If you have ever experienced pain during sex, you may have a condition known as dyspareunia. People who experience dyspareunia may struggle to maintain intimacy in relationships. In this article, we will explain what dyspareunia is, what causes it, its symptoms, and potential treatments for the condition.
What is Dyspareunia?
Simply stated, dyspareunia is the term for painful intercourse. It is far more likely to affect women than men. In fact, 75% of all women experience painful sex at some time in their lives.
The most common symptoms of dyspareunia are sharp pains in the genitals or pelvic area during intercourse. The pain may be intense, and it may occur before, during, or after intercourse. It can be difficult to enjoy sex if you have dyspareunia.
In some cases, dyspareunia may occur only with a specific partner or even with tampon use.
What Causes Dyspareunia?
There are many factors that can cause or contribute to dyspareunia, including both physical and emotional issues. The physical causes may include the following:
- Vaginal dryness caused by birth control and other medications, childbirth, breastfeeding, menopause, or insufficient arousal before sex.
- Yeast and urinary tract infections
- Vaginitis (inflammation in the vagina)
- Skin disorders that that may cause itching, cracks, or ulcers
- Injuries caused by childbirth, episiotomy, hysterectomy, or accidents
- Vaginismus (a condition that causes spontaneous tightening of vaginal wall muscles)
- Pelvic inflammatory disease
- Irritable bowel syndrome
- Uterine fibroids
- Chemotherapy or radiation
- Other medical conditions including arthritis, cancer, diabetes, and thyroid disease
Emotional distress may also contribute to dyspareunia.
- A history of sexual abuse or rape
- Fear or shame related to sex
- Relationship problems
- Self-image or body issues
Because so many different things can cause or contribute to dyspareunia, it’s essential to be honest with your doctor about potential contributing factors, since treating these may resolve the painful intercourse you are experiencing.
How Dyspareunia is Diagnosed
If you experience painful intercourse, it’s important to be examined by a doctor to determine the causes of the pain. The exam may include three things, starting with a conversation. Your doctor will likely ask you when you experience the pain and if it happens only in certain positions or with a particular partner. They should also ask about underlying health issues and other symptoms, such as vaginal dryness.
The second element of diagnosis is a pelvic exam. A pelvic exam will help the doctor see if there are any physical issues that may be causing the pain you’re experiencing. For example, they will be able to see if you have a skin inflammation or a genital wart.
The third and final element of diagnosis involves lab tests. Your doctor may request a urinalysis to check for a UTI or to confirm a yeast infection. They may also run tests for sexually transmitted infections if they believe it to be necessary. An allergy test may also be useful if you or your doctor believe that your condition may be caused by a product you have used.
Treatments for Dyspareunia
Treatments for dyspareunia may vary depending on the contributing factors. The primary goal is to allow the patient to experience pain-free intercourse.
When painful sex is caused by an infection, the most common treatments are antibiotics, antifungal medications, and topical or injectable corticosteroids to reduce inflammation.
Since hormones can play a big role in dyspareunia, your doctor may test your estrogen levels and prescribe oral or topical estrogen to alleviate pain. Estrogen rings may also be useful.
If emotional issues are causing pain, you may get a referral for therapy or counselling, either alone or with your partner.
Finally, you may want to consider some simple home remedies, including the following.
- Use of a water-based lubricant before intercourse
- Taking a warm bath before sex to relax your pelvic muscles
- Adding additional foreplay to ensure that you have the lubrication you need
- Taking an over-the-counter pain reliever before sex
- Applying a cold compress after sex
You should also talk to your partner about the positions and activities that are most pleasurable for you as well as which positions cause the most discomfort. A supportive partner will be happy to work with you to ensure that sex is enjoyable for both of you.