareunia?
Dyspareunia is the term used to describe painful vaginal intercourse that occurs either frequently or all the time. It may involve feeling genital pain at any point just before, during, or after intercourse. Common symptoms of the condition include:
- Pain during sexual penetration
- Pain during any type of penetration, such as tampon insertion
- Deep pain with each thrust
- Pain that develops following painless intercourse
- Throbbing pain that lasts long after intercourse
What causes painful intercourse?
A range of problems can lead to pain during intercourse, including:
- Physical issues
- Gynecological conditions
- Emotional problems
Emotions or relationship problems that make it hard for you to relax during sex can make intercourse painful, as they interfere with arousal. Medications, including some birth control methods, can also interfere with your sexual response and lead to painful intercourse. Gynecological issues that may be at the root of painful sex include:
Vulvodynia
This common pain disorder affects the vulva, and may be the result of:
- Inflammation
- Nerve damage
- Pelvic floor muscle dysfunction
Vaginismus:
This is the reflex contraction, or tightening, of vaginal muscles during sex. It can make intercourse painful, particularly during penetration.
Vaginitis:
A yeast or bacterial infection is usually responsible for vaginitis, the often painful inflammation of the vagina.
Contact dermatitis
A skin disorder that frequently affects the vulva, contact dermatitis is an itching, burning, or painful reaction to an irritating substance such as a lubricant or a perfumed soap.
Perineum trauma
Women who have experienced either tears in the perineum or an episiotomy during childbirth may suffer from painful intercourse for months after giving birth.
Hormonal changes
The drop in estrogen during perimenopause and menopause can cause vaginal dryness and make intercourse less comfortable.
What are my treatment options?
Before you can find a treatment that will work for you, you’ll need a proper diagnosis of the underlying problem. Your OB/GYN will:
- Ask you about your symptoms
- Take your medical history
- Perform a comprehensive physical exam including a pelvic exam
You may also undergo ultrasound or laparoscopic testing if further diagnostic information is needed.
Treatment options range from changing prescription medications that may interfere with natural lubrication, to applying topical estrogens or lubricants prior to intercourse. Physical therapy or surgery may be required for vaginal trauma or injury. For women affected by menopause, bioidentical hormone therapy and vaginal rejuvenation are two of the most effective treatment options.
