Causes of dyspareunia and treatments for sex-associated pain

Maybe the name doesn’t sound so familiar, but dyspareunia can be summed up as pain related to the moment of sexual intercourse. Most women have already felt, in a certain situation, a nuisance during sex. The problem is when the discomfort is recurrent.

The characteristics of pain are varied, as well as the causes that may even be of emotional origin. Therefore, each case must be investigated by the gynecologist. See below for the main symptoms, causes and treatments for dyspareunia.

what is dyspareunia

Maura Azzi Tassi (CRM 5298909-6), a gynecologist and obstetrician at the Maieve Corralo Institute, explains that dyspareunia is pain that occurs immediately before, during or after sex. “It can affect both men and women, but it is more common in women. Women may experience pain in the vulva (area around the opening of the vagina), inside the vagina, or in the lower part of the belly,” she points out.

Symptoms of dyspareunia

Pain can manifest itself in different ways and intensity, so, according to the professional, symptoms of dyspareunia can include:

• Pain in the vulva/vestibule/introitus (outer part), vagina (inner part), pelvis or the pelvic floor;
• Burning and/or discomfort;
• Pain isolated or in several places;
• Constant pain (with each sexual event and activity) or situational (with some experiences or partners but not others, for example).

Maura emphasizes that the intensity of sensations is relative. “It can be mild, moderate, or reach acute manifestations, when the pain is excruciating,” she says.

Introital dyspareunia, also called vaginismus, is the most common manifestation when the cause of pain has emotional origins. “It occurs because the contraction of the vaginal muscles prevents comfortable and pleasurable penetration”, explains the doctor.

She also complements with the information that there are women who suffer from dyspareunia up to 12 months after childbirth. “Distorted anatomy, inflamed granulation tissue, or development of a trigger point are all possible causes. Postpartum dyspareunia can also have a psychological basis because after childbirth, doubts about the body and sexuality are normal.” In addition, all this can be intensified by the couple’s change of routine with the arrival of the baby.

Causes of dyspareunia

The gynecologist highlights that possible causes for dyspareunia in women are:

• Childbirth: Sex can be painful for several weeks or months after giving birth.
• Endometriosis: It can cause stomach pain during sex.
• Vaginal dryness: it can be caused by menopause itself or not being excited before sex.
• Vulvodynia: Pain when touching the vulva (the main cause of sexual pain in women under 50).
• Interstitial cystitis: This condition causes bladder pain and other symptoms.
• Chronic pelvic pain: Pain in the lower abdomen that lasts for six months or longer.
• Infection in the vagina or bladder: among other symptoms, you may also experience pain during sex.
• Skin issues around the vagina: Skin irritations can also make the area more sensitive.
• Bad feelings: about a partner or relationship, as well as lack of sexual desire for it.
• A painful experience in the past: such as a past experience of sex or a medical exam that hurt.
• Emotional circumstances: history of sexual abuse, stress, depression, anxiety, rigid beliefs, fears (such as getting pregnant), body insecurity, lack of self-knowledge, self-esteem problems.

Pain in intercourse is not a sign of pregnancy, but there is a higher prevalence of dyspareunia in the third trimester of pregnancy compared to the pre-pregnancy period. “What can happen due to the fact that the woman feels more vulnerable and uncomfortable with uterine contractions caused by orgasm, possible discomfort in sexual positions and/or the subjective idea of ​​lack of physical attractiveness in this period”, adds Maura.

The specialist highlights that feeling some kind of discomfort in sexual intercourse, mainly related to some position, is normal. Therefore, she indicates that consideration should be given to analyzing cases of recurrent discomfort with single and isolated episodes.

treatment for dyspareunia

Treatments for dyspareunia, explains Maura, will vary depending on the cause. “Antibiotics or antifungal medications, for example, will help if the pain is caused by an infection in the vagina or bladder; creams or gels may be given to keep the vagina moist; physical therapy may still be indicated to relax the muscles around the vagina, if applicable,” she says.

Psychological support may be needed if the pain is caused by bad feelings about sex, particularities of a relationship and/or low self-esteem issues, fears, etc. The doctor also adds that consultations with a specialist in sexology can help in some cases. And, depending on the cause of the pain, surgery may be indicated.

It is impossible to talk about a single type of treatment, as the causes are numerous, ranging from physical issues to emotional factors. This reinforces the importance of seeking medical help when finding that the pain has been frequent. See also things about sex you shouldn’t worry about.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.