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Dyspareunia: what to do if you experience pain during sex

According to various data, from 8% to 20% of women experience pain during sexual intercourse. However, these figures may be significantly underestimated due to the sensitivity of the issue. Because of the fear of judgment and isolation, embarrassment and shame, women do not rush to seek help. While the problem of painful sex is so common that there is even a special medical term for it – dyspareunia.
Despite the fact that dyspareunia occurs in men, women are most often affected by this problem. According to the American College of obstetricians and gynecologists, 3 out of 4 women have experienced pain during sex at least once in their lives.

Dyspareunia and its symptoms
Dyspareunia is pain before, during, and sometimes after sex. This pain can be both superficial and deeper and will spread not only to the vaginal area, but also to the labia, clitoral head, perineum, uterus, bladder, and even the lower back.

Among the most common symptoms of dyspareunia are the following:

Pain during penetration of the penis, vibrator, or tampon into the vagina
Deep pain during frictions
Burning or dull pain during sexual intercourse
Throbbing pain lasting several hours after sexual intercourse

Possible causes of pain
Vaginal dryness
It happens when there is not enough vaginal lubrication. This can occur for a number of reasons: low libido, insufficient time allotted for foreplay, decreased estrogen levels, lactation, and taking certain medications.

Inflammatory and infectious diseases
Thrush, urogenital infection, sexually transmitted diseases, eczema and other skin problems in the genital area, and even an allergic reaction to underwear – all this can cause painful sexual intercourse.

Damage or irritation of the vagina
Pain during sex can be caused by vaginal injuries, female circumcision, and scars from episiotomy and hysterectomy. The use of spermicides and syringes often causes irritation of the vagina, thereby increasing the pain during sexual contact.

Gynecological disease
Pain with deep penetration is most often caused by problems such as vaginismus, endometriosis, vaginal prolapse, uterine bend, fibroids, cystitis, irritable colon syndrome, hemorrhoids and ovarian cysts of the ovaries.

Emotional factors
Our emotions are deeply intertwined with sexuality and cannot but affect the quality of sexual intercourse.

So anxiety, depression, dissatisfaction with your appearance, fear, guilt, shame, embarrassment – all these factors negatively affect the libido and prevent you from relaxing, which, in turn, prevents arousal and causes pain during sex.

Problems in relationships with partners, also do not contribute to healthy sex. Interestingly, the most common difficulty of a sexual nature in the relationship of partners is a mismatch of the sex drive. So, if your partner insists on sex when you don’t want it at all, it’s no wonder that the body can rebel and respond with pain to an unwanted sexual intrusion.
Time to sound the alarm
Despite the fact that in some cases sexual intercourse can cause discomfort, especially the very first time, it should never be painful.

However, it is sometimes too difficult to understand and feel where the line between discomfort and pain passes. Because of the established stereotype of sex as an endless source of pleasure and a series of endless orgasms, women stop trusting their body and question the presence and intensity of pain experienced: is it really painful for me, or is it normal?

To prevent dyspareunia from developing into a serious psychological problem, it is necessary to consult a specialist at the first symptoms.

Diagnostics
Due to its specificity, dyspareunia is not always easy to diagnose. It cannot be felt or examined with an ultrasound machine. The diagnosis is based on the woman’s subjective feelings and analysis of symptoms.

Diagnosis can also be difficult due to the fact that many women, for various reasons, deliberately keep silent about the symptoms, preferring to stay one-on-one with their problem. While it is very important to be completely honest with your doctor. The smallest detail matters. For example, subtleties such as the location of concentration and the nature of pain, whether it is at the simple touch of the genitals, at the entrance to the vagina, or at a deeper penetration – the key to diagnosing the causes of painful symptoms.

As a rule, during the consultation, the doctor asks a number of standard questions. The reception will be much more effective if you prepare answers to them in advance:

Have you ever had painless sexual intercourse, or have you always suffered from dyspareunia?
Do vases have enough natural vaginal lubrication, or do you have to use a pharmacy lubricant to improve symptoms of vaginal dryness?
How regular are your periods, do you experience hot flushes and vaginal dryness? – History of your sexual contacts to determine whether there is a risk of sexually transmitted infections.
Have you ever been sexually assaulted or suffered genital injuries?
The second part of the diagnosis of dyspareunia is a gynecological examination, during which the doctor examines the vagina for dryness, inflammation, warts, scars, as well as signs of endometriosis and pelvic tumors.

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