Dyspareunia | Painful Intercourse

Dyspareunia is defined as genital pain that occurs before, during or after intercourse. This is a common sexual problem. Dyspareunia can occur in women and men. Some sources estimate dyspareunia occurs in two-thirds of all women. The medical literature does not quantify the number of men with this condition. Vaginal infections or infections of the prostate are the most common successfully-treated causes of dyspareunia.

What is Dyspareunia?

Dyspareunia (difficult mating) is defined as genital pain that occurs before, during, or after intercourse.

“The repeated experience of pain during intercourse can cause marked distress, anxiety, and interpersonal difficulties, leading to anticipation of a negative sexual experience and eventually to sexual avoidance, (American Psychiatric Association, 4th ed. 1994).”

This is not a well understood condition, and it can be lifelong or acquired.

If dyspareunia has not always been present, it usually occurs ten years after the start of sexual activity.

How Common is Dyspareunia?

“Dyspareunia is one of the most common sexual dysfunctions seen by gynecologists and is estimated to affect about two-thirds of women during their lifetime, (Marinoff, S.C. and Turner, M.L.C., 1993).”

The medical literature does not quantify the number of men faced with this problem.

Dyspareunia Sufferers should Consider the Mind and Body

Dyspareunia can have psychological as well as physical factors.  It is important to consider both the mind and the body in any treatment regimen.

According to Novak’s Textbook of Gynecology, 12th Edition, by Jonathan S. Berek, 1996:

“Women with dyspareunia usually discuss the pain with their sexual partner, but fewer than one-half of these women consult a physician.

“Because dyspareunia is a psychophysiologic condition, both psychologic and physical factors must be considered.”

Psychological Factors Contributing to Dyspareunia Include:

  • Development factors, e.g., an upbringing that invested sex with guilt and shame;
  • “Traumatic factors, e.g., childhood sexual abuse or other sexual assault;
  • “Relationship factors, e.g., anger and resentment toward a sexual partner.”

Physical Factors Contributing to Dyspareunia -Vaginal Infection | Prostate Infection

“Vaginal infection is the most common cause of successfully treated dyspareunia,  (Glatt, A.E. 1990).”

In men, infection of the prostate is the most common cause of successfully treated dyspareunia.

Other common physical causes are genital glands and adhesive bands that swell only in relation to intercourse.

Dyspareunia|Hypersensitivity or Irritation of the Clitoris or Prostate

Stimulation of the genitalia by sitting, and conditions such as hypersensitivity or irritation of the clitoris or prostate can be causes of frustrating pain.

Other anatomical causes of dyspareunia in women can be a rigid hymenal ring or scar tissue in an episiotomy scar.

Irritation from Over-the-Counter Products

Dyspareunia can also be caused by irritation from over-the-counter feminine spray products, douches, and contraceptive devices (i.e., condoms, sponges, diaphragms).

Dyspareunia can be Minimized with Water Soluble Lubricants

A common cause of dyspareunia is inadequate sexual arousal.

This situation can be resolved by counseling the couple to spend more time with foreplay, ensuring that the woman has adequate lubrication prior to intercourse.

Use of a water-soluble lubricant is also helpful.  When using lubricant, always use water-soluble products, such as KY Jelly or Astroglide.

Dyspareunia can be Associated with Menopause and Lactation

Finally, pain associated with intercourse can be the result of vaginal atrophy from estrogen deficiency in menopausal or lactating women.

This condition can be diagnosed by your physician and can be treated with vaginal or systemic estrogen replacement therapy.

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