Painful Intercourse

Treatment for painful intercourse:

Dyspareunia is painful sexual intercourse due to medical or psychological causes. The pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain.

Numerous physical, psychological, and social or relationship causes can contribute to pain during sexual encounters. 

Underlying causes determine treatment. Many women experience relief when physical causes are identified and treated. 

The treatment for pain with intercourse depends on what is causing the pain. After proper diagnosis one or more treatments for specific causes may be necessary.

For pain due to yeast or fungal infections, a clinician may prescribe mycogen cream (nystatin and triamcinolone acetonide), which treats both a yeast infection and associated painful inflammation and itching because it contains both an antifungal and a steroid.
For pain thought due to post-menopausal vaginal dryness, estrogen treatment can be used.

For women with diagnostic criteria for endometriosis, medications or surgery are possible options.
In addition, the following may reduce discomfort with intercourse:

Both of you shave the pubic region regularly.
Use vaginal vibrator.

Also, add pleasant, sexually exciting experiences to your regular interactions, such as bathing together (in which the primary goal is not cleanliness), or mutual caressing without intercourse. In couples where a woman is preparing to receive vaginal intercourse, such activities tend to increase both natural lubrication and vaginal dilation, both of which decrease friction and pain. Prior to intercourse, oral sex may relax and lubricate the vagina.
Apply water-soluble sexual or surgical lubricant during intercourse. Discourage petroleum jelly. Lubricant should be liberally applied (two tablespoons full) to both the penis and the orifice. A folded bath towel under the receiving partner's hips helps prevent spillage on bedclothes.
Ask your partner to control the insertion by her hand.
For those who have pain on deep penetration because of pelvic injury or disease, recommend a change in coital position to one with less penetration. In women receiving vaginal penetration: maximum vaginal penetration is achieved when the receiving woman lies on her back with her pelvis rolled up off the bed, compressing her thighs tightly against her chest with her calves over the penetrating partner's shoulders. Minimal penetration occurs when a receiving woman lies on her back with her legs extended flat on the bed and close together while her partner's legs straddle hers.