Nearly 75% of women experience pain during intercourse at some point in their lives. Despite its frequency, painful intercourse should not occur as often as it does. Why, then, do women experience this problem? Is it a short-term or long-term issue? What should you do if you experience painful intercourse? We have answers that will help.

What is Dyspareunia?

Dyspareunia is the clinical term for painful intercourse. Sexual pain often occurs externally on the vulva. It may also be felt internally within the vagina or pelvis. You may also experience discomfort in your lower back and bladder. However, no matter where you feel the pain, dyspareunia should not be most people’s standard reaction to sexual activity. To put it simply: sex doesn’t have to hurt. 

If you have dyspareunia, you may experience:

  • Aching or burning 
  • Pain at being penetrated (this can include putting in a tampon)
  • Pain during the sex act
  • Lingering pain after sexual activity is over

Why does this happen to your body? We’ll go over several common causes of painful intercourse.

What Causes Painful Intercourse?

Loving couple embraces outside, laughing as they do.Pain during intercourse can be caused by several different factors:

  • You may not have enough lubrication, which increases friction and causes discomfort
  • Irritation related to old injuries (such as surgery or an episiotomy)
  • Inflammatory conditions, such as skin disorders like eczema
  • Vaginismus (an involuntary spasm of the vaginal walls)
  • Birth defects (such as vaginal agenesis, which causes the irregular development of the vagina)  
  • A sexually transmitted disease

Deep pain inside the body may be caused by:

  • Illnesses such as endometriosis or pelvic inflammatory disease, uterine fibroids, or other conditions
  • Surgeries that leave internal scarring, such as a hysterectomy
  • Emotional issues that affect your sexual function. This can include:
    • A history of sexual abuse
    • Psychological issues such as depression or a fear of intimacy
    • Stress (which can cause the pelvic muscles to tighten)

Without seeing a doctor, it can be hard to determine the exact cause of your pain. Self-diagnosis often leads to incorrect assumptions and may exacerbate the issue–you even may avoid sex altogether, which could drive a wedge between you and your partner. We know dyspareunia can be difficult to talk about, but if you’re experiencing painful intercourse, it’s time to see a doctor.

How Is Painful Intercourse Diagnosed?

Smiling couple lays in the grass, head to head.Dyspareunia is a medical condition diagnosed by a doctor. For women, an obstetrician-gynecologist (OB/GYN) or a family practice doctor are good places to start.

Both women and men often hesitate to bring up sex with their doctor because they are uncomfortable talking about it. We understand why you feel that way, although there is nothing to be embarrassed about. Conversations between doctors and patients are private and legally protected by doctor/patient privilege–what happens in the privacy of your OB/GYN’s office stays there.

So, what happens during your visit? A clinical team will start by conducting a thorough evaluation of your medical history. During this process, you will answer several questions related to your sexual health:

  • When did the pain start?
  • Do you experience pain during sex frequently or only on rare occasions? 
  • Where does it hurt?
  • Can you describe the pain?
  • Are there sexual positions that are less painful? Are there others that cause more pain?

Your doctor will likely ask about your sexual history as well as the history of your reproductive health. For example, a doctor will ask if you are pregnant or have recently given birth. Answer these questions as truthfully as you can. Remember, your doctor is here to help, so don’t worry about being judged. 

The next step is a pelvic exam. During the exam, your doctor will look for visible indicators of infection, anatomical issues, or other external physical red flags. The doctor may apply gentle pressure to see if you have pain in certain areas. You may also have an internal exam. If this is painful, let your doctor know.

Starting with these general procedures, your doctor may order other tests, such as a pelvic ultrasound. With a diagnosis, several different treatment options are available to you.

How Is Dyspareunia Treated?

Young couple poses on a grey couch with kitchen cabinets behind them.Dyspareunia treatments vary depending on the location of the pain. Treatment options include medications, home remedies, therapy, and more.

If you have an infection, treating the condition should diminish your sexual pain. 

In many cases, dryness is the main cause of pain during intercourse. The condition is common in post-menopausal women, although younger women can experience similar issues. Dryness also contributes to yeast infections and other issues caused by a PH imbalance. 

In some cases, adding lubricant will resolve the problem of vaginal dryness. Topical estrogen cremes applied directly to the vagina may also help. Ospemifene is a common medication used to treat vaginal dryness, although it does have side effects that you should discuss with your doctor first.

Certain therapeutic approaches may also help with painful intercourse. 

For example, desensitization therapy can resolve vaginal spasms with relaxation exercises you can perform at home. Sex therapy and counseling are also effective treatments that work for many women and can involve your partner. Cognitive behavioral therapy is one of many treatments that can help you cope with negative thoughts that associate sex with pain.

Your doctor may also talk with you about steps you can take at home to improve your sexual experiences. Many doctors recommend changing your position during sex, which can alleviate the pain caused by certain sex positions. Try talking with your partner about extending foreplay to allow your body to naturally lubricate and ease its way into sex.

Painful intercourse isn’t normal. What is normal is reaching out to Advanced OB/GYN of Lake County for help. We treat our patients with the utmost respect, providing specialized care in a confidential and comforting setting. Call on us. We can help.

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