Overview
Painful intercourse, also known as dyspareunia, is a common condition characterized by persistent or recurrent genital pain that occurs before, during, or after sexual intercourse. It can be caused by a range of factors, including structural problems, hormonal imbalances, medical conditions, injuries, or psychological concerns. Symptoms of painful intercourse may include pain during penetration, deep pain during thrusting, burning or aching pain, and throbbing pain that lasts hours after intercourse. If you experience recurrent pain during sex, it is important to consult your healthcare provider to determine the underlying cause and explore appropriate treatment options.
Understanding the disease
Symptoms
The symptoms of painful intercourse, also known as dyspareunia, include:
- Pain only at sexual entry (penetration)
- Pain with every penetration, including putting in a tampon
- Deep pain during thrusting
- Burning pain or aching pain
- Throbbing pain, lasting hours after intercourse These symptoms may be caused by various factors such as insufficient lubrication, certain medications, injury or irritation, inflammation, infection, skin disorders, vaginismus, or structural problems present at birth. If you are experiencing recurrent pain during sex, it's important to talk to your healthcare provider to determine the cause and receive appropriate treatment.
Development
Painful intercourse, or dyspareunia, can develop due to a variety of physical and emotional factors. Physical causes may include inadequate lubrication, vaginismus, or anatomical issues such as vaginal agenesis or imperforate hymen. Deep pain during penetration may be associated with conditions such as endometriosis, pelvic inflammatory disease, or uterine fibroids. Emotional factors may contribute to sexual pain, including anxiety, depression, stress, or a history of sexual abuse. It is essential to consult with a healthcare provider to determine the underlying cause and develop an appropriate treatment plan.
Assessment and Diagnosis
Triage
You should see a doctor if you experience recurrent pain during sex or other related symptoms. The doctor should be consulted if you have painful intercourse, which is referred to as dyspareunia. This can help identify and treat the underlying cause, improving your overall sexual experience, emotional intimacy, and self-image.
Diagnosis
To diagnose painful intercourse (dyspareunia), a medical evaluation is necessary. The evaluation typically includes a thorough medical history, a pelvic exam, and possibly additional tests depending on the suspected cause. During the pelvic exam, a healthcare provider checks for signs of skin irritation, infection, or anatomical problems and might apply gentle pressure to the genitals and pelvic muscles to locate the pain. If an infection or medical condition is suspected to be causing the pain, additional tests like a pelvic ultrasound might be recommended.
Management and Treatment
Complications
Painful intercourse can have several potential complications if left untreated, including:
- Emotional distress: Pain during or after intercourse can lead to feelings of frustration, anxiety, and low self-esteem, negatively impacting a person's emotional well-being.
- Relationship strain: The persistent pain and associated emotional distress can cause tension in romantic relationships, leading to a decline in intimacy and communication.
- Reduced sexual enjoyment: Chronic pain during intercourse can make the experience unpleasant and may discourage people from engaging in sexual activities, thereby reducing their overall sexual satisfaction.
- Sexual dysfunction: If left untreated, painful intercourse can contribute to or exacerbate other sexual dysfunctions, such as low libido or difficulty achieving orgasm. It is important to consult with a healthcare provider to address the underlying causes of painful intercourse and manage any potential complications.
Treatment
Treatments for painful intercourse (dyspareunia) depend on the underlying cause. Some common treatments include:
- For lack of lubrication: Increase foreplay, use over-the-counter lubricants, or consult your doctor about hormone therapy if you are experiencing a drop in estrogen levels due to menopause, childbirth, or breastfeeding.
- For vaginismus: Engage in pelvic floor exercises, use vaginal dilators, or seek therapy to help manage the involuntary muscle spasms.
- For physical causes such as injury, trauma, or skin disorders: Treat the underlying condition, which may involve medication, surgery, or other interventions, depending on the specific issue.
- For infections or inflammation: Treat the underlying infection or inflammation with appropriate medications, such as antibiotics or antifungals.
- For emotional or psychological concerns: Consider couples therapy or sex therapy to address any underlying emotional or mental health issues that may be contributing to the painful intercourse. It is important to consult with a healthcare provider to determine the underlying cause and develop an appropriate treatment plan.
Preparing for medical consultation
To prepare for an appointment regarding painful intercourse, make a list of your sexual problems, including when they began and how often they occur, note your key medical information and medications, and prepare a list of questions to ask your healthcare provider. Expect your provider to ask about the duration and location of your pain, and be open and honest about your sexual concerns.