Dyspareunia or pain during sexual intercourse: causes and recommendations
Dyspareunia is defined as painful intercourse , although in reality the discomfort can appear at any time before, during or after intimate relations.
It's important to know that occasional pain is not usually a cause for concern, as most women have experienced it at some point in their lives. What we're going to talk about is the chronic condition that requires specialized diagnosis and treatment.
In most cases, dyspareunia can be reversed. This involves addressing the underlying cause or implementing a series of measures to alleviate the discomfort that prevents sexual relations from being a fully pleasurable experience.
Causes of dyspareunia or pain during intercourse
1. Poor lubrication
Insufficient lubrication, whether due to:
- la absence of erotic games previous,
- the decrease in estrogen after menopause -vaginitis or senile colpitis-,
- el Birth,
- la lactation
- or the consumption of certain drugs -for example, those indicated to reduce blood pressure, antidepressants, sedatives, antihistamines or some types of birth control pills-,
It can promote the development of discomfort of varying intensity.
2. Irritations caused by barrier contraceptive methods
Such barrier contraceptives are, for example:
- Condoms,
- el diaphragm,
- intrauterine devices –IUD
- or spermicides.
3. Vaginismus
Vaginismus is characterized by the involuntary contraction of the muscles surrounding the vagina . This sexual dysfunction can originate from psychological factors or stem from a lack of information or communication with a partner. It can be rooted in fear or traumatic experiences, which is why it should be diagnosed and treated as soon as possible.
4. After giving birth…
In addition to decreased lubrication after childbirth or during breastfeeding, women may also experience pain if they have given birth by instrumental delivery - that is, through extraction devices such as vacuum extraction or forceps - if they have had an episiotomy or vaginal tearing.
Episiotomies are incisions in the perineum made during childbirth to prevent tearing of the tissues in the area.
5. Endometriosis and pelvic inflammatory disease
These two conditions can lead to chronic inflammation of the vagina , uterus, fallopian tubes, or ovaries. This inflammation causes pain during or after intercourse.
Both conditions should be treated with appropriate medical therapy and, in some cases, with surgery.
6. Uterine prolapse
Uterine, vaginal, or rectal prolapse can have various causes. It can also lead to dyspareunia (painful intercourse), urinary incontinence, lumps on the external genitalia, pelvic pain, or difficulty walking.
Treatment may be medical , with pelvic floor strengthening exercises or the insertion of intravaginal pessaries. In cases where these therapies are ineffective, surgery will be considered.
7. Uterine retroversion
When the uterus is retroverted, meaning it's tilted towards the spine instead of the abdomen, it can cause discomfort during deeper penetration. However, there are positions that allow for fully satisfying intercourse.
8. Benign genital tumors
The pain caused by uterine fibroids or ovarian cysts depends on their size. If they are not very large, they should not cause dyspareunia (painful intercourse).
9. Urinary or vaginal infections
Both urinary tract and vaginal infections can cause pain during sexual intercourse. Therefore, it is recommended to treat the infection and wait until it has completely cleared before resuming sexual activity.
10. Irritable bowel syndrome
The Spanish Digestive Motility Group has released a study revealing that 36% of those affected by irritable bowel syndrome suffer from recurrent and intense abdominal pain. This condition affects, among other areas, their physical and sexual relationships.
11. Hysterectomies
A hysterectomy, or removal of the uterus, if performed completely, can have several consequences that affect sexual relations. It can cause discomfort and pain, which can be intensified if the surgical scar retracts . Therefore, if the condition that necessitated the removal of the uterus is benign, it is advisable to remove only the uterine body and preserve the cervix. This procedure is called a subtotal hysterectomy.
Treatment to combat dyspareunia
Due to the wide variety of disorders or conditions that can lead to dyspareunia, specialist medical advice is essential. This is crucial both for identifying the source of the problem and for applying the most appropriate treatment in each case.
However, the following recommendations will help you promote a more satisfying and healthy sex life:
- Put aside fears or traumas and face the problem with open attitude and active communication with partner.
- Give greater importance to the preliminary, the so-called sexual foreplay.
- Try different postures.
- Use lubricants.
- Perform drill specific to learn to control the movement of the vaginal muscles.
- Like we have already said, go to the gynecologist to request professional advice and counsel.
Recommended Articles
- What is Pelvic Floor Physiotherapy?
- Kegel exercises for pelvic floor recovery
- Vaginal gynecological laser
If you found this article interesting and would like to be seen by a specialist in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized unit in this area. You can request more information by calling 917303673, schedule an in-person appointment , or book an online consultation if you prefer; always with top specialists.