What You Need to Know About Dyspareunia (Painful Intercourse)

Overview

What causes dyspareunia?

Several conditions can cause dyspareunia. For some women, it’s a sign of a physical problem. Other women may experience pain as a result of emotional factors.

Common physical causes of dyspareunia include:

• vaginal drynessfrommenopause, childbirth, breastfeeding, medications, or too little arousal before intercourse
• skin disordersthat causeulcers,cracks,itching, or burning
• infections, such asyeastorurinary tract infections (UTIs)
• injury or trauma from childbirth, an accident, anepisiotomy, ahysterectomy, or pelvic surgery
• vulvodynia,或疼痛centered in the vulva area
• vaginitis, or inflammation of the vagina
• vaginismus, or a spontaneous tightening of the muscles of the vaginal wall
• endometriosis
• cystitis
• pelvic inflammatory disease (PID)
• 子宫肌瘤
• irritable bowel syndrome (IBS)
• radiationandchemotherapy

Factors that reduce sexual desire or affect a person’s ability to become aroused can also cause dyspareunia. These factors include:

• stress, which can result in tightened muscles of the pelvic floor
• fear, guilt, or shame related to sex
• self-image or body issues
• medications such as birthcontrol pills
• relationship problems
• conditions such ascancer,arthritis,diabetes, andthyroid disease
• history of sexual abuse or rape

What are the symptoms of dyspareunia?

Dyspareunia pain can vary. Pain may occur:

• in thevagina,urethra, orbladder
• during penetration
• during or after intercourse
• deep in the pelvis during intercourse
• after pain-free intercourse
• only with specific partners or circumstances
• with tampon use
• along with burning,itching, or aching
• with a feeling of stabbing pain, similar to menstrual cramps

Who’s at risk for dyspareunia?

Both women and men can experience dyspareunia, but the condition is more common in women. Dyspareunia is one of the most common problems ofpostmenopausal women.

Around 75 percent of women have painful intercourse at some time, according to theAmerican College of Obstetricians and Gynecologists (ACOG). You’re at an increased risk if you:

• take medications that cause vaginal dryness
• have a viral or bacterial infection
• are postmenopausal

How’s dyspareunia diagnosed?

Several tests help doctors identify and diagnose dyspareunia. Your doctor will start by creating a complete medical and sexual history. Possible questions your doctor may ask you include:

• When and where do you feel pain?
• Which partners or positions cause pain?
• Do any other activities cause pain?
• Does your partner want to help?
• Are there other conditions that may be contributing to your pain?

Apelvic examinationis also common in diagnosis. During this procedure, your doctor will look at the external and internal pelvic area for signs of:

• dryness
• inflammation or infection
• anatomical problems
• genital warts
• scarring
• abnormal masses
• endometriosis
• tenderness

The internal examination will require a speculum, a device used to view the vagina during aPap test. Your doctor also may use a cotton swab to apply slight pressure to different areas of the vagina. This will help determine the location of the pain.

The initial examinations may lead your doctor to request other tests, such as:

• pelvicultrasound
• culture test to check for bacteria oryeast infection
• urine test
• allergy test
• counseling to determine the presence of emotional causes

How’s dyspareunia treated?

Medications

Dyspareunia treatments are based on the cause of the condition. If your pain is caused by an underlying infection or condition, your doctor may treat it with:

• antibiotics
• antifungal medicines
• topical or injectable corticosteroids

If a long-term medication is causing vaginal dryness, your physician may change your prescription. Tryingalternative medicationsmay restore natural lubrication and reduce pain.

低雌激素检测lscause dyspareunia in some women. A prescription tablet, cream, or flexible ring can deliver a small, regular dose of estrogen to the vagina.

An estrogen-free drug called ospemifene (Osphena) acts like estrogen on vaginal tissues. It’s effective in making the tissues thicker and less fragile. This can reduce the amount of pain women experience with sexual intercourse.

Home care

These home remedies can also reduce dyspareunia symptoms:

• Use water-soluble lubricants.购买水溶性润滑剂。
• Have sex when you and your partner are relaxed.
• 人事处沟通enly with your partner about your pain.
• Empty your bladder before sex.
• Take a warm bath before sex.
• Take an over-the-counter pain reliever before sex.Find a selection of pain relievers online.
• Apply an ice pack to the vulva to calm burning after sex.Shop for ice packs.

Alternative therapies

Your doctor may also recommend therapy. This can includedesensitization therapy or sex therapy.In desensitization therapy, you’ll learn vaginal relaxation techniques, such asKegel exercises, that can decrease pain.

Insex therapy, you can learn how to reestablish intimacy and improve communication with your partner.

防止ing dyspareunia

There’s no specific prevention for dyspareunia. But you can do the following to reduce the risk of pain during intercourse:

• After childbirth, wait at least six weeks before resumingsexual intercourse.
• Use a water-soluble lubricant when vaginal dryness is an issue.
• Use proper hygiene.
• Get proper routine medical care.
• 防止sexually transmitted diseases (STDs)by using condoms or other barriers.
• Encourage natural vaginal lubrication with enough time for foreplay and stimulation.

What’s the outlook for dyspareunia?

Alternatives to sexual intercourse may be useful until underlying conditions are treated. You and your partner can use other techniques for intimacy until penetration is more comfortable. Sensual massage, kissing, oral sex, and mutual masturbation may be satisfying alternatives.