Painful intercourse (dyspareunia) - Symptoms and causes | Medtalks

By  Dr. Deepak K Jumani

Painful intercourse (dyspareunia) - Symptoms and causes | Medtalks

Painful Sex | How to Reduce Pain During Sex

You won't want to have sex if it aches. Pain, for the most part, puts a stop to desire. Vaginal pain is said to be experienced by roughly 20% of women during foreplay or intercourse. Infections, yeast, STDs, allergies, drug reactions, nerve damage, and chronic illnesses are only a few of the reasons for pain, which can be intermittent or persistent. Unfortunately, many women who experience pain during sex are rejected as being repressed, having psychological concerns, or just exaggerating the problem, when their symptoms are caused by legitimate medical conditions.

What are the Possible Causes | How to Reduce Pain During Sex

Here are a few of the most common reasons for sexual discomfort:


1. Low Arousal  -The labia, clitoris, and vagina expand when a woman gets excited, and natural lubricant is generated inside the vagina - all of which assist protect a woman from discomfort during intercourse. The vaginal tissue can be dry and brittle without these natural protective processes, producing unpleasant friction or even tears. Unfortunately, women with pre-existing pain issues frequently clench their teeth and proceed with intercourse, asking their partners to "just get it over with" — exacerbating the pain cycle. If you're having trouble identifying the source of your sexual pain, consult a gynecologist. To improve pleasure and comfort during foreplay and intercourse, use lubricant. Before trying intercourse, spend at least 30 minutes in foreplay.


2. Clenching of the Vaginal Muscles- You're going to flinch if you're about to perform anything that has previously caused you pain. When sex hurts, women involuntarily tighten their vaginal muscles, reducing the amount of room available for the penis to penetrate, making intercourse even more painful. If this happens to you, seek treatment. Sexual pain is treated by a specialty known as "women's health physical therapy."


3. Large Penis- While guys may be concerned about being too little, ladies complain to doctors about his being too big twenty times as often. If he is well-endowed in terms of length or girth, sex might be painful. If you're having trouble with this, see a sex therapist to learn how to alter your sexual positions and rhythms for better comfort. A referral to a physical therapist is also a good idea.


4. Menopause- The vulvar and vaginal tissue of a woman thins and gets less lubricated when the hormone estrogen declines. To compound the situation, couples generally stop having sex as frequently in their forties and fifties as a result of one or both partners' declining desire. Vaginal atrophy can be caused by infrequent sexual intercourse. If this happens to you, talk to your doctor about whether you're a candidate for hormone replacement therapy or vaginal estrogen cream. To keep your vagina in excellent health, strive to continue with regular love-making until sex no longer hurts.


5. Vestibulitis- This searing sensation occurs right at the entrance or "vestibule" of the vagina - most commonly around the lower crescent of the vagina (from 4 o'clock to 7 o'clock in clock terminology). The vaginal entrance is frequently surrounded by a crimson patch in the case of vestibulitis.  However, without this red demarcation, the diagnosis may be overlooked during a routine gynecological checkup.


6. Vaginismus- The inability to be penetrated is known as vaginismus. When a woman's vagina contracts and refuses to allow any type of penetration, anxiety lies at the base of her discomfort. Women with vaginismus frequently experience difficulties with tampons, unpleasant gynecological examinations, and fear of uncomfortable intercourse.If you're having trouble with this, sex therapy can help you figure out what's causing your fear and create a plan to gradually enable pain-free penetration.

The Bottom Line

Painful sex or dyspareunia can occur due to a multitude of reasons as listed above. The wisest step you could take in this scenario is to consult a therapist specializing in couples and sex therapy. Most causes are easily resolvable through therapy alone and don’t require medical or surgical intervention.

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Dr. Deepak K Jumani

Prof Dr Deepak K Jumani is a well-known and senior sexual health physician and counsellor from Mumbai. He is attached to the Sir JJ Govt Group of Hospitals and Grant Medical College as an Assistant Professor of Medicine (sexual health). He is also attached to the Mumbai Police Hospital, Doctor House, and Apollo Sugars Clinics as a consultant sexologist. He is an American Board Certified Clinical Sexologist and a fellow of American College of Sexologists.

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