Painful Sexual Intercourse: Everything You Need to Know

Painful intercourse, also known as dyspareunia, can be caused by several factors ranging from structural to psychological problems.

Painful intercourse in women can be described as the persistent or recurrent genital pain that occurs just before, during or after sexual intercourse.

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Consult your doctor if you’re having painful intercourse. Treatments focus on the cause, and can help to get rid of or ease symptoms.

Symptoms of Dyspareunia

Other symptoms associated with painful intercourse include:

  • Pain only at penetration
  • Pain with every penetration, including inserting a tampon
  • Deep pain during thrusting
  • Burning or aching pain
  • Throbbing pain which lingers long after intercourse

Causes

Entry pain

Pain during penetration might be associated with a range of factors, including:

  • Insufficient lubrication:When a woman isn’t properly lubricated prior to penetration, it may be as a result of drop in estrogen levels after menopause or childbirth or during breast-feeding.

Certain medications such as antidepressants, sedatives. Drugs for hypertension, and some birth control pills, are known to affect sexual desire or arousal, which can decrease lubrication and make sex painful.

  • Injury, trauma or irritation: This includes injury or irritation from female circumcision, an accident, pelvic surgery, or a cut made during childbirth to enlarge the birth canal.
  • Inflammation, infection or skin disorder:An infection in your genital area or urinary tract can lead to painful intercourse.
  • Vaginismus: This is an involuntary spasms of the muscles of the vaginal wall. It can lead to painful intercourse.
  • Congenital abnormality.A problem at birth, such as the absence of a fully formed vagina or development of a membrane that blocks the vaginal opening could lead to painful intercourse.

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Deep pain

Deep pain usually occurs with deep penetration. Causes include:

  • Certain illnesses:Medical conditions like uterine prolapse, cystitis, endometriosis, uterine fibroids, pelvic inflammatory disease, retroverted uterus, ovarian cysts, irritable bowel syndrome, and hemorrhoids.
  • Surgeries or medical treatments.Scarring from pelvic surgery, including hysterectomy, can cause painful intercourse. Radiation and chemotherapy for cancer, can lead to painful intercourse.

Emotional factors

Emotions also affect sexual activity. Emotional factors include:

  • History of sexual abuse:If a woman has been sexually abused in the past, it could cause her to experience dyspareunia. Though this isn’t applicable to every woman.
  • Psychological issues:Depression, anxiety, relationship issues, fear of intimacy, and concerns about your physical appearance can contribute to a low level of arousal and a resulting pain during intercourse.
  • Your pelvic floor muscles tend to tighten in response to stress in your life. This can contribute to pain during intercourse.

Diagnosis and Treatment

To properly diagnose dyspareunia, your doctor may perform the following:

  • Your doctor may ask questions about your sexual history, surgical history and previous childbirth experiences.
  • Your doctor will perform a pelvic exam to check for signs of skin irritation, infection or anatomical problems. He or she may also try to identify the location of your pain by applying gentle pressure to your genitals and pelvic muscles.
  • Your vagina may undergo a visual examination using an instrument called a speculum to separate the vaginal walls. Some women who experience painful intercourse are also uncomfortable during a pelvic exam. You can ask to stop the exam at any time if it’s too painful.
  • A pelvic ultrasound may be recommended if your doctor suspects certain causes of painful intercourse.

Treatment options vary depending on the cause of the pain.

Medications

If dyspareunia is caused by an infection or medical condition, treating the cause might resolve your problem.

Dyspareunia in most postmenopausal women is caused by insufficient lubrication resulting from low estrogen levels. Often, this can be treated with topical estrogen applied directly to the vagina.

A capsule called prasterone (Intrarosa), which is placed inside the vagina daily, is also used to relieve symptoms of dyspareunia.

Therapies

Certain non-medication therapies also might help with dyspareunia:

  • Desensitization therapy:This involves vaginal relaxation exercises that can decrease pain.
  • Counseling or sex therapy:Counseling session helps restore back your sex life because if sex has been painful for some time, you might have a negative emotional response to sexual stimulation even after treatment. If you and your partner have avoided intimacy because of dyspareunia, you might also need help improving communication with your partner.

Sources: mayoclinic.org, webmd.com, emedicinehealth.com

Disclaimer: The content provided on healthdiary365.com is purely informative and educational in nature and should not be interpreted as medical advice. Please use the content only in consultation with an appropriate certified medical doctor or healthcare professional.

 

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