Dyspareunia Vs. Vaginismus In Females

Dyspareunia is a medical terminology that is used to describe painful sex. It is imperative to keep in mind that dyspareunia is a generalized term that denote to all kinds of sexual pain, whether upon penile penetration, or during/ after the sexual intercourse. Needless to say, that unwanted pain can greatly compromise the quality of sexual intercourse. The pain can be felt in the genital area including, vagina, labia, and clitoris. The pain can be severe, pricking, stinging, bumping, burning or panging.

What Is Vaginismus?

Pain during sexual intercourse or difficulty in permitting penile penetration due to unintentional or involuntary vaginal tightening is termed as vaginismus.

What Is The Association Between Dyspareunia And Vaginismus?

Dyspareunia may occur due to several reasons out of which, vaginismus is one. Vaginismus refers to uncontrollable vaginal tightening or contraction that occur as a result of irritation or inflammation of pubococcygeus (PC) muscles. The tightening of muscles during sex leads to discomfort and painful penetrations. Vaginismus is also closely linked to dyspareunia and any kind of sexual pain may lead to aggravation of vaginismus. In this situation, vaginismus acts as an additional source of pain in addition to already existing dyspareunia and even if the root cause is treated, the pain due to vaginismus remains. In fact, a lot of women confuse vaginismus with actual pain generating problem and think that the primary cause is not resolved yet.

If there is a vaginal discomfort and no apparent physical issue is detected, vaginismus should be considered the possible culprit or the primary reason of dyspareunia.

Diagnosis

With complications of vaginismus, diagnosis and treatment of sexual pain can be problematic. For example, a lady had vaginal infection (type of dyspareunia) and that infection had stimulated vaginismus. It is possible that when she reached to the physician, her infection was fixed but vaginismus was still there. Upon examination, there will be no appropriate physical cause for pain, as it is no longer due to infection. Moreover, the explanation of pain can be misleading because there are two different

problems at different times, causing the pain.

Usually when there are two types of pain and the secondary one is due to vaginismus, doctors advise to treat the primary condition first.

Myths Regarding Treatment Of Vaginismus

Though vaginismus can be treated without any intervention, yet there are many doctors who think surgeries and other invasive procedures are essential for the treatment of vaginismus.

Women should be very cautious and must refer to another doctor for the second opinion, before undergoing any invasive method. Consult doctors who are expert in dealing with female sexual pain disorders.

What Are Some Other Causes Of Dyspareunia?

Besides vaginismus, there are some other causes of painful sex that must be ruled out before making the diagnosis of vaginismus. These are;

• Pelvic inflammatory disease (PID)
• Cyst in ovaries
• Tumor in pelvis or genitals
• Vulvodynia and vestibulodynia
• Dryness in vagina
• Inadequate lubrication of vagina
• Urinary tract infection (UTI)
• Urethritis
• Interstitial cystitis
• Postpartum injury/trauma
• Injury to genital or pelvic area
• Trauma due to sexual abuse
• Radiotherapy
• Vulvar cancer
• Yeast or bacterial infections in vagina
• STDs
• Skin problems such as eczema, psoriasis, Lichen Planus, Lichen Sclerosus
• Menopause or other age related problems
• Side effects of medicines
• Hypersensitive reactions to condoms, spermicides, contraceptive foams, and clothing
• A painful pelvic examination
• Endometriosis
• Female genital mutilation (FGM)
• Bartholin’s Cyst

Vaginismus may occur simultaneously with above mentioned conditions and may persist even after those conditions are managed or treated. Speak to your doctor today if you are experiencing painful or discomforting sex with your partner.

References

• Binik, Y. M., Faaborg-Andersen, M., & Lahaie, M. A. (2013). Dyspareunia and vaginismus. In Encyclopedia of Pain (pp. 1090-1096). Springer Berlin Heidelberg.
• Simonelli, C., Eleuteri, S., Petruccelli, F., & Rossi, R. (2014). Female sexual pain disorders: dyspareunia and vaginismus. Current opinion in psychiatry, 27(6), 406-412.
• Perez, S., Brown, C., & Binik, Y. M. (2016). Vaginismus: When Genito-Pelvic Pain/Penetration Disorder Makes Intercourse Seem Impossible. In Management of Sexual Dysfunction in Men and Women (pp. 273-285). Springer New York.