Dyspareunia, or pain during sexual intercourse. What is the treatment of dyspareunia?

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Dyspareunia is a sexual dysfunction characterized by pain experienced during sexual intercourse. Symptoms may also appear before and after intercourse. Possible causes of this condition include vaginal dryness or inflammation, and psychological reasons, such as unpleasant associations with sex.

Dyspareunia – definition

Dyspareunia is a type of sexual dysfunction that manifests itself in pain during intercourse. It happens that this symptom also occurs before and after intercourse. Feeling pain during sex may have various causes – it may depend on the underlying diseases and have a mental condition. Many women complain of this kind of ailment. Do not underestimate this problem and in any case consult a doctor who will find a way to solve this problem. The type of treatment depends on the cause of dyspareunia and aims to relieve pain. Dyspareunia can manifest itself in several ways, including:

1. burning / burning pain,
2. pain felt only when penetrating the penis in the vagina,
3. pain when inserting the epidermis into the vagina
4. pain felt when you move suddenly and deeply during intercourse,
5. pain that occurs only with selected partners under certain circumstances.

What are the causes of dyspareunia?

The causes of dyspareunia can be both physical and psychological. At the root of dyspareunia may be, inter alia, inflammation of the genital organs, vaginal dryness, complications after surgery in the genital tract and childbirth (e.g. after cesarean section). Sometimes pain is also associated with unpleasant associations from the past, such as attempts at intercourse with infections of intimate parts. In addition, pain during intercourse may occur as a result of:

1. genital infections,
2. inflammation in the pelvic area,
3. pathological structure of the genital organs,
4. vulvodynia (pain in the vulva with no apparent cause).

It is worth looking at the emotional factors that significantly affect the quality of sexual life. Depression, self-complexities, anxiety and fear of sexual intercourse – can cause dyspareunia and less sexual arousal. The culprit can also be stress, which leads to tightening of the pelvic muscles, which is consequently felt as pain during intercourse. Bad memories and injuries related to sex also contribute to the development of ailments.

The physical causes of painful intercourse may vary depending on whether the pain is felt when the penis is inserted into the vagina or during deep penetration. Penetration pain is often the result of insufficient vaginal lubrication and a short foreplay. Vaginal dryness can also occur as a result of a decline in estrogen levels during puberty or during breastfeeding. In addition, some medications taken by patients are responsible for the low hydration of the vagina, e.g. antidepressants, sedatives and contraceptive pills.

Another physical cause of pain is injury and irritation in the vulva area. Pain can also occur as a result of vaginismus. This is a dysfunction that results in uncontrolled contraction of the muscles at the entrance to the vagina. The contractions can cause pain as you move your penis inside the vagina.

The deep pain during penetration increases especially in certain sexual positions. Then the cause may be some diseases, e.g.

1. uterine fibroids
2. endometriosis
3. hemorrhoids
4. retroversion of the uterus
5. inflammation of the uterine organs
6. cysts on the ovary
7. uterine prolapse
8. irritable bowel syndrome.

Surgery may also cause pain during intercourse, such as scarring in the pelvic area after hysterectomy.

Dyspareunia – diagnostics

A medical interview with the patient is very important in the diagnosis of dyspareunia. It is necessary to determine what pain the patient is experiencing and how: with each partner? or in any sexual position? Information on previous operations and births is also important. It is very important to answer honestly any questions asked by the doctor, because it is possible to determine the cause of this unpleasant ailment. Then the doctor performs a gynecological examination, performs an ultrasound and examines the pelvic organs. To find the site of pain, it delicately presses the organs and muscles of the pelvis. The gynecological examination assesses the vaginal wall and the cervix using a speculum (women with dyspareunia may experience pain during the examination).

How to cure dyspareunia?

The choice of treatment method depends on the cause of the pain. If a woman has a genital infection or other ailment, the underlying disease should be treated first. Thanks to this, the discomfort will be reduced, and it may even turn out that further treatment is unnecessary. In the case of vaginal dryness (due to the medications taken), it is enough to discontinue or switch to other medications. In turn, in women during menopause who have low levels of estrogens, it is recommended to use gels or pills containing hormones.

Another type of therapy are vaginal relaxation techniques and Kegel exercises (responsible for strengthening the pelvic floor muscles). Unfortunately, women who have struggled with dyspareunia for a long time may still develop negative emotions related to sex, even after recovery. Then, psychotherapy or therapy for two at a sexologist may be necessary.

How to prevent dyspareunia?

Here are some ways you can protect yourself from unpleasant sensations:

1. visit your gynecologist regularly,
2. take care of intimate hygiene,
3. if you have had, for example, a vaginal infection, refrain from intercourse for some time after its completion (ask your gynecologist for detailed information on this),
4. take care of your well-being before intercourse – remember that it should be a pleasure for you,
5. if you go to the swimming pool or use the public sauna, take care to follow the rules of hygiene in these places (shower after bath, in the sauna only sit on your towel).

Also read: When sex hurts

Text: lek. med. Matylda Mazur