Dyspareunia is the medical term used to refer to the pain experienced during sexual intercourse. It is more often used to refer to the pains perceived by women. Dyspareunia can have different causes, both physical and mental.

We speak of dyspareunia in case of pain during sexual intercourse. These can appear before, during or after intercourse. They can be felt in both men and women. However, dyspareunia is a medical term that is generally used to refer to the pain experienced by women.

The different types of pain

In women, it is common to distinguish two types of dyspareunia:

• superficial dyspareunia, or intrusion dyspareunia, when pain occurs near or in the orifice of the vagina;
• deep dyspareunia, in case of pelvic pain, that is to say pain felt in the pelvis region, including the lower abdomen and genital area.

In case of pain during sexual intercourse in women, the term vaginismus is sometimes used. Some specialists consider vaginismus to be a special type of dyspareunia. It results in an involuntary contraction of the musculature of the perineum, which prevents any intromission.

Pain during intercourse can have many causes, both physical and psychological.

Causes of physical origin

Dyspareunia is said to be of physical or organic origin, when the pain is for example due to:

• gynecological infections, which include vaginal yeast infection, such as vaginal candidiasis, or certain STIs, such as gonorrhea;
• inflammations including those affecting the vulva (vestibulitis), bladder (cystitis), urethra (urethritis), uterine tubes (salpingitis) or vagina (vaginitis);
• an allergic reaction ;
• of the varicose veins in the pelvic region;
• a endometriosis, which is characterized by the formation of uterine lining outside the uterus;
• pelvic floor abnormalities, that is, disorders in the muscles, ligaments and tissues of the pelvis area;
• a pelvic tumor ;
• certain medical examinations, especially during radiotherapy to the pelvis, abdomen or root of the thighs;
• certain gynecological operations, especially during a hysterectomy, removal of the uterus;
• injuries during childbirth ;
• hormonal imbalance, especially during menopause.

Causes of psychic origin

Dyspareunia can also be of psychological origin when the pain is for example caused by:

• nervous tension, especially in cases of stress or anxiety;
• a lack of excitement which leads to vaginal dryness;
• a feeling of fear, especially during fear of pain or fear of an unwanted pregnancy;
• previous trauma, which can follow a bad first sexual experience or a sexual trauma.

Dyspareunia is characterized by the appearance of pain during intercourse. These can be:

• localized or diffuse, by manifesting itself for example in women at the level of different regions of the intimate zone such as the lips, the vagina, the clitoris, or even the vulva;
• superficial or deep.

In dyspareunia, the pain can be manifested in particular by:

• burning, stinging, or cutting sensations ;
• tingling ;
• itches ;
• spasmodic contractures.

A medical opinion is recommended in the event of persistent, repeated or high intensity dyspareunia. A series of questions on the pain felt during intercourse allows a first diagnosis to be made. This can be confirmed or deepened by additional medical examinations.

Treatment for dyspareunia depends on its origin. Depending on the case, the treatment of pain may for example be based on:

• a psychotherapy, especially in the event of traumatic experiences;
• drug treatment, especially during gynecological infections;
• hormonal substitution, especially during menopause;
• homeopathic treatments, especially in cases of anxiety;
• a surgery, especially in case of endometriosis.