Rita loved her husband. The only problem was the extreme discomfort she experienced while having sex. Some times it would hurt so much that she’d beg her husband to stop and soon the couple started having less and less sex. Pain during sex or dyspareunia is more common among women than men and it’s estimated it affects one of out every  five woman at some point in their lives.  Sadly, more often than not the issue gets swept under the rug and people don’t discuss the issue. Rachel Hercman, a psychotherapist specialising in sexuality, dating and relationships writes more about the issue. 

In my work treating female sexual dysfunction, I often meet women who are suffering silently from pain before, during, or after sexual intercourse, clinically known as dyspareunia.  For some, the pain has been there since their first intercourse and for others it only manifested later on.  Dyspareunia is not a disease, but rather a symptom of a core physical or psychological condition. A woman suffering from dyspareunia may experience mild or severe pain in almost any area of the vagina or pelvic region.

Most women with dyspareunia experience pain upon penetration. Other symptoms include:

• Pain at entry
• Pain with any penetration (including a tampon)
• Sudden pain after intercourse
• Deep pain during thrusting
• Burning pain
• Aching pain

Causes of dyspareunia include:

• Insufficient lubrication that may cause friction between the penis and the skin
• Muscles that may have tightened due to age, childbirth, disuse or other reasons
• Possible nerves positioned in such a way that the penis pushes against them, causing pain during intercourse
• A muscular or bone formation that has shifted, causing pain during sex or any other type of contact
• Stress
• Psychological factors

Also read: Sex education: The need of the hour?

The goal of treating dyspareunia is to reduce the pain or discomfort.  Treatment may include:

• Use of vaginal dilators
• Trying to increase lubrication through topical creams or gels
• Using hormone therapy
• Increasing the blood flow with Viagra, a vibrator or a suction/pump
• Trying different lubrications
• Stretching exercises
• Physical therapy to strengthen supporting muscles to alleviate pressure from other muscles
• Exploring psychological factors that may be contributing

Since there are a number of different types of pain a woman may experience during sexual intercourse, it is important to see a medical practitioner who is able to help identify the source and location of the pain, something that may be difficult for the woman herself to do.  Once a practitioner can determine the source of pain, one or more conditions can be specified. As defined by us here at the Medical Center for Female Sexuality:

• Vulvodynia and Vulvar Vestibulitus are conditions of dyspareunia where the outside of the vagina, known as the vulva, is irritated or in pain.  The vulvar region includes the pad of mons pubis – the fatty tissue at the base of your abdomen, the labia, the clitoris and the vagina opening.
• Vaginismus is a condition where the vaginal muscles involuntarily contract, making penetration painful and sometimes impossible. In its mildest form, a woman can get a penis into the vagina for very short periods, but it’s unpleasant and painful. Or it can be so severe that she can’t touch herself near her vagina, can’t have a gynaecological exam and can’t insert a tampon because the pain is so severe and the fear is so great.

Coping with dyspareunia can be a confusing and isolating experience for a woman and can affect her relationship with her partner beyond the bedroom.  The good news is that there is effective treatment that can restore a woman’s ability to enjoy pain-free intercourse or be able to finally experience it in the first place.  However, many women continue to suffer with dyspareunia because they feel uncomfortable discussing the issue or don’t know where to turn for help.

If you are suffering from painful sex, know that there is help out there.  Talk to your medical provider and if they can’t help you, find a specialist in your area who is familiar with treating female sexual dysfunction.  Don’t give up!  It takes courage to reach out for treatment, but you deserve to have a pleasurable sex life with your partner.   

Check out the various symptoms of dyspareunia on our Symptoms Search feature. 

Rachel Hercman, LCSW (Licensed Clinical Social Worker) is a psychotherapist specializing in sexuality, dating, and relationships. She works at the Medical Center for Female Sexuality in New York, a center that provides cutting-edge medical and psychological treatment for female sexual dysfunction, where she helps women improve their sexual functioning, body image and relationship satisfaction.

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Source: Health Guru