Painful intercourse is dyspareunia is a recurrent or persistent genital pain that occurs just before, during or after sex, that can lead to distress and relationship problems and inability to practice coitus.
Pain during sex can happen for multiple reasons that range from structural problems to psychological concerns which can affect both men and women, but more common in women.
Common Symptoms
Pain can range from moderate to severe. During a painful intercourse, one might feel:
- Pain that may occur at the vaginal opening (called penetration) or deep in the pelvis.
- Pain with every penetration, including putting in a tampon.
- Deep pain during thrusting.
- Throbbing pain lasting hours after sex.
- The pain may be distinct and localized, with the sense of great discomfort.
- Aching, burning, throbbing, or ripping sensation.
- Dissatisfaction with, or disinterest in, intercourse can result.
Possible Causes of painful sex in Females
- Being over-weight (Obesity)
- Entry pain may be associated with vaginal dryness – not enough lubrication (due to lack of foreplay!).
- A drop in oestrogen levels around menopause, childbirth or during breastfeeding also cause lack of lubrication.
- Certain medicines (such as antidepressants, high blood pressure medicines, sedatives, antihistamines and birth control pills) can affect sexual desire or arousal. That can decrease lubrication.
- Virilism (presence of male characteristics in female)
- Anal fissure and haemorrhoids
- Painful perineal scar after childbirth
- Painful tight hymen (membranous fold covering the vaginal orifice)
- Cysto-urethritis
- Interstitial cystitis: A chronic painful bladder condition
- Vaginitis
- Narrow introitus (vaginal opening)
- Vaginal stenosis following any operation
- Endometriosis
- Prolapsed ovaries
- Injury, trauma or irritation.
- Vulvar vestibulitis that is Inflammation, infection.
- Skin disorders or irritation: from eczema, lichen planus, lichen sclerosis etc.
- Vaginal yeast infections, urinary tract infections, or sexually transmitted infections (STIs).
- Allergic reactions to clothing, laundry detergents, or personal hygiene products.
- Not having a fully formed vagina since birth. or having a membrane that blocks the vaginal opening.
- Certain illnesses and conditions such as endometriosis, PID’s – pelvic inflammatory disease, uterine prolapse, retroverted uterus, fibroids, cystitis, IBS – irritable bowel syndrome, pelvic floor conditions, adenomyosis, and ovarian cysts etc.
- Scarring from hysterectomy – pelvic surgery or genital mutilation.
- Side effects of treatments for cancer, such as radiation and chemotherapy.
- Psychological issues. Anxiety, depression, concerns about physical appearance, fear of intimacy or relationship problems can contribute to a low level of arousal and resulting discomfort or pain.
- Psychological vaginismus (painful spasm of vagina)
- Fear of pregnancy
- Pelvic floor muscles tend to tighten in response to stress.
- History of sexual abuse or sexual violence may contribute to dyspareunia too.
DO’S & DONT’S
Educate yourself about sexual relationship as ignorance is one of the major causes.
Both the partners should reassure each other and give a lot of emotional support to one another
Reduce weight if obesity is one of the causes
Pain experienced during intercourse can be reduced by:
- Using water-based personal lubricants
- Engaging in longer foreplay to encourage secretion of the body’s natural lubricants
- Choosing comfortable sexual positions
- Practicing good genital hygiene and safe sex.
- Women with vaginismus may find Kegel exercises useful to strengthen the pelvic floor muscles.
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Some patients may experience a little aggravation or worsening of their symptoms, specially in skin disorders – which is absolutely normal and a good sign, as most natural remedies tend to bring the disease in its expressive state – rather suppressing it deeper under the skin etc.
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