Dyspareunia (Painful Sex): Symptoms, Causes, and Treatment

Having a perfect sexual experience isn't a straightforward journey. Many women find themselves wrestling with a rather sensitive question: why does it hurt during intimate moments with their partner? Sometimes, the discomfort is so intense that they just want to rush through it, but the fear of ruining the mood lingers. Over time, this apprehension can turn into insecurity around sex.

Painful sex is a topic that often hides in the shadows but that certainly deserves our attention. In this article, we unravel the mystery of painful sex, figuring out why it happens, and, most importantly, finding ways to make it go away.

Table of Contents

1. Dyspareunia: What It Is

2. Symptoms of Dyspareunia

3. Causes of Dyspareunia

4. Treatment Options for Dyspareunia

5. Can Dilators Help Dyspareunia?

6. Conclusion

Dyspareunia: What It Is

The medical term for painful sex is dyspareunia. A term often unfamiliar to many, it refers to persistent or recurrent pain experienced during sexual intercourse. This discomfort can manifest in various forms, ranging from mild to severe, and can occur before, during, or after intercourse. 

Dyspareunia is more common than you might think. According to Dr. Jen Gunter, a gynecologist in California and a columnist for The New York Times, sexual pain is a widespread occurrence, with nearly 75% of women having experienced it.

Symptoms of Dyspareunia

Dyspareunia can manifest itself in any of the following forms:

• Sharp pain at insertion or during penetration, including when using a tampon
• Throbbing pain after intercourse
• Pelvic tightness or muscle spasms
• Burning pain or aching
• Deep pain during thrusting

When to see a doctor

While a high percentage of women experience painful sex, most do not seek medical help. If you’re experiencing recurring pain during sex, we advise you to promptly seek medical attention to understand the cause and find ways to improve.

Causes of Dyspareunia

Both physical causes and psychological issues can contribute to sexual pain. Physical causes differ based on where the pain occurs: superficial, involving pain limited to the vulva or vaginal entrance, and deep, where the pain extends into the deeper parts of the vagina or lower pelvis.

Superficial Pain:

1. Insufficient lubrication is a common cause of pain during sex and can occur due to a lack of foreplay or hormonal imbalances after menopause, childbirth, or breastfeeding. Additionally, certain medications are known to impact sexual desire or arousal, leading to reduced lubrication and potential discomfort during sex. These medications include antidepressants, high blood pressure medications, sedatives, antihistamines, and specific types of birth control pills.
2. Vaginismus, which occurs when the muscles around the entrance of the vagina tighten on their own, leading to difficulty or pain during penetration.
3. Injury, trauma, or irritation to the vulva or vagina as a result of accidents, pelvic surgery, female circumcision, or episiotomy (a cut made during childbirth to enlarge the birth canal).
4. Inflammatory conditions such as perineal inflammation, vaginitis, Bartholin's gland cysts, and urethritis can contribute to sexual pain. Additionally, infections in the genital area or urinary tract and skin disorders like eczema can also lead to painful intercourse.

Deep Pain:

1. Gynecological conditions and certain diseases, including endometriosis, pelvic inflammatory disease (PID), uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, pelvic floor dysfunction, adenomyosis, hemorrhoids, and ovarian cysts might cause deep pain during penetration.
2. Surgeries or medical treatments, such as pelvic surgery, including hysterectomy, can lead to scarring that causes painful intercourse. Similarly, medical treatments for cancer, like radiation and chemotherapy, can induce changes in tissue structure that make sex painful.

Emotional factors

Emotions play a significant role in sexual activity and can indeed lead to sexual pain. This is primarily attributed to a lack of knowledge or experience around sex. Some emotional factors include:

1. Anxiety, depression, and other concerns about physical appearance, fear of intimacy, or relationship problems may lead to a low level of arousal, resulting in discomfort or pain.
2. Stress in your life can cause pelvic floor muscles to tighten, making it challenging to relax during sex.
3. Past sexual experiences (for instance, if pain is experienced during the first encounter) might create a misconception that every subsequent encounter will be painful, leading to fear.

While dyspareunia isn’t always linked to sexual abuse, traumatic experiences are often a contributing factor, as they may lead to mental tension during sexual encounters.

Treatment Options for Dyspareunia

There are several approaches available to address painful sex. The good news is that some of them do not require medical intervention.

1. Non-Medical Treatments:
• Postpartum Pain — Wait at least six weeks after childbirth before resuming intercourse. Practice gentleness and patience during this period.
• Vaginal Dryness — Use water-based lubricants to address dryness or a lack of lubrication. Consider incorporating a non-irritating lubricant for relief. If pain persists, consult your gynecologist as soon as possible to create a treatment plan. 
2. Medical Treatments Requiring Doctor's Care: 
• Hormonal Imbalances  — Identifying and treating underlying medical conditions is a primary step in addressing dyspareunia. Consult a healthcare professional about estrogen creams or other prescription medications to address and alleviate symptoms like vaginal dryness associated with menopause.
• Other Underlying Causes  — Prescription drugs may be necessary for treating painful intercourse caused by other medical conditions like infections. If infections are suspected, appropriate antibiotics or antifungal medications may be prescribed.
3. Sexual Therapy: Sexual therapy can benefit various types of sexual dysfunction with psychological causes or impacts, such as inner conflicts about sex or feelings related to past negative sexual experiences. Sex therapists also offer guidance on communication, intimacy, and techniques to enhance the sexual experience while managing pain.
4. Pelvic Floor Physical Therapy: Targeted exercises and therapies can help strengthen and relax the pelvic floor muscles, addressing muscle-related causes of pain.
5. Seeking Medical Attention: If you experience symptoms such as bleeding, genital lesions, irregular periods, or involuntary vaginal muscle contractions, consult a doctor. For other concerns, always seek a referral to a certified sex counselor and healthcare professional for personalized advice.

Can Dilators Help Dyspareunia?

Vaginal dilators have emerged as a potential aid in managing painful sex. These tube-shaped medical devices are designed to gently stretch the vaginal muscles, keeping your vagina elastic. They are commonly used together with breathing techniques and other treatment options to reduce pain. 

The VWELL Dilator Set comes with different sizes to progressively improve vaginal flexibility and decrease sensitivity to insertion. Thanks to their quality, VWELL dilators are a viable option for women seeking a supportive tool on their journey to pain-free intimacy. Learn more about these extra-soft, body-safe, medical-grade silicone dilators here.

Conclusion

So, there you have it! Discussing painful sex might be challenging, but we've provided enough insight for you to feel at ease taking action. By understanding the situation, you can explore ways to improve and rediscover joy in intimate moments.

FAQs:

1. Who is most likely to have dyspareunia? 

Dyspareunia, or pain during sex, can affect both men and women of all ages. Female dyspareunia can be caused by factors such as age-related vaginal dryness, medical conditions like endometriosis, psychological factors, hormonal changes, and infections.

2. How is dyspareunia diagnosed?

Your healthcare provider will diagnose dyspareunia by thoroughly collecting your medical history and conducting a detailed physical examination. The latter includes checking your pelvis, abdomen, vagina, and uterus. To identify the source of pain and any underlying medical conditions, additional tests such as pelvic exams, transvaginal ultrasounds, and, in rare cases, laparoscopy may be conducted.

3. How long will I need to continue treatment before things get better?

It varies for everyone. It depends on factors like underlying causes and the effectiveness of interventions. Reach out to your healthcare professionals for tailored advice and remember to be patient throughout the process.