Painful Intercourse – Dyspareunia in women
The pain one may feel during or after sexual intercourse is not in itself a medical condition but caused by medical or psychological problems. It is not an uncommon occurrence for women to feel pain during sex particularly if it is an isolated occurrence. It also occurs in men but rarely. It is a common cause of disharmony in a couple’s sexual relationship and negative emotional sexual perception or response.
Painful intercourse can arise from abnormality in external genitalia, dysfunctional psychophysiologic reaction to sexual union, incomplete sexual arousal, gynecological conditions such as endometriosis, cervical fibroid, Pelvic Inflammatory Disease (PID) et al.
Where is the pain felt during sex?
Pain felt at the entrance during penetration may be associated with a range of factors ranging from insufficient lubrication, narrowing of the entrance as consequence of female genital mutilation (female circumcision) or thick hymen with narrow opening, sudden spasm (an involuntary sudden muscle contraction)of the vaginal wall at attempt of penetration, infection of the vagina lips e.g. warts, swelling of the vaginal lips e.g. vulvodynia, chemical irritant e.g. perfumes, douching (squirting water or other fluids into the vagina).
Deep pain usually occurs with deep penetration and may be pronounced with certain sexual positions. Causes include endometriosis, PID, uterine prolapse, uterine or cervical fibroid, ovarian cyst, hemorrhoids, pelvic surgeries, hormonal changes at menopause, Urinary Tract Infection (UTI).
What are patient’s complaints?
Symptoms include; burning sensation, ripping sensation, tearing sensation, aching during or after sex at the opening, deep in the pelvis or anywhere in between.
Because pain is an unpleasant experience, the woman is distracted from the feeling of pleasure and excitement resulting in decrease vaginal lubrication and dilatation thus more pain.
Your mind and sexual pain
The mind and body works together. Often the problem that first caused the pain may go away but one has learned to expect and anticipate pain.
The state of mind
Emotions such as fear, guilt, shame, embarrassment or awkwardness about having sex may make it hard to relax, thus making arousal difficult and pain results.
Stress and fatigue can also cause reduced sexual desire and arousal.
Relationship problems occur when there is mismatch between partners level of sexual desire.
Diagnosis is based on patient symptoms, childhood history, medical history and sexual history.
Physical examination helps to determine the cause. A pelvic examination or an ultrasound examination often gives a clue to the cause of some kind of pain. Further laparoscopy may be necessary.
If you have pain during sex, see your doctor. Knowing that it is caused both by medical conditions and psychological problems, management will require methods that tackle the root cause.
However, here are some self help measures you can try to relieve pain during sex.
– Making time for sex eliminates tiredness and anxiety.
– Talk to your partner so he knows when you feel pain and more importantly what to do not to put you off.
– Use lubricants that you will tolerate. Do not use petroleum jelly, baby oil or mineral oil, rather use a water soluble lubricant or silicone- based lubricant.
– Change your sexual position.
– Try non-sexual but sensual activities like message.
– Allow time for fore play.
– Empty your bladder, have a warm bath and some analgesic.
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By Doctor Badmus Owoo