Ask yourself, is pain during sex ruining your sex life?
A surprising number of women experience pain during sex, and not only does it interfere with their sexual pleasure, it can cause significant distress and suffering if left unaddressed.
Pain during sex is formally known as dyspareunia.
This common health issue can be linked to with a whole host of different causes – but not to worry, most of these are actually easily treatable.
So ask yourself –
- Is your sexual pleasure being compromised by pain?
- Does painful sex diminish your self confidence?
- Does it limit the emotional intimacy within your relationship?
Well, we have some answers for you.
What are the symptoms?
Dyspareunia is experienced differently by individual patients – some descriptions include a burning, aching, cramping, tearing, or throbbing sensation.
The timing of the pain also varies.
While some women have pain only on initial penetration, others experience a continuous deep pain with penile insertion and thrusting.
The pain may even persist for hours after intercourse, causing significant discomfort and distress.
In some women, any insertive action, such as use of fingers, or tampons, can precipitate the discomfort.
Dyspareunia may not have been present when you first started having sex, but can develop at anytime during your sexual lifetime.
What are the causes?
Dyspareunia has many different causes. What are the 11 Causes of Dyspareunia (Pain During Sex)?
1. Insufficient lubrication
Dryness of the vaginal walls can lead to increased friction, causing chafing and pain.
An estrogen deficiency, whether transient after childbirth, or permanent, with menopause, can result in dryness.
Estrogen levels are also relatively lower in breastfeeding mothers and can make re-initiation of intercourse difficult.
Some decongestant medications, chemotherapy drugs, as well as autoimmune conditions can also interfere with vaginal lubrication.
Infection or inflammation of the superficial and deep structures of your pelvis can result in pain.
These are the common infections/inflammatory conditions that result in painful intercourse –
- Candidiasis (thrush)
- Bacterial vaginosis
- STDs eg. chlamydia, gonorrhoea, Trichomoniasis, HSV
- Local irritation of the skin (vulvitis)
As all of the above are easily treatable, you should consult your doctor if you suspect you have any of these.
3. Pelvic Disease
Deeper structures within your plevis include the cervix, the womb (uterus), and the ovaries.
Endometriosis, uterine fibroids or polyps, and ovarian cysts can create unpleasant sensations during intercourse.
Don’t ignore dyspareunia as it may actually be a harbinger of something dangerous!
Pelvic inflammatory disease is a serious infection of your pelvic structures due to STDs, which if left untreated can result in infertility.
Another cause? Consider cancer of the ovaries, uterus or cervix.
Both PID and cancer are critical conditions that warrant prompt investigation and management.
Dyspareunia could be your warning sign, so seek medical advice about it.
4. Post-procedure scarring
Scar tissue can form in the pelvis following previous medical procedures such as surgery or radiation – this can contribute to pelvic pain during sex.
In instances following delivery, the inflammation in your pelvic tissues and lower genitals can take several weeks to resolve.
This is especially if you had a vaginal tear or surgically placed cut (episiotomy) during vaginal delivery.
If intercourse is uncomfortable, it may need to be further delayed until things have healed and settled down.
Vaginismus is the painful, involuntary spasm of the vaginal walls following penetration.
The exact cause of vaginismus is unknown but may be related to fear or anxiety of sex.
Some women might experience it only with certain partners but can enjoy normal intercourse with others.
In many women with vaginismus, other triggers include insertion of fingers, tampons, or medical devices during a pelvic examination.
6. Emotional/Psychological Causes
Sex, and the different ways each of us experience it, involves a complex mental, emotional and physical construct.
Sometimes, the emotional or psychological factors can actually manifest as physical pain, and interfere with sexual enjoyment.
While anxiety, depression and body image disorders are more commonly linked to dyspareunia, simpler issues such as tension within your relationship, or stress in other areas of your life can affect your sexual health.
Speaking to your doctor or a sexual counsellor may be beneficial.
How can this be treated?
The treatment of dyspareunia varies significantly, depending on the cause.
First, speak to your doctor about it.
An open discussion about the circumstances in which you have pain, along with a detailed sexual and medical history is necessary.
Your doctor will also help to review your concurrent medications, and relevant lifestyle related factors.
After performing a physical examination, your doctor may recommend further investigations in the form of blood tests, swabs and imaging of the pelvis.
Subsequent treatment of dyspareunia depends on the cause.
If your dyspareunia is due to infection, this can be treated with antibiotics.
Topical and systemic estrogens, or commercially available lubricants can be useful in women suffering from vaginal dryness.
For women with vaginismus, desnsitisation therapy has been shown to be highly effective.
There are many other modalities of treatment available for dyspareunia, so don’t suffer in silence.
If you think you have dyspareunia, start a conversation with your doctor today.
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