Dyspareunia or Pain During Intercourse is a condition whereby people experience pain during sexual intercourse. Both men and women can experience pain during sex sometime during their lives. However, it is much more common for women. Particularly in young women who are inexperienced or women who are in the perimenopause or menopause stages.
There is not much awareness about this topic as there is still a stigma surrounding it. Consequently, women are not speaking to their sexual partner, friends, close family or doctor when faced with this issue. If the situation is not dealt with, it may lead to other problems. Besides not being able to enjoy sex, the pain will progressively worsen due to the muscles tightening up.
Dyspareunia will have a negative physical impact on you, as well as being able to emotionally affect you and your partner’s relationship.
Pain During Intercourse can be classified into either deep or superficial pain during sex.
Causes of superficial pain include:
Vaginismus is the spasms of vaginal muscles which arises from the fear of being hurt. This can cause both deep and superficial pain, making sex extremely painful and sometimes even impossible. As a result of fear of vaginal examinations, women with vaginismus may never be able to use tampons or have a pap smear test.
The causes of vaginismus can be attributed to a restrictive upbringing, a history of rape or sexual abuse as a child, or past painful vaginal infections such as genital herpes.
2.) Lack of Vaginal Lubrication
This is arguably the most common cause of dyspareunia. Lack of vaginal lubrication can be due to nervousness, failure to relax, not having enough foreplay, or having unskilled foreplay performed by the male partner. Dyspareunia because of this can be resolved through increased foreplay, using lubricants by both counterparts, or if the female can become more relaxed.
One feature of menopause is the fall in production of the female hormone oestrogen, this causes vaginal dryness in perimenopausal or menopausal women. In this case, using lubricants during sex should reduce the pain substantially. Other treatment options available for these women are hormone replacement therapy (HRT) or vaginal hormone creams with the purpose to actively boost oestrogen production.
3.) Vaginitis (Inflammation of the Vagina)
Vaginitis is essentially the inflammation of the vagina which is caused by infections from thrush (candida), trichomonas or bacterial vaginosis (BV).
Common symptoms of this condition would be abnormal vaginal discharge, as well as itchiness and a burning sensation in the vagina and vulva (opening of the vagina).
Another type of causes, especially if associated with an infection, can also cause pain.
- Genital herpes
- Foreign body in the vagina
- Forgotten tampon
Generally, treating the infection will simultaneously clear dyspareunia.
4.) Vulvitis (Inflammation of the Vulva)
Vulvitis is the inflammation of the vulva (opening of the vagina) that can progressively lead to cracks in the skin of the vulva. It can also cause pain (including dyspareunia), itching and a burning sensation in the vulva.
Contact dermatitis is a common skin disorder that can also lead to inflammation of the surrounding skin of the vulva either due to an allergic reaction or direct exposure to agents like perfumed soaps, douches or lubricants.
Injuries to the vulva commonly stem from labour. During labour, episiotomy cuts or tears can occur. If unattended to, it may cause pain during sex for an extended period of time. Otherwise, badly healed stitches can cause pain too.
If you are experiencing any of these problems, it is advised to see a doctor sooner.
Causes for deep pain include:
6. Problems with the Cervix
During sex, the penis is able to come into contact with the cervix (opening of the womb). This can cause pain due to deep penetration, also known as ‘collision dyspareunia’. This open contact can also cause STDs such as gonorrhoea, chlamydia, trichomoniasis, genital herpes and others.
Additionally, if an intrauterine contraceptive device (IUD) or ‘coil’ planted at the cervical canal becomes displaced during sex, this can also cause pain.
7. Problems with the Uterus (womb) or Ovaries
Womb disorders or other problems in this region can cause deep pain during sex, such as:
- Fixed retroverted uterus
- Ovarian cysts
Endometriosis is a disorder in which the tissues intended to line the uterus start growing outside the uterus. The location where endometriosis occurs will determine how much pain you experience during sex. The pain is expected to be more intense if endometriosis occurs behind the vagina and lower part of the uterus.
9. Pelvic inflammatory disease (PID)
PID is caused by a sexually-transmitted infection in the upper female genital tract (pelvis). During sex, pressure on these badly inflamed tissues in the affected region can cause deep pain.
10. Pelvic Adhesions
Pelvic adhesions are when the tissues in the upper female genital tract (pelvis) become stuck together. This development is usually due to the aftermath of surgery, injury (trauma), radiation treatment or infection, like a complication of pelvic inflammatory disease (PID). These adhesions can cause pain, including dyspareunia.
11. Ectopic Pregnancy
An ectopic pregnancy is when the pregnancy is located outside the womb, like in the fallopian tubes, cervix or ovary. As this type of pregnancy develops, it will stretch out the surrounding tissue, creating discomfort. Pressure on this region during sex will cause more pain.
If you are experiencing repeated pain during or after sex, do not hesitate to see a doctor or visit our clinic as dyspareunia is not normal and often the underlying cause is curable. The longer you leave it, the more issues it may cause to yourself and also may lead to a detrimental effect on your relationship with your partner.
If you are experiencing Pain During Intercourse, it is highly recommended to visit our doctor at our DTAP Clinics as soon as possible, especially if the pain becomes persistent. Most causes of dyspareunia are not serious. However, there is a few that can be severely detrimental to your health and well-being.
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