pain during intercourse

Pain during intercourse: what it is and what to do

It is called dyspareunia but not all women know that it can directly depend on a pathological, chronic and progressive condition that is very common in menopause. Here are the causes, consequences and possible treatments.


Before telling you what there is to know (and to do), a premise for you who are reading us: in this article, we are not talking about that slight annoyance or that simple unpleasant feeling that some women can experience during a relationship, but of more important pain , sometimes so strong as to force you to stop what you are doing.

The causes can be very different, but often depend on a change in the tone and elasticity of the vaginal and vulvar tissues that can be injured during intercourse because they are not sufficiently hydrated. But not only.

Let’s find out together what it is and how the situation can be improved.


Pain during intercourse: what it is

It is called dyspareunia and is a fairly common type of disorder: pain during sexual intercourse can manifest itself with burning, stabbing or spasms in the pelvic area and up to the lower abdomen. It can make itself felt immediately after sexual intercourse or even later (even two days later) and have various causes.

Indeed, in addition to modifying intimacy in menopause, in the most serious cases, it can have consequences both on a physical and emotional level, as well as on the balance of the couple. Yet little is said about it, even for reasons of embarrassment. Pretending nothing and keeping quiet, both in front of the partner and in check-ups at the gynaecologist is a very bad idea because dyspareunia does not go away by itself and does not improve over time.

Sometimes the dyspareunia can become a disorder chronic because the tension due to pain (or, before that, the fear of pain) can give origin to a voltage that contracts the muscles of the pelvic floor more and more. In this case, psychological conditioning (fear of pain) can also be a factor that can make the situation worse.

Locating pelvic pain accurately is important to help the gynaecologist diagnose because there are two different types of dyspareunia :

  1. Superficial dyspareunia: pain that is felt immediately, during intercourse, and is localized in the outermost parts of the genital and pelvic area
  2. Deep dyspareunia: pain is internal to the lower abdomen (can also occur after intercourse and up to two days after)

Pain during intercourse: Vulvo Vaginal Atrophy may be among the causes

Very often, pain during intercourse can be caused by Vulvo Vaginal Atrophy. It is a chronic and progressive pathological condition that is very common in this phase of female life: after the age of 50, in fact, it affects 1 in 2 women.

It manifests itself with:

Due to the changes in the tissues that this disease causes, the vulva and vagina are more exposed to lesions and micro-lesions that can cause pain and stiffness. In addition, the vagina could be subject to stenosis, that is, shrink, making penetration more painful.

Pain during intercourse: what can be the causes

Dyspareunia can also have other causes or contributing causes, in addition to Vulvo Vaginal Atrophy:

  • vaginal dystrophies
  • inflammations
  • vaginal infections
  • endometriosis (but in this case it should be known before menopause)

Even the psychological influences may play a role in causing pain during intercourse. In any case, after the age of 50, dyspareunia almost always has biological causes due to changes in the genital system as a result of hormonal alterations.

Pain during intercourse: what can be the consequences

In menopause, the consequences of pain during intercourse can be “important” both physically and emotionally. The consequence of dyspareunia, in addition to the pain that is its manifestation and derivation together, can involve above all the emotional sphere.

Fear of pain is the main reason that leads many women to choose to “file the practice” and stop having relationships. But, in addition to the fact that forced abstinence is not good for the psyche, there is the fact that it could also cause a more rapid wasting of the vulva and vagina, if atrophic. This is because an intimate activity stimulates the blood supply and therefore allows the tissues to feed and oxygenate. On the contrary, inactivity worsens the already scarce elasticity and could make any attempt more difficult.

You know, this is a delicate phase for a woman’s life: menopause changes intimacy in itself, also due to the inconvenience and inconvenience it can entail but also due to a natural decrease in desire that is encountered by many women.

The stress can easily accompany the changes of menopause and in the presence of a problem such as the one we are considering is the risk that certain emotional distress is more concrete can lead to anxiety or even depression.

Pain during intercourse: what to do?

Only the gynaecologist can diagnose the causes of pain during intercourse and start the patient on the right path, but a lot also depends on you (and not only in taking the first step of making an appointment with the specialist). In fact, to treat dyspareunia, it is essential to report in detail to the gynaecologist:

  • the nature of the pain
  • the localization of pain
  • the moment of pain

Without embarrassment or modesty: a sincere and open interview, which helps the doctor to have as much information as possibly useful for formulating a correct diagnosis, is the first step in finding a solution to pain during intercourse.

You can also consider the hypothesis of going to the gynaecologist in the company of your partner: it could be a way to overcome the embarrassment in front of the doctor but also to make your partner participate in the matter: the problem is not in the absence of desire but in the pain due to real biological causes.

From whatever point of view you look at it, closing yourself in silence is never a good choice, neither for your love life nor for the solution of the problem. Love in menopause can and must continue: living a satisfying sex life even after the “door” is essential for your serenity but also to keep your mind and body young.

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