Dyspareunia in Women

Pain during intercourse or female dyspareunia is sexual condition in which females experience persistent or recurring pain at or around the genital areas during the act of physical intercourse. The underlying cause of dyspareunia is usually psychological but in a number of cases, anatomical or physiological aberrations can also lead to dyspareunia in women.According to a new study, the prevalence of dyspareunia in women is fairly high, but unfortunately most cases are under-reported. In poorly managed cases, the quality of sexual and personal life is greatly compromised in both partners, which is why it is highly recommended to look for practical intervention to identify and minimize the symptoms.

Symptoms of Dyspareunia in Women

Some of the most characteristic symptoms of dyspareunia in women are:

• Excruciating pain at the time of entry of penis (penile penetration)
• Pain when a tampon is being inserted inside the vagina
• Pain after the completion of the act of intercourse (characterized by severe constricting spams in the vaginal walls)
• Severe pain at thrusting
• Burning sensations in the genitals
• Burning sensations and pain that may last up to several hours after sexual encounter

Consultation with the physician become necessary if a female is experiencing any of the above symptoms. Correct diagnosis and treatment can help in regaining the control over social and sex life.

Causes of Dyspareunia In Women?

According to extensive medical research, there are two primary causes of dyspareunia in women. These are classified as:

Physical Factors:

This includes all the factors associated with penile penetration and are marked by onset of severe pain with the entry of penis or during thrusting. Some eminent causes are:

• Inadequate Lubrication: Vaginal secretion serves as a lubricant and facilitates the entry of penis in the female genital tract. Inadequate lubrication can be functional (i.e. poor foreplay) or pathological (caused by a decline in the estrogen levels). Impaired estrogen levels are usually reported after menopause or during breast feeding. Additionally, some medications such as anti-depressants, antihistamines can also decrease the release of lubricating fluid in the vagina; thereby leading to dyspareunia.
• Irritation and Trauma: A direct injury or trauma to the pelvic region such as pelvic surgery, episiotomy (an incision made on vagina to increase the size of the birth canal) or female circumcision can lead to dyspareunia.
• Infections and Inflammatory Conditions: urinary tract infections and skin conditions such as eczema can also cause pain during intercourse.
• Vaginismus: Sudden involuntary contractions or spasm of the vaginal muscles can also lead to severe pain.
• Congenital problem: Vaginal development abnormalities including vaginal agenesis and vaginal perforations can also cause pain.

Causes of Deep Pain:

• Medical Conditions: Diseases such as PID (pelvic inflammatory disease), endometriosis, reteroverted uterus etc. are a major cause of deep pain during sexual encounters.
• Surgeries and Treatments: different surgeries such as hysterectomy can also cause scarring in the area which causes pain during intercourse. Treatment therapies such as radiation therapy and chemotherapy are also known to increase the pain.

Emotional Factors:

Emotional factors which are involved in disrupting the sex life by causing pain include,

• Anxiety, depression, relationship issues.
• Mental stress, which causes tightening of the pelvic muscles.
• History of sexual abuse

Lifestyle Modifications

Following steps can be taken to increase the quality and satisfactory level of sex life.

• Change in Positions: If the pain is felt during thrusting then it is possible that the penis is striking the cervix directly, which is causing the stretching of pelvic muscles leading to development of pain. A change in position such as coming on top of the partner can significantly reduce the pain.
• Communication: Discuss with your partner when the pain is felt. Changing the intensity or force with the cooperation of your partner can help in reducing the risk of dyspareunia.
• Don’t Panic: Panic, anxiety and rushing into the sexual intercourse can decrease the release of lubricants which can further aggravate the pain and irritation during penetration.
• Proper Lubrication: Use of different lubricating fluids can help in overcoming the pain.
• Support and Coping: Alternative ways for achieving satisfaction such as kissing, mutual masturbation and sensual massage are recommended until the penetration pain completely resolves.

References:

1. Danielsson, I., Sjöberg, I., Stenlund, H., & Wikman, M. (2003). Prevalence and incidence of prolonged and severe dyspareunia in women: Results from a population study. Scandinavian Journal of Public Health, 31(2), 113-118.
2. Simonelli, C., Eleuteri, S., Petruccelli, F., & Rossi, R. (2014). Female sexual pain disorders: dyspareunia and vaginismus. Current opinion in psychiatry, 27(6), 406-412.
3. Furukawa, A. P., Patton, P. E., Amato, P., Li, H., & Leclair, C. M. (2012). Dyspareunia and sexual dysfunction in women seeking fertility treatment. Fertility and sterility, 98(6), 1544-1548.
4. Pazmany, E., Bergeron, S., Verhaeghe, J., Van Oudenhove, L., & Enzlin, P. (2014). Sexual Communication, Dyadic Adjustment, and Psychosexual Well‐Being in Premenopausal Women with Self‐Reported Dyspareunia and Their Partners: A Controlled Study. The journal of sexual medicine, 11(7), 1786-1797.