Dyspareunia (pain during sexual intercourse)

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Dyspareunia (dys*pa*reu*nia) means difficult or painful sexual intercourse.

Although the condition is present in both sexes, it is far more common in women, where it is being described as pain with initial penetration, and/or during thrusting, and/or after intercourse (an after-effect).

I never understood why tampons were so painful when everyone can use them just fine . . . Intercourse? I expected pain the first time, but it keeps being painful every time, from the moment he begins to penetrate until he is done. Although we have two kids, I am reluctant to engage in intercourse and still cannot use tampons. Gynecologic exams are also painful, and the doctor does not know what the problem is.

What are the causes of pain during intercourse (Dyspareunia)?

  • Medical causes, such as vaginal infections, sexually transmitted diseases, skin conditions, hormonal problems, conditions of the intestines or genitals or urinary system, etc.
  • Physical causes, such as vaginal abrasions, scars, nerve damage, complications from vaginal delivery, size incompatibility, etc.
  • Functional causes, such as genital irritation due to excessive hygiene or sensitivity to cleansing agents, poor hygiene, friction irritation due to sports such as cycling or horseback riding, insufficient vaginal lubrication, etc.
  • Psychophysical causes, such as postpartum crisis, interpersonal difficulties, forced sexual encounters, vaginismus, etc.

Dyspareunia can be a source of great conflict and anxiety to the woman who suffers from it, causing marked distress and interpersonal difficulties. Although intercourse is possible, the accompanying pain has been associated with a more negative attitude toward sexuality, with more sexual function impairment, and with lower levels of sexual adjustment.

Unfortunately, many women are putting up with painful intercourse, depriving themselves of the healthy intimacy that should be the cornerstone of their relationship.

Treatment for sexual pain: a thorough assessment is imperative in order to identify the particular type of dyspareunia the woman has and to offer the appropriate intervention. The clinician who takes the time to obtain a complete and careful medical and sexual evaluation can help resolve most of these problems.

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