Sexual intercourse is seen as a pleasurable activity but for some women, and even men, it can be a nightmare. A condition called dyspareunia is responsible as it is manifested by persistent pain in the genital area during or after the intercourse. Medically speaking, the condition is not serious as it rarely has implications as far reaching as female infertility or any other major complication.

However, it can impact the quality of life and relationships as the patient may sometimes suffer in silence to save her relationship. Therefore, it becomes all the more vital to delve deeper into the actual cause of dyspareunia and take the right line of treatment so that it may be resolved before all is lost for the woman.

Understanding Dyspareunia

Dyspareunia is a common condition which involves pain in the vagina, labia or clitoris of a woman while having intercourse or after it (in men, it causes pain in the penis, though it is less common). The pain may be superficial, at the point where penetration begins, or it can be experienced during deep penetration. It could be accompanied by a burning sensation and could last for hours after the intercourse.

Vaginismus is a condition when a woman experiences muscular tightening of the vagina during penetration, making it painful and uncomfortable. Dyspareunia becomes so acute in some cases that it goes beyond sexual intercourse; even inserting a tampon can be painful for such patients. When a woman comes across any of these symptoms, she should seek medical advice to get her life back to normal as the condition is easily treatable.

Common Causes of Dyspareunia

The causes of dyspareunia may be physical or psychological and the doctor looks to establish the exact one to tackle the case accordingly.

  • Vaginal dryness is the most prevalent reason of dyspareunia. It can happen due to lack of lubrication, usually when there is insufficient foreplay and the woman is not ready for penetration. Post menopausal women as well as breastfeeding mothers experience vaginal dryness as their estrogen levels drop.
  • Most women experience thinning of the vaginal lining (atrophic vaginitis) after menopause, which is another common reason of pain during intercourse.
  • Prolonged usage of certain medications such as sedatives, contraceptive pills, high blood pressure medicines and antihistamines can also have a negative impact on sexual arousal and reduce vaginal lubrication. Similarly, spermicides, douches and scented chemicals (in soaps and washing powders) can lead to allergic reactions in the genital areas, which in turn can be responsible for dyspareunia.
  • Another common cause of dyspareunia is skin diseases and infection of the vaginal area or urinary tract. This could lead to inflammation and affect the quality of sex.
  • A previous trauma or surgery such as episiotomy made during childbirth or pelvic surgery, could contribute to painful intercourse. It could happen due to some congenital deformity too, as in women with abnormally formed vagina (vaginal agenesis) or those in who the vagina is blocked by imperforate hymen.
  • The presence of certain medical conditions such as endometriosis, uterine fibroids, ovarian cyst, pelvic inflammatory disease and uterine prolapse can result in pain during deep penetration.
  • In yet other cases, the reason for dyspareunia is emotional rather than physical. Women who have history of sexual abuse may fear sex and find it painful. Stress, depression, relationship issues ad low self esteem could be other psychological causes of the condition. Initial pain during intercourse can develop fear in a woman’s mind and she tends to find it painful every time she does it.

Diagnosis and Treatment of Dyspareunia

Dyspareunia is an intimate problem and many women may be apprehensive about seeking medical advice. But it is always better to visit a doctor sooner than later as the problem can have bearing on the patient’s relationships. Effective communication is the key and the woman needs to be open with her doctor so that the condition may be properly diagnosed. Besides asking some questions about the patient’s medical history, sexual behavior and emotional makeup, the doctor can recommend certain diagnostic tests. Physical examination of the genital and pelvic region is done to identify the external factors while a pelvic ultrasound may be done for patients with suspected internal problems.

Depending upon the underlying cause, the doctor will offer the apt one amongst the various treatment options for dyspareunia. If the condition is caused by vaginal dryness, over-the-counter lubricants and adequate foreplay are the effective solutions, while antibiotics are useful for relieving sexually transmitted disease and infections of the urinary tract. Pain induced by skin allergies can be treated by application of local application of steroidal creams. Estrogen therapy, oral or topical, is prescribed for women battling with dyspareunia caused by hormonal issues.

In those cases where dyspareunia is due to internal complications, doctors may have to resort to surgical procedures for removing abnormal growths such as endometrial tissue and uterine fibroids. Pelvic floor exercises can relive the pain caused due to muscular tension. Psychological counseling may be advisable in cases where stress and emotional factors are responsible for the condition. Also, physical and emotional support from the partner can play a key role in effective treatment of dyspareunia, as they can focus on making sex enjoyable rather than an experience to fear.

Gaudium IVF is one of the top infertility clinics in Delhi, which not only offers the latest infertility techniques for its patients but also provides treatment and support for various gynecological and sexual issues. Visit here for free second opinion from Dr Manika Khanna, the leading infertility specialist in Delhi.