What is painful sex?
Painful sex, otherwise known as dyspareunia, is genital pain that occurs during or after sexual intercourse. This particular pain is distinguished by the fact that it occurs as a direct result of sexual activity. Besides the obvious discomfort it brings, it can also cause emotional distress and relationship problems, so it's important to diagnose the problem as soon as you can. Most women experience this at some point in their lives; the causes can vary from both physical and psychological conditions but treatment is available to reduce or eliminate the problem.
What are the symptoms?
If you're experiencing painful sex, you may notice this occurring at particular stages of intercourse. For example, you might feel pain only when you are first penetrated, with every penetration (including with tampons) or during thrusting. You might experience a throbbing, stabbing or aching pain, or even an itching or burning sensation in the vagina or pelvic area. Muscle tightness or spasms are also common.
There are many reasons you might have these experiences. For women, it is common when the vagina is not sufficiently lubricated. This is usually caused by a lack of foreplay, a drop in oestrogen levels or certain medications such as anti-depressants, sedatives, antihistamines and birth control pills. STDs and other infections may contribute to pain during or after intercourse, as can endometriosis, genital injuries and pregnancy. Vaginismus, the involuntary spasms of the vaginal muscles, is a key factor in causing painful sex. These issues can usually be diagnosed by a pelvic examination, or your doctor may perform a pelvic ultrasound. Dyspareunia may also have psychological causes: stress may trigger tightening in the pelvic area, while anxiety and depression can reduce sexual arousal and lead to vaginal dryness. Trauma and sexual abuse can also contribute to this.
The first recommendation may be to increase sexual arousal and ensure that the vagina is sufficiently lubricated by engaging in longer, more stimulating foreplay and using water-based lubricants. Certain sexual positions may be more comfortable and help to reduce pain. Medications can be prescribed to help with lower oestrogen levels and vaginal dryness. In some cases, your doctor may advise desensitisation therapy to learn techniques that will relax your vaginal muscles. For psychological causes or otherwise unexplained pain, counselling or sexual therapy may be the best form of treatment. This may help you to deal with any sexual trauma or abuse and improve communication and restore intimacy between you and your partner. Cognitive Behavioural Therapy (CBT) can also be helpful in changing negative thought patterns that may prevent you from enjoying sex.
On occasion, pain may be as a result of scar tissue from birth trauma or previous surgery. Surgical correction of this can be discussed with your doctor.