What Is Dyspareunia?
Dyspareunia is a general term for painful sexual intercourse for women. Dyspareunia is not a single condition but a syndrome, that is, a set of symptoms. It’s estimated that 50% of women experience painful intercourse at some time. Dyspareunia is not serious, and a number of treatments are available.
What Are the Symptoms?
Each woman has her own set of symptoms. Pain, of course, is the chief symptom. The pain occurs just before, during or after intercourse. Some women feel the pain on the surface or just inside the vagina (superficial pain). Others feel the pain down inside the pelvis (deep pain). Women have described the pain as cramping, burning and sharp.
When Should a Woman See Her Doctor?
Although widespread, painful intercourse is not normal. The pain usually signals a serious underlying medical or physical problem. A woman should see her doctor when the pain reoccurs and interferes with a normal sex life.
What Causes Dyspareunia?
Sources of superficial pain include:
• Vaginal dryness because of too little foreplay; some medications, such as antidepressants and certain birth control pills; or a drop in estrogen levels after childbirth or menopause
• Vaginismus, an involuntary tightening of the vagina muscles
• Damage or injury to the genital area from an accident, certain surgeries or a congenital (inborn) abnormality
• An infection in the genital area or urinary tract
• A skin irritation in the genital area
• Vulvar vestibulitis, an unexplained stinging or burning around the opening of the vagina
Causes of deep pain include:
• An illness, such as pelvic inflammatory disease, cystitis (inflammation of the bladder) or irritable bowel syndrome
• An infection in the fallopian tubes, uterus, ovaries or cervix
• Radiation treatments or chemotherapy for cancer in the pelvic region
• Certain conditions, such as hemorrhoids, ovarian cysts or prolapsed uterus (when the uterus slides from its normal position into the vaginal canal)
• Adhesions (scar tissue) resulting from surgeries in the pelvic region, uterine fibroids (benign tumors in the uterus) or endometriosis (when cells in the lining of the uterus grow elsewhere in the body)
In some cases, emotional or psychological problems are at the root of the pain. More often, however, they contribute to the underlying medical or physical cause. Mental illness, stress, fear of getting pregnant or not getting pregnant, insecurity over one’s sexual performance and negative attitudes toward sex can add to the pain.
What Are the Treatments for Dyspareunia?
The first step, naturally, is to relieve the pain with nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen. The second step is to attack the underlying cause of the pain with the appropriate medication or therapy, for example:
• Antibiotics or fungicides for infections
• Estrogen replacement therapy for vaginal dryness
• The Wurn technique to break down and remove scar tissue
• Kegel exercises to strengthen the pelvic floor muscles
• Sex counseling
Many of these treatments can be carried out at home. But women should always check with their doctor before beginning any medical treatment.
How Can Dyspareunia Be Prevented?
Although it can’t be totally prevented, the risk of suffering dyspareunia can be reduced by:
• Maintaining good hygiene and overall health
• Lubricating the vagina before sexual relations
• Prolonging foreplay for natural lubrication
• Trying different sexual positions
• Changing meds that cause vaginal dryness
• Protecting oneself from sexually transmitted diseases
• Avoiding deep penetration, especially if endometriosis is present
• Communicating openly with one’s sexual partner