Dr. Spurthy

Pain during or after sexual intercourse is known as dyspareunia. Although this problem can affect men, it is more common in women. Women with dyspareunia may have pain in the vagina, clitoris or labia. There are numerous causes of dyspareunia, many of which are treatable. 

Common causes include the following:

1. Vaginal dryness
2. Atrophic vaginitis, a common condition causing thinning of the vaginal lining in postmenopausal women
3. Side effects of drugs such as antihistamines and tamoxifen (Nolvadex and other brands)
4. An allergic reaction to clothing, spermicides or douches
5. Endometriosis, an often painful condition in which tissue from the uterine lining migrates and grows abnormally inside the pelvis
6. Inflammation of the area surrounding the vaginal opening, called vulvar vestibulitis
7. Skin diseases, such as lichen planus and lichen sclerosus, affecting the vaginal area
8. Urinary tract infections, vaginal yeast infections, or sexually transmitted diseases
9. Psychological trauma, often stemming from a past history of sexual abuse or trauma.

Symptoms of Dyspareunia:
Women with dyspareunia may feel superficial pain at the entrance of the vagina or deeper pain during penetration or thrusting of the penis. Some women also may experience severe tightening of the vaginal muscles during penetration, a condition called vaginismus.

Diagnosis:
Your health practitioner will check for the following things

1. If there was ever a time you had painless intercourse or if you have always had dyspareunia
2. If you have enough natural lubrication and if your symptoms improve when you use commercially available lubricants
3. About your sexual history (to help assess your risk for sexually transmitted infections)
4. If you have ever been sexually abused or had a traumatic injury involving your genitals.

Treatment:

1. Lubrication with an over-the-counter lubricant such as K-Y jelly.
2. Antifungal medication(if you have any kind of fungal infection)
3. Sitz baths for removing the inflammation
4. For skin diseases affecting the vaginal area, lichen sclerosus and lichen planus often improve with steroid creams.
5. Therapies include topical estrogen cream, low-dose pain medications, and physical therapy with biofeedback to lower the muscle tension in the pelvic floor
6. Surgeries can also be prescribed for abnormal growths

For dyspareunia that has no apparent physical cause or has lasted for months or years, you may need psychological counseling to address stress or anxiety regarding sexual intercourse.

In case you have a concern or query you can always consult an expert & get answers to your questions!