The occurrence of pain in women during intercourse is referred to in medicine by the term dyspareunia (or algopareunia).

These pains can be deep, superficial, systematic or intermittent, occur at the start of penetration, affect the vulva, the entrance or the bottom of the vagina, manifest in the form of burning, stinging, itching or diffuse pain, etc.

The pain can be present primarily, that is, from the first sexual intercourse, or appear suddenly after a period of sexual activity without problems.

There are therefore rather dyspareunias than one. It is a very common symptom in women, affecting up to 40% of them at some point in their lives.

There are many causes of pain during intercourse. They can be organic (genital, mechanical, inflammatory, urinary, etc.) or psychological.

To determine what is causing the pain, the doctor or gynecologist will look at the patient’s age, the characteristics of the pain, her gynecological and obstetric history, aggravating or triggering factors, psychological factors that may influence her well. -be sexual.

The examination can help locate painful areas and look for a possible organic cause, such as:

• Perineal tear or episiotomy scars from childbirth or other injuries
• vaginitis or vulva-vaginitis (infection by Candida, trichomonas, gonocoque, etc.)
• vulvodynia, which corresponds to vulvar discomfort such as burns appearing in the absence of vulvar affection
• lack of vaginal lubrication
• narrowing of the entrance to the vagina
• vulvar eczema, vulvar lichen sclerosus, etc.
• tenderness of the cervix (scar, lesion, etc.)
• endometriosis
• uterine fibroids
• gynecological cancer (which can cause vaginal dryness)

Namely: deep dyspareunias almost always have an organic cause (cervical lesion, endometriosis, retroversion of the uterus, etc.).

Certain events such as childbirth and the procedures associated with it (episiotomy, forceps, etc.), miscarriage or termination of pregnancy, surgery can trigger the onset of pain during intercourse.

In some cases, digestive causes, such as irritable bowel syndrome or chronic inflammatory bowel disease, can cause sexual pain.

These pains can have major repercussions on the lives of women, on their married life and on their morale.

Even if an organic cause is responsible for the pain, psychic factors are always associated, the sexual intercourse becoming distressing for the woman, who struggles to relax and suffers all the more.

It is therefore important to consult quickly to find solutions and prevent dyspareunia from becoming chronic and systematic.

If an organic cause is responsible for the pain, it must obviously be treated adequately, for example with antibiotics or antifungals if it is an infection.

Local corticosteroid treatments may be necessary, for example in cases of vulvovaginal atrophy, perineal rehabilitation sessions may be offered if the pain comes from vulvodynia or after childbirth, etc.

In the event of endometriosis, pharmacological or surgical therapies will be considered. Surgery can also help remove troublesome fibroids.