Dyspareunia is defined as an abnormal pain during sexual intercourse. It may result from abnormal conditions of genitalia, forcible coition or incomplete sexual arousal. It is a pain that occurs only in sexual act. It is not a disease but a symptom of underlying physiological or psychological disorder. The pain, which may be mild or sever, is commonly felt in the genitals, the pelvic region or in the lower back. It is more common in women that in men.
Causes and Risk Factors: For women, causes include:
1. Vaginismus which means the spasm in the vaginal muscles.
2. Scars left from epiosiotomy.
3. Thinning and dryness of the vaginal wall due to the deficiency of the estrogen during the conditions like breastfeeding and menopause.
4. Inadequate foreplay.
5. Pelvic Inflammatory Disease
6. Varicose Veins in pelvis
8. Ovarian Cysts
9. Ectopic Pregnancy
10.Infections which are sexually transmitted which can irritate the wall of the vagina or the skin of the penis.
11. Bladder or other urinary tract disorders such as cystitis or uretheritis.
12. Cancer in the sex organs of the pelvic region.
For men, it may be the result of the irritation of the skin of the penis due to an allergic rash, physical abnormalities of the penis like tight foreskin or bowed erection and infections of the prostrate gland or testes.
Symptoms of Dyspareunia: The symptoms of the dyspareunia include burning, ripping, tearing or the aching sensation associated with penetration. The pain can be present at the vaginal opening, deep in the pelvis or anywhere in-between. It may also be felt throughout the entire pelvic area and the sexual organs and may occur only with the deep thrusting.
Treatment of Dyspareunia: The treatment is mainly aimed at identifying and properly treating the underlying disorder. Medications are usually prescribed to treat the infections, if they exist.
1. If an allergy to latex is suspected, alternative methods of contraception should be considered.
2. If the spermicide is causing discomfort, different brands should be considered or alternate methods of birth control should be followed.
3. A water-based lubricant may help to ease the discomfort and friction. However, oil-based lubricants should be completely avoided. Oil-based lubricants like petroleum jelly are avoided because they dissolve the latex in condoms and may actually promote infections.
4. If vaginismus is suspected, insertion of graduated set of dilators into the vagina may be used to treat it.
5. Pain during intercourse due to an episiotomy generally subsides over time.
6. Couples therapy can help to improve communication between partners and resolve problems that may be a factor in painful coitus.
7. Sex therapy may be offered to provide complete information about the physical aspects of arousal and orgasm.
8. Recommending a change in coital position to one admitting less penetration.
9. Surgery may be needed to remove the cysts or abscesses or to open a rigid hymen or to repair an anatomical abnormality.
10. Psychological counseling may be advised if no underlying cause can be found.