What is Dispareunia (Definition)

Dyspareunia is a recurrent or persistent genital pain that appears just before or after sex, or during sex. Although this condition can occur in both men and women, it is more frequent in the latter.

Dispareunia Causes

 Women

It is believed that the cause is related to physical factors.

Some pains occur during vaginal penetration, but decrease over time. Often, this happens because there is not enough lubrication due to lack of excitement and sexual stimulation. It can also be caused by dehydration or as a side effect of some medications, such as antihistamines. Frequent vaginal washes can also cause problems.

In women, there may be other causes:

•   Postpartum period after delivery
•   Vaginal infections, such as yeast vaginitis
•   Postmenopausal atrophic vaginitis: irritation of the vaginal mucosa due to lack of estrogen
•   Endometriosis
•   Herpes or genital warts
•   Pelvic inflammatory disease, a serious infection of the female reproductive organs
•   Infection of the urinary tract
•   Problems that affect the pelvic bones

Chronic constipation

 The cause of the dyspareunia can also be related to psychological factors, although this is less common.
 Some examples include the following:

•   Previous sexual trauma, such as rape or abuse
•   Feelings of guilt
•   Negative attitudes toward sex

These factors can cause a condition called vaginismus, which consists of involuntary and painful contractions of the vaginal muscles. This is usually a response to past sexual trauma or other painful circumstances, but may also be due to chronic irritation with physical causes.

Men

The most common causes of pain in men are:

  Prostatitis: inflammation of the prostate
  Urethritis: inflammation of the urethra

Pain occurs at the time of ejaculation.

The pain that is felt while an erection occurs may be associated with:

•   Inflammation of the foreskin
•  Loss of elasticity of the prepuce
•   Trauma to the penis
•   Herpes or genital warts
•   Local allergies or irritation
•   Curvature of the penis due to Peyronie's disease

Dispareunia Risk factors

The factors that can increase your likelihood of suffering from dyspareunia are the following:

 In women:

•   Postmenopausal symptoms 
• Take medications that cause vaginal dryness
•   Previous vaginal surgery

In men and women, viral or bacterial infections can also increase the chances of suffering from dyspareunia.

Dispareunia Symptoms

The pain associated with dyspareunia can:

• Feeling during intercourse or after
• Include itching, burning, shooting pain

Feel in the following regions:

•   Vagina
•   The urethra
•   The bladder
•   Pelvis
•   Penis
•   Testicles
•   Occur during all phases of sexual contact
•   Also feel when using a tampon, since the fabric absorbs the natural lubricant from the vagina

Dispareunia Diagnosis

In general, the diagnosis is based on the symptoms. You will be asked about your medical and sexual history. You will have a physical exam.

For the women:

The vaginal wall is checked to detect the following:
 

Signs of dryness

•   Inflammation
•   Infection
•   Genital warts
•   Cicatrization

You will have a vaginal touch to detect the following:

•   Abnormal pelvic masses
•   Sensitivity

  Signs of endometriosis

 For men and women:

 The doctor may order more tests, for example, cultures to detect infections. Diagnostic imaging studies, such as ultrasounds, can also be used. It could be referred to a counselor to help determine if there are psychological causes.

Dispareunia Treatment

Women

 Your doctor may recommend that you use water-soluble creams or lubricants that contain estrogen.  You may also be prescribed other medications.

• Infections can be treated with antibiotics or antifungals.
•   Inflammation and dermatitis can be treated with corticosteroids for external use or injectable.
•   Viral infections, such as herpes and genital warts, should be treated.
•  Endometriosis can be treated with medications;  In some cases, surgery may be necessary.

Men

To treat prostatitis and urethritis, your doctor may recommend:

•   Treatment with antibiotics
•  Sitz baths: soak the hip area and buttocks in warm water
•   Avoid the consumption of alcohol and caffeine, which may be useful in case of prostatitis

 In some cases, surgery can be done to treat the foreskin and other erection problems.

Men and women

If a physical cause for pain is not found, sex therapy may be helpful. Some concerns should be treated in therapy.
 These could include:

•   Guilt  
•    Internal conflict
•   Unresolved issues about past abuses
•   Need for self-punishment

Dispareunia Prevention 

• Wait, at least, six weeks before having sex after childbirth. It may be necessary to use a lubricant due to the hormonal changes that cause vaginal dryness.
• Use proper hygiene techniques and receive regular medical attention.
• Practice safe sex in order to prevent sexually transmitted diseases.
• Adequate excitement and stimulation help ensure proper lubrication of the vagina.
• Use a water-soluble lubricant. Vaseline should not be used as a lubricant. It is not soluble in water and can cause vaginal infections.