Definition

Dyspareunia is pain experienced during sexual intercourse.

Incidence

This is a common complaint but one which many couples are reluctant to talk about.  It can affect all age groups from the young to the old.

Causes/prevention

There are numerous causes of painful intercourse some of which are psychological and some due to disease.  Sometimes both disease and psychological problems exist at the same time.  There are two main types of painful intercourse – superficial and deep. 

Superficial is a pain around the front passage (vagina) at the start of penetration and deep is a pain deeper inside the body experienced during or after penetration.  The causes are usually different.

Common causes of superficial pain:

Vaginismus – spasm of the muscles surrounding the vagina
Infection – e.g. thrush, sexually transmitted disease
Atrophy – after ‘the change’, vaginal tissues become thinner because of reduced oestrogen levels
Following childbirth – if you were cut or torn around the vagina, sometimes it heals poorly causing a narrowing to the vaginal entrance.

Common causes of deep pain:

Chronic pelvic infection
Endometriosis
Ovarian cysts
Scar tissue (adhesions)
Psychological

Signs and Symptoms

The doctor will usually wish to perform an internal examination.  This allows the doctor to determine if there is any reason for your complaint.  What is detected depends on the disease present.

Complications of disorder

Painful sex, if there is no underlying disease does not cause any serious complications.  It does however put great strains on relationships and marriages. Treatment can help and it is worth overcoming the embarrassment and seeing your doctor.

Tests

The doctor will need to perform an internal examination and often will take swabs to exclude infection.  If you are menopausal lacking in hormones, the doctor can tell.  If you have had a baby and there is scarring, the doctor will advise if any surgery is needed.  If you are suffering from Vaginismus, the vaginal muscles will spasm, making examination difficult.  If the painful intercourse is of the deep type, the doctor may recommend a laparoscopy to exclude pelvic disease.

Treatment

This depends on the cause of the problem.  It may mean antibiotics for infection, hormone replacement therapy if going through ‘the change’ or surgery.  Simple remedies like lubricating gels can help.

Vaginismus and other psychological problems are best managed by referral to an expert psychosexual counsellor.  Sometimes vaginal dilators can help.  These are dilators of varying size, which are gently introduced into the vagina starting with very narrow ones and gradually getting bigger.

Outcome

It is important to ask for help, as the majority of women will benefit.

Source: www.privatehealth.co.uk