Is sex often a painful and uncomfortable experience? Do you feel a little embarrassed to talk about it? This is not just a problem for you. Many people suffer from this condition. But the best thing is that it can be treated and the causes can be found. So today, let's talk openly about this condition, which is called dyspareunia in medical science.
Simply put, what is dyspareunia?
Dyspareunia is a condition that is persistent or recurring before, during, or after sexual intercourse. Although this condition is more common in women, it can also affect men.
There are several places where women can feel this pain. Some people may feel it outside the vagina, near the labia or the opening of the vagina. Others may feel the pain inside the body. For example:
- Pelvic floor muscles
- Skin of the vaginal canal
- Uterus
- Ligaments that support the uterus
- Lower abdomen
Men may experience pain in the head of the penis, shaft of the penis, testicles, or pelvis.
This pain is not only physically painful, but it can also be very psychological. It can lead to a decrease in intimacy between a couple and problems in the relationship. Therefore, it is very important to talk about this.
If you're having this problem, your doctor may refer you to a sexual health specialist, such as a gynecologist, who can determine the underlying cause of your symptoms and determine the most appropriate treatment.
Are there different types of this pain?
Yes, you can classify this according to where you feel the pain. Then it will be easier to find the cause.
| Type of pain | Description and possible causes |
|---|---|
| Entry pain | This is felt at the beginning of sexual intercourse, that is, when the penis is inserted into the vagina. The pain is located near the vaginal opening. This can be caused by hormonal changes, vaginal dryness, long-term allergies, infections, or some injury. |
| Positional pain | If you only experience pain during certain sexual positions, it may be this type. This can mainly be caused by pelvic floor muscle problems, vaginal dryness, or infections. |
| Deep pain | This pain is felt when the penis is inserted deeply into the vagina. This pain may be worse in certain positions. Conditions such as bladder or bowel diseases, pelvic floor dysfunction, and endometriosis can cause this. |
It can also be classified in another way depending on the time the pain occurs:
- Primary pain: This means that this pain has been present since the first day you became sexually active.
- Secondary pain: If you had sex without any pain before, and this pain occurs later, it belongs to this type.
- Complete pain: If you feel pain every time you have sex.
- Situational pain: If the pain only occurs at certain times, in certain positions, or with certain partners.
How common is this condition?
Pain during sex is very common among women. According to surveys, 3 out of 4 women will experience it at some point in their lives. Because it is such a sensitive topic, many people are reluctant to talk about it or seek medical advice. Therefore, the true statistics may be much higher.
This condition is commonly seen in women approaching and post-menopausal. The main reason for this is the decrease in the hormone estrogen. This hormone is very important for maintaining the moisture and flexibility of the vagina.
But remember, don't just assume that this is normal as you get older. Not all pain is caused by age.
What are the symptoms of Dyspareunia?
If you have pain during sex, it can feel different.
- Sharp pain felt when entering the vagina or even when using a tampon.
- Deep pain during sexual intercourse.
- A burning or aching sensation after sex.
- Pelvic cramping.
- Muscle stiffness or spasms.
- Bladder pain.
This pain can feel like a stab, a burning, or a squeezing sensation. It can be in one spot or spread throughout the genital area.
Does this pain cause bleeding?
Bleeding does not always occur. If you bleed during sex, it could be due to an underlying medical condition. It may or may not be associated with pain. However, if you bleed during sex, it could be normal, a sign of infection, or, rarely, a sign of cancer, so be sure to see a doctor.
What are the main reasons for this?
Often, the main cause of this pain is insufficient lubrication , which means vaginal dryness. However, infections, injuries, and various medical conditions can also cause it.
1. Various medical conditions
- Endometriosis: The growth of tissue that lines the inside of the uterus (endometrium) outside the uterus, in other places (for example, the fallopian tubes, abdominal cavity).
- Skin diseases: Skin diseases such as dermatitis that occur in the genital area.
- Pelvic floor dysfunction: Problems with the muscles and ligaments in the pelvic cavity.
- Intestinal problems: Intestinal diseases such as irritable bowel syndrome (IBS), ulcerative colitis, and Crohn's disease.
- Bladder problems: Conditions like recurrent urinary tract infections (UTIs) and interstitial cystitis (IC).
- Hormonal changes: Hormonal changes, especially during perimenopause.
- Nervous system problems: Nerve-related problems, such as pinched nerve in the spine.
- Breastfeeding mothers: Hormonal changes during breastfeeding can also cause vaginal dryness and pain.
- Vulvodynia: Long-term pain in the area around the vaginal opening (vulva).
- Vaginismus: Involuntary, tight contractions of the muscles of the vagina. This can be caused by a previous trauma or fear of pain.
2. Trauma or injury
- Having sex soon after surgery or childbirth .
- Injury to the vagina or the area around the vaginal opening. For example, a vaginal tear during childbirth or an episiotomy.
3. Infections
- Vaginal infections: Common infections such as yeast infections or bacterial vaginosis.
- Sexually transmitted infections (STIs): Infections such as genital warts and herpes.
How to recognize this condition?
Your doctor will ask you about your medical history and perform a physical exam to try to determine the cause. This physical exam may include examining your pelvis, abdomen, vagina, and uterus.
The following tests can be done to find the exact cause of the pain:
- Pelvic exam: At this time, a sample of vaginal discharge or a urine sample may be taken to check for infection.
- Ultrasound scan: A transvaginal ultrasound can get a good picture of the organs of your reproductive system.
- Laparoscopy: This is rarely done. This is a surgical procedure that uses a small camera to examine the inside of the abdominal cavity if other tests cannot find a cause.
Don't be embarrassed to talk to a doctor about a problem like this. It's normal. Remember, your doctor has heard these things before, and they're here to help you.
Your doctor may ask you questions like these:
- Where do you feel the pain?
- How often does the pain occur?
- How long has this pain been there?
- What does the pain feel like? (e.g., burning, aching?)
- What medicine are you using?
- Have you had any previous surgeries?
How is it treated?
Treatment options depend on the cause of the pain. For example, if the pain is due to pelvic floor dysfunction, physical therapy may be recommended first.
- Medication: If vaginal dryness is caused by a lack of estrogen, there are estrogen-containing creams that can be applied to the vagina. Medications may also be prescribed to treat infections or other conditions.
- Lubricants: If vaginal dryness is the main cause, using a water- or silicone-based lubricant can be very helpful.
- Other tips: Avoid using perfumed soaps, bubble bath, scented sanitary pads, and toilet paper in the genital area.
Things you can do to manage pain at home
- Use a water- or silicone-based lubricant before having sex.
- Try other sexual activities or positions that don't cause pain.
- Take an over-the-counter pain reliever like paracetamol before having sex.
- Take time to relax and de-stress before having sex.
- After sex, apply an ice pack to the area around the vaginal opening.
How long this pain lasts varies depending on the cause and treatment. Sometimes you may feel relief right away after starting treatment. Other times, it may take a while to find the right treatment.
The best part is, this can often bring relief. So don't give up hope.
Take-Home Message
- Pain during sex (Dyspareunia) is a very common condition. There is no need to be ashamed of it or suffer alone.
- This pain can be caused by both physical and psychological factors, so it is very important to find the exact cause.
- Don't ignore this as a normal part of aging. Every pain has a cause and a cure.
- If you experience new pain during sex, bleeding, or unusual vaginal discharge, be sure to see your doctor.
- Talking openly about this with your partner is very important for the relationship. Talk about ways to understand each other and create a closeness that is not painful.
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