Home Health Dyspareunia (Painful Intercourse): Causes, Diagnosis & Treatment – Health Essentials from Cleveland Clinic

Dyspareunia (Painful Intercourse): Causes, Diagnosis & Treatment – Health Essentials from Cleveland Clinic

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Pain during sex, or dyspareunia, is persistent or recurring pain just before, during or after sex. The pain is felt in the genital region. Women can have pain externally in the vulvar region — to the labia (lips of the vagina) or at the opening to the vagina. Some feel the pain internally—in the cervix, uterus or lower abdomen.
It's a common condition that can have negative emotional and psychological effects. In addition to the physical pain, couples may suffer from loss of intimacy or experience strain in their relationship.
Your healthcare provider can recommend the appropriate treatment based on your symptoms and determine the underlying cause of your pain.
Pain during sex is more common in women. It can affect both men (male dyspareunia) and women (female dyspareunia) of all ages. The pain is often due to physical factors or medical conditions, but it can also be psychological.
Pain during sex is one of the more common gynecologic problems healthcare providers treat. It affects 10% to 20% of people in the United States at some point in their lives.
The location of the pain can help determine what type of dyspareunia you are experiencing:
Pain during intercourse can also be described as primary, secondary, complete or situational:
In many cases, you can experience pain during sex if there is not sufficient vaginal lubrication. In these cases, the pain can be resolved if you become more relaxed, increase foreplay or if you use a sexual lubricant.
In some cases, you have painful intercourse if one of the following conditions is present:
Like women, men can also feel pain if there is not enough vaginal lubrication during sex. This can be solved by using a sexual lubricant. In men, painful sex can be caused by certain penile disorders:
If you have pain during sex, you may feel:
The most common symptom is pain with intercourse that occurs at the vaginal opening or deep in the pelvis. It can be a distinct pain in one area or it may affect the entire genital region. There can be feelings of discomfort, burning or throbbing.
Dyspareunia doesn't necessarily cause bleeding. Any bleeding that occurs during sexual intercourse is likely caused by the underlying medical issue. The bleeding could be caused by the same issue that is causing the painful sex.
Talk openly with your healthcare provider about any pain during sexual intercourse. Some questions your healthcare provider may ask you are:
Your healthcare provider can diagnose the underlying cause of pain during sex with a thorough health history and physical examination. The physical exam could include checking your pelvis, abdomen, vagina and uterus.
To locate the source of the pain and diagnose any medical conditions, healthcare providers may perform the following:
Some treatments for sexual pain do not require medical intervention. For example, in the case of painful intercourse after pregnancy, wait at least six weeks after childbirth before attempting intercourse. Make sure to practice gentleness and patience. In cases in which there is vaginal dryness or a lack of lubrication, try water-based lubricants.
Some treatments for sexual pain do require prescription medication. If vaginal dryness is due to menopause, ask your healthcare provider about estrogen creams, tablets, rings or other medications. Other causes of painful intercourse also may require prescription medications.
For cases of sexual pain in which there is no underlying medical cause, sexual therapy might be helpful. Some individuals may need to resolve guilt, inner conflicts regarding sex or feelings regarding past abuse.
Applying a water-based lubricant to your vagina, vulva and labia is helpful to some women when dryness is the main cause. Those who have pain during sex often stop using vaginal perfumes, bubble baths or scented sanitary pads or toilet paper.
Yes, there is a medicine available to treat pain during sex. If vaginal dryness due to low estrogen is the cause of your painful sex, topical estrogens can be applied to the vagina. The Food and Drug Administration (FDA) approved a drug called ospemifene for dyspareunia due to menopause. It can be taken orally. Medication can also be prescribed to treat pain due to infection or underlying medical conditions.
There are some things you can do on your own to manage the pain you feel during or after sex:
The recovery time for dyspareunia varies depending on the underlying cause for the pain you feel during sex. The good news is that you can find relief and recover from painful sex. Whether it is medication, counseling, surgery or using lubrication—your healthcare provider can find a treatment that can improve or eliminate dyspareunia.
There is usually not much you can do to reduce your risk of dyspareunia. It's often something you have no control over. Some of the factors within your control are having safe and protected sex and maintaining good hygiene.
Contact your healthcare provider if there are symptoms such as new or worsening pain during sex, bleeding, genital lesions, irregular periods, vaginal discharge or involuntary vaginal muscle contractions. For pain with no underlying medical cause, ask for a referral to a certified sex counselor or therapist.
Painful sexual intercourse can be physically and emotionally difficult. Some questions you may ask your healthcare provider are:
A note from Cleveland Clinic:
Pain during sex can lead to physical discomfort, emotional distress and loss of intimacy. If having sex hurts you, contact your healthcare provider. Do not feel embarrassed to discuss your symptoms. Treating the problem can help your sex life, intimacy and confidence.
Last reviewed by a Cleveland Clinic medical professional on 10/14/2021.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

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