The cause of painful intercourse (dyspareunia) in women depends on where her pain occurs. Many women afflicted with this condition wonder if the problem is in their heads, or if it is caused by technique, or physical problems. The key to deciding if you have a problem is personal.
When experiencing dyspareunia, you may have symptoms of pain with penetration, pain with a certain partner, new pain after previously enjoyable intercourse, the sensation of something being bumped during intercourse, or burning pain.
If sex is consistently uncomfortable for you, and you can’t figure it out after discussing it with your partner, you may want to discuss it with your doctor to rule out physical cause and get tips on how to help make your lovemaking more enjoyable.
Here are some questions to ask:
- What may be causing my sexual difficulties? There are many possible causes for dyspareunia:
• Poor lubrication (not enough foreplay, or dryness related to childbirth, breastfeeding, menopause, etc.)
• Injury, trauma or irritation (pelvic surgery, episiotomy, or congenital abnormality)
• Inflammation, infection or skin disorder (genital infection, or eczema)
• Birth control or other reaction (allergy to semen, foam, jellies, or latex)
• Vaginusmus (involuntary spasms of the vaginal wall muscles)
It also may be caused by certain illnesses or medical treatments, or (more rarely) by psychological problems such as stress or history of sexual abuse.
- Do I need any medical tests? Your doctor may perform a medical history, pelvic exam, and ultrasound to rule out physical reasons for your difficulties. A counselor or therapist may be able to help get to the bottom of underlying psychological barriers to intimacy.
- What treatment approach do you recommend? Before visiting with your doctor (or even after) you may want to try different sexual positions to see if it helps alleviate some pain. Talk with your partner about sex and what you’re going through; building aninterpersonal bond can also help make your sex more satisfying. Use foreplay to help stimulate your natural lubrication and fortify as needed with water-based lubricants to smooth out the rough spots further.
- What medications and other therapies may help my condition? If there are underlying conditions where medication may be prohibiting your ability to have pain-free sex, you doctor may try to switch your medicine. Estrogen therapy may increase natural lubrication production to help make sex less abrasive. Counseling and desensitization therapy may also help.
- How much improvement can I reasonably expect with treatment? Chances are, your treatment will be a process and will not change overnight. You should give it time, and do all you can at home to help things along so you can reach your goals. Until you can tolerate vaginal penetration you may want to try other things like sensual massage, kissing and mutual masturbation. Trying different things may also help strengthen your relationship with your partner.
- Are there any lifestyle changes or self-care steps that may help? Doctors recommend limiting alcohol use and quitting smoking, both of which can have sexual side effects. It also is important to follow a healthy lifestyle of eating well and exercising regularly. You may want to avoid scented bath products (shower gel and body washes), and skip douching, which can irritate the genital area and impede natural lubrication.
- Do you recommend therapy?n Counseling can help youwork through psychological difficulties you may be having, however, in most cases, painful intercourse can be attributed to physical reasons.
- Should my partner be involved in treatment? It may be a good idea to include your spouse in your treatment where applicable—your recovery is important to him/her, too. And work with him/her toward finding other ways, at least for the time being, to help increase your bond, which should work to help your sexual intimacy later on.
- Are there any brochures or other printed material I can take home with me? Which websites do you recommend visiting? Your doctors can recommend their favorite websites for educating yourself, gaining support, and learning about alternative treatment options.
This information is not meant to be a replacement for talking with your doctor. Talk with your team of doctors to get the full picture for your particular case.
Resources:
www.mayoclinic.com Painful Intercourse (dyspareunia)
www.obgyn.net Painful Intercourse by D. Ashley Hill, MD
Do you have a question about dyspareunia? Check out EmpowHER’s page. Sign-up, post a question, share your story, connect with other women in our community and feel EmpowHERed!
Christine Jeffries is a writer/editor for work and at heart, and lives in a home of testosterone with her husband and two sons. Christine is interested in women’s health and promoting strong women.
Copyright © 2024 HW, LLC d/b/a EmpowHER Media unless otherwise noted. EmpowHER does not provide medical advice, diagnosis, or treatment.
