If you were wondering about pain during sexual intercourse in the genital area or deep in the pelvis, you are not alone. This condition is called Dyspareunia and is quite common. Approximately 75% of women feel pain during intercourse at some point of time in their lives.
There are several reasons of painful intercourse. It could be related to emotions or can be a part of the disease spectrum.
Common causes of painful intercourse:
- Pain related to menopause: A large number of postmenopausal women feel pain during intercourse due to vaginal dryness. While menopause is an entirely physiological process, painful intercourse could be bothersome and have an impact on the emotional health.
- Yeast infection of vagina or even urinary tract infection leading to burning and itching can lead to painful intercourse.
- Sexually transmitted infections can cause ulcers or rashes in the vagina or the vulva leading to painful intercourse.
- Pelvic inflammatory disease (PID) can cause inflammation of the pelvic organs or even fluid collection in the area behind lower part of the uterus.
- Inflammation or infection of the bladder (cystitis) can also cause dyspareunia
Related: 3 ways to prevent a UTI
Also read: How to clean after sex to avoid infections
- Pelvic condition such as endometriosis in which there is endometrial tissue collection in the pelvis can lead to pain during intercourse. It can lead to sharp recurring pain and the pain can be intense during periods.
- Apart from above stated conditions, any trauma to the genital area or surgical procedures such as episiotomy during childbirth or hysterectomy can lead to painful intercourse.
- Chemotherapy or radiotherapy can also lead to dyspareunia.
Other factors not related to any pathological conditions and more commonly seen in younger age group include the following:
- History of sexual abuse in the past
- Stressful relationship
- Birth control pills
Can pain during intercourse vary?
Yes, it does. Dyspareunia varies from person to person and also depends upon the tolerance to pain. Also, dyspareunia can be mild to very severe. Endometriosis is a condition leading to intense pain.
What are the symptoms of dyspareunia?
Dyspareunia can be before, during or after intercourse. The pain can be in the vagina or can be deep seated in the pelvic area. Painful intercourse can be with specific partner or during specific circumstances.
Can dyspareunia be treated?
Yes, dyspareunia can be treated. Most of the time dyspareunia is related to a cause and can be treated with appropriate interventions.
A pelvic examination needs to be done to look for
- Vulval warts, sores, rashes
- Vaginal redness, infection or dryness
- Black spots suggestive of endometriosis
- Abdominal or pelvic masses
Having done with the internal examination, your doctor may write a series of tests to confirm the diagnosis. These may include:
- PAP smear test
- High vaginal swab test
- Pelvic ultrasound
- Urine test
Also, your doctor may book an appointment with a counsellor or a psychologist having failed to find any organic cause.
How is dyspareunia treated?
- Water-based lubricants can very well be effective in reducing the pain during intercourse.
- Ice packs can be applied on the vulva to reduce the pain.
- Pain killers available over the counter can be taken (after consulting your doctor) before intercourse to provide symptomatic relief.
- Pain patches are now available that can be applied during periods and are effective in painful intercourse as well.
- Glycerine-based lubricants are available in the market for years now to alleviate the symptoms of dyspareunia.
- Oestrogen creams are often prescribed to postmenopausal women to reduce the postmenopausal dryness and help in painful intercourse. These are to be taken only after consulting your doctor as these are hormones and can have adverse effects in the long term.
- Treating the underlying pathology like giving drug treatment for endometriosis or fibroids.
- Antibiotics are often prescribed in case your doctor finds a yeast infection or pelvic inflammatory diseases.
- Antifungal and antibiotic pessaries are often also prescribed to deal with fungal vaginitis.
As such there are no preventive techniques for dyspareunia but you can try the following.
- Prevent sexually transmitted infections by using barrier methods of contraception like condoms.
- Maintaining genital and vaginal hygiene.
- Using water soluble method of lubrication when facing vaginal dryness.
- Maintaining proper hygiene during periods, pregnancy and after childbirth.
- Resuming sexual activity at least after a month of childbirth and after healing of episiotomy site.
- Having regular check-ups with your doctor and getting timely PAP smear done.
Even if you have not had dyspareunia, someone in your circle might be suffering in silence with the condition. So spread awareness about it by sharing.