What Is Dyspareunia?

Some people develop pain in the genital area before, during, or after sexual intercourse. That pain is referred to medically as dyspareunia. Though it is more likely to occur in cis women, anyone can experience dyspareunia.

This article discusses the symptoms, causes, and treatment options for those with dyspareunia.

Types of Dyspareunia

There are two types of dyspareunia: entry and deep. Entry dyspareunia describes pain during the initial penetration period of sexual intercourse. Deep dyspareunia is the type that develops during sexual intercourse when deep penetration occurs.

The condition can also fall into two other categories: primary and secondary. Primary dyspareunia refers to pain that occurs the first time a person has sex. In contrast, the pain in secondary dyspareunia refers to pain that develops after a period of pain-free sex.

Roughly 10–20% of females and 1–5% of males will experience dyspareunia at some point in their lifetimes.

What Are the Symptoms of Dyspareunia?

The main symptom associated with dyspareunia is persistent or recurrent pain before, during, or after sexual intercourse. The pain for both males and females is similar but not exactly the same.

Males

• Affects the entire genital region, including the pelvis

• Can be accompanied by sexual dysfunction

• Pain during ejaculation or erection

• Can be accompanied by skin irritation or a rash on the penis

Females

• May radiate into the pelvis

• Pain may occur only at the entrance of the vagina or in the vaginal canal

• Can be accompanied by or lead to other forms of sexual dysfunction

The type of pain that develops in people with dyspareunia can present as intense feelings of:

• Burning

• Dull throbbing

• Sharp and stabbing

• Resemble menstrual cramps

• Muscle spasms or tightness

Related:Painful Ejaculation (Male Dysorgasmia)

What Causes Dyspareunia?

Many things can cause dyspareunia, including infections or chronic diseases. The causes differ depending on whether a male or a female is experiencing it.

Causes in females include:

• Skin diseases, such as lichen planus, lichen sclerosis, and psoriasis

• Urethritis

• Vaginitis

• Postpartum dyspareunia

• Vaginal atrophy

• Vaginismus

• Vulvodynia

• Endometriosis

• Pelvic inflammatory disease

• Interstitial cystitis

• Pelvic adhesions

• Retroverted uterus

• Uterine myomas

• Uterine fibroids

• Childbirth

• Sexually transmitted infections such as chlamydia or gonorrhea

Dyspareunia in males can be caused by the following:

• Peyronie disease

• Infections of the urethra, prostate, seminal vesicles, or bladder

• Sexually transmitted diseases such as chlamydia or gonorrhea

Another possible cause of dyspareunia is a lack of lubricant during sexual intercourse. If the area is dry and there is too much friction, all genders can experience pain during sexual activity.

Related:Sore Vagina

How Is Dyspareunia Diagnosed?

Healthcare providers will gather a health history and a list of symptoms as the first step in the diagnostic process. Some standard information you will need to share includes:

• The level of pain, how long it lasts, when it comes on, and where it is located

• Any history of pelvic floor surgery or trauma to the area

• Issues with your bowel and bladder, such as whether you experience constipation, diarrhea, an urgency to use the bathroom, or an increased frequency in using the bathroom

• Your sexual history, including how often you engage in sexual activity, your desire and arousal levels, your relationship status, and how satisfied you are with your current sexual activity levels

• Psychological aspects, such as whether you have a mood disorder, anxiety, or depression

• If there is any history of abuse, whether sexual, physical, or neglect

A physical exam of the genital area will follow this collection of your past and current state of health. During the physical exam, muscle strength in the genital area will be examined through a series of movements, such as coughing, when the medical provider says so.

Cultures or biopsies of the area may also be taken to help further confirm the cause of dyspareunia.

Because there are so many causes of dyspareunia, including infections and dermatologic conditions, cultures and biopsies are necessary to help rule out or confirm the diagnosis of possible causes, such as sexually transmitted infections or skin disorders.

Related:STD Diagnosis

How Is Dyspareunia Treated?

Treating dyspareunia has to be personalized to the individual because there are many different causes. For example, if a person has an STI, they will be given antibiotics to clear it up, which will be the course of treatment for their specific cause.

However, for disorders that are not as simple to treat, medical providers often take a multipronged approach to address dyspareunia's physical, emotional, and behavioral aspects. Possible treatments can include:

• Using more lubrication during sexual intercourse

• Hormone therapy to help adjust hormone imbalances that could cause vaginal dryness

• Cognitive behavioral therapy and sex therapy to address the psychological aspect of dyspareunia

• Penile traction, medical injection therapy, and/or surgery to correct any structural changes causing the pain, as is the case with Peyronie disease

• Local topical anesthetics to reduce pain sensations in the genital region

• Botox in the pelvic floor muscles

• Medications, such as tricyclic antidepressants or anticonvulsants

• Pelvic floor therapy to learn how to strengthen and relax pelvic floor muscles

In some cases, using multiple treatment methods works best for dyspareunia. Research has shown that combining different treatments, such as acupuncture, neural therapy, and trigger point therapy, may help to cure or alleviate the pain felt in dyspareunia.

Read Next:A Guide to Regular STI Screenings

How to Cope With Dyspareunia

Dealing with dyspareunia isn’t easy. That is why developing proper coping techniques while you wait for treatment to alleviate the pain is crucial to your overall recovery. To avoid creating a poor body image or a poor relationship with sex, you can:

• Engage in other intimate acts with your partner that don’t involve penetration, such as massage or mutual masturbation.

• Improve your relationship with your body by reminding yourself of your positive attributes and wearing clothing that makes you feel confident.

• Speak to a professional sexual health counselor to help you navigate and work on personal characteristics that hinder your growth or self-fulfillment.

Summary

Dyspareunia is a common affliction that can affect all people. When the pain develops, it can feel dull and throbbing, stabbing and sharp, or resemble menstrual cramps. Because there are many causes of dyspareunia, you must speak to your healthcare provider to get a proper diagnosis. That way, you can find the optimal treatment to remedy the situation and alleviate the pain.

Having pain during sexual intercourse can reduce overall satisfaction in life and partnerships. Because of that, treatment addresses both the pain and the psychological consequences it can have on a person. To cope with dyspareunia while undergoing treatment, it’s helpful to establish a healthy relationship with yourself, your body, and your partner through inner work, counseling, and non-penetrative intimacy.