The pain one may feel during or after sexual intercourse is called dyspareunia. It is not a condition in itself but is caused by medical conditions or psychosocial problems.
Dyspareunia is almost exclusive to women, but it also affects men in rare cases. It is not uncommon for women to feel pain during intercourse; although true dyspareunia in women frequently occurs along with vaginismus, a condition that causes the vaginal muscles to tense up during penetration.
It may result from abnormal conditions of the genitalia, dysfunctional psychophysiologic reaction to sexual union, forcible coition, or incomplete sexual arousal.
Dyspareunia is also associated with hormonal changes of menopause and lactation that result in drying of the vaginal tissues and with endometriosis, which may result in painful adhesions around the vagina and ligaments, decreasing their flexibility during intercourse.
What are the symptoms of dyspareunia?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.
Symptoms include a burning, ripping, tearing, or aching sensation associated with penetration. The pain can be at the vaginal opening, deep in the pelvis, or anywhere between. It may also be felt throughout the entire pelvic area and the sexual organs and may occur only with deep thrusting.
When pain occurs, the woman experiencing dyspareunia may be distracted from feeling pleasure and excitement. Both vaginal lubrication and vaginal dilation decrease. Even after the original source of pain has disappeared, a woman may feel pain simply because she expects pain.
For men, the condition can result from such disorders as irritation of the skin of the penis due to an allergic rash; physical abnormalities of the penis, like a tight foreskin or a bowed erection; and infections of the prostate gland or testes.
What are the causes of dyspareunia?
Any part of the genitals can cause pain during sex. Some conditions affect the skin around the vagina. The pain from these conditions is usually felt when a tampon or penis is inserted into the vagina, but pain can also occur even when sitting or wearing pants.
Inflammation or infection may be the cause; such as a yeast infection, urinary tract infection or inflammation of the vagina. Injury to the vagina and the surrounding area can also cause pain. If a diaphragm or cervical cap not fit correctly, sex may also be painful.
Pain during intercourse may feel like it is coming from deep in the pelvis. The uterus may hurt if there are fibroid growths, the uterus is tilted or if the uterus falls into the vagina.
Certain conditions or infections of the ovaries may also cause pain, especially in certain sexual positions. Past surgeries may leave scar tissue that can cause pain. Because the bladder and intestines are close to the vagina, they may also cause pain during sex. Endometriosis and pelvic inflammatory disease may also cause dyspareunia.
The mind and the body work together. This is also seen with sexual problems. Often the problem that first caused the pain may go away, but one has learned to expect the pain. This can lead to further problems because one may be tense during sex or unable to become aroused.
Negative attitudes about sex, misinformation about sex and misinformation about the functions of the woman’s body are often associated with some types of pain.
In men, as in women, there are a number of physical factors that may cause sexual discomfort. Pain is sometimes experienced in the testicular or glands area of the penis immediately after ejaculation.
Infections of the prostate, bladder, or seminal vesicles can lead to intense burning or itching sensations following ejaculation. Men suffering from interstitial cystitis may experience intense pain at the moment of ejaculation. Gonorrheal infections are sometimes associated with burning or sharp penile pains during ejaculation. Urethritis or prostatitis can make genital stimulation painful or uncomfortable.
Anatomic deformities of the penis, such as those existing in Peyronie’s disease, may also result in pain during coitus. One cause of painful intercourse is due to the painful retraction of a too-tight foreskin, occurring either during the first attempt at intercourse or subsequent to tightening or scarring following inflammation or local infection.
During vigorous intercourse or masturbation, small tears may occur in the frenum of the foreskin and can be very painful.
Dyspareunia typically is diagnosed based on symptoms. Medical and sexual history and a physical examination will help the doctor to determine the cause of symptoms.
Distinguishing pain that occurs with touching the genitals or early penetration from pain that occurs with deeper penetration is a clue to the cause of symptoms. A doctor will ask questions about the exact location, length and timing of the pain.
If a patient is middle-aged, a doctor will ask whether one is experiencing irregular periods, hot flashes or vaginal dryness, symptoms suggesting that one may have atrophic vaginitis.
In new mothers, the doctor will ask whether one is breastfeeding, because breastfeeding also can lead to vaginal dryness and dyspareunia.
During a physical examination, a doctor will check vaginal wall for signs of dryness, inflammation, infection (especially yeast or herpes infection), genital warts and scarring. A doctor also will do an internal pelvic examination to look for abnormal pelvic masses, tenderness or signs of endometriosis. He or she also may suggest that one speak with a counselor to determine whether a history of sexual abuse, trauma or anxiety may be contributing to symptoms.
What are the treatment options for Dyspareunia?
Dyspareunia is caused both by medical conditions and psychological problems; therefore, it requires a combination of treatment methods that tackle both causes.
One can minimize the chances of pain by making the following changes to sexual activity: change position, communicate with your partner, involve more foreplay, stay properly lubricated.
For dyspareunia caused by medical problems, the treatments include: estrogen therapy, desensitizing therapy, sex therapy, and pain medication.
There is no definite way to prevent dyspareunia, but some measures can be taken to reduce risk.
Good hygiene and routine medical care will help to some degree. Adequate foreplay and stimulation will help to ensure proper lubrication of the vagina.
The use of a water-soluble lubricant like K-Y Jelly may also help. Vaseline should not be used as a sexual lubricant since it is not water soluble and may encourage vaginal infections.
Author: Akwesi Osei
An avid reader and writer who has written articles for HypeNationGh, LoudsoundGh and akwesiosei.wordpress.com.
Currently the blogger and owner of The Health Bro