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Painful Sex/Dyspareunia

What is Dyspareunia?

Pain just before, during, or after penetration is called dyspareunia. This may happen during sexual intercourse, tampon insertion, or masturbation.

What are the Symptoms of Dyspareunia?

Dyspareunia can feel like burning, aching, or throbbing pain. This pain may happen when occasionally or every time penetration is attempted. Some women experience pain only during deep thrusting or in certain positions. Some women experience pelvic muscle contractions (Vaginismus) or abnormal sensations when their genital area is touched (Vulvodynia).

What Causes Dysparenia/Painful Sex?

Dyspareunia can be roughly classified into two types: superficial and deep.

Superficial Dyspareunia: If you experience burning and pain around the vaginal opening then look out for these causes:

  • Vaginal dryness: Read more about it here.

  • Increased sensitivity to pain (Vulvodynia): Read more about it here.

  • Infections: Various bacterial and fungal infections can cause pain in the genital area.

  • Inflammation of the vulva.

  • Infection of the urinary tract.

  • Radiation therapy in the pelvic area can make the vulva less elastic and dry.

  • Surgeries that reduce the vaginal opening

  • Injury to the pelvic area

  • Tight hymen

  • Involuntary contraction/spasm of pelvic muscles (Vaginismus)

Deep Dyspareunia:  This kind of pain is internal, usually felt while thrusting. If you have deep dyspareunia then get examined for the following:

  • Infections in the cervix, uterus, fallopian tube (Pelvic Inflammatory Disease): this can lead to pus formation, swelling and inflammation, thus causing pain.

  • Endometriosis: when the lining of the uterus is present outside the uterus it's called endometriosis.

  • Tumors in cervix, uterus, or fallopian tube

  • Retroverted uterus: sometimes the uterus is bent backward causing pain during intercourse.

  • Fibroids in uterus

  • Intrauterine devices such as copper-T

What Should I Do?

Visit your Gynaecologist. She will take a detailed history and examine you to find out what's causing the pain.

Treatment

  • Use a water-based lubricant such as KY Jelly during sexual intercourse

  • Avoid soaps, oils, fragrances, lotions

  • Estrogen gels/creams can be used for atrophic vaginitis.

  • If infections are suspected then the partner must also be examined and treated. Visit a dermatologist for partner management.

  • A tight hymen can be surgically corrected.

  • A different sexual position can be tried for deep dyspareunia. Most women are comfortable with women on top position, as they can control the depth of penetration.

  • Surgical removal of cysts and tumors

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