Sexual Pain in Dysapreunia: when making love hurts

Have you ever had pain during intercourse? If so, what explanation do you provide regarding this? Are you underestimating the problem or trying to find out more?

Today we will talk about it. From a condition that appears to affect both sexes, even though the majority are women. What disease are we talking about? About dyspareunia.

What does this term mean and what does this disorder mean? Let’s take a look below and try to break down the different aspects.


What is dyspareunia?

The term “dyspareunia” comes from the Greek word δυσ (difficulty) παρά (near) εÙνή (bed) and denotes the painful condition a woman experiences when having sex near the area affecting the vagina.

Sexual pain from dyspareunia can also affect men, including the genitals.

Often associated with vaginismus, eg. The disorder that usually occurs before intercourse, dyspareunia, is precisely sexual pain that is felt during the experience or full vaginal penetration.


Data on dyspareunia

According to statistics, dyspareunia is widespread.

It is estimated that 12-15% of women of childbearing age and about 45% of postmenopausal women are affected due to greater dryness and loss of vaginal elasticity, which occurs as soon as the menstrual cycle disappears.



This disorder may offer a choice of different classifications based on different parameters, including stress since none of these women complains of dyspareunia.

At the onset, pain can be an indispensable element in dividing dyspareunia into primary or secondary (acquired).

In primary dyspareunia, also known as lifelong, sexual pain occurs during penetration early in sexual life.

However, in the latter case, the pain tends to appear after several years.

Dyspareunia can be further divided into:

  • superficial, pain that does not allow penetration and is usually localized in the superficial or first vaginal canal.
    deep, pain arising from full vaginal penetration.
    mixed, characterized by the presence of the two species just seen.

One final classification that can be made in terms of the correlation between symptoms and context is in terms of duration of sexual pain.

In this sense, we have generalized dyspareunia, where the pain is constant even when partners change, and situational dyspareunia, when pain occurs only in certain situations or in only a few partners.

How is this disorder diagnosed?


Diagnosis and Symptoms of Sexual Pain

Since we have different types of dyspareunia, the diagnosis is based on pelvic examination and symptoms.

For superficial dyspareunia, the assessment is based on examining the entire skin of the vulva, including the joints between the labia minora and labia majora and clitoris, jellyfish urethra, hymen, and duct openings of the large vestibular gland.

For deep dyspareunia, the examination requires a close bimanual examination to determine whether moving the cervix or palpation of the uterus or appendix is ​​causing pain or to look for vaginal nodules or adultery.


The main symptoms of dyspareunia?

More or less acute sexual pain that occurs during penetration or when the penis has been fully inserted into the vagina.

This can feel like a burning sensation and may even continue after intercourse.

Other symptoms associated with sexual pain may include vaginal dryness (associated with possible arousal disorders or hormonal imbalances), changes in vaginal pH, and intolerance of using internal tampons during the menstrual cycle.

However, the perception of pain is similar to that of dyspareunia on gynaecological examination.

The size of the penis and the depth of penetration can only affect the presence and severity of symptoms.



Causes Related to Dyspareunia

As noted earlier, dyspareunia can be superficial or deep.

These types of dyspareunia are felt by women in the early stages of intercourse and can be attributed to causes that are psychosexual, biological and relational.

Let’s see what they really are.


Psychosexual causes

Psychosexual causes are those that arise or worsen as a result of sexual dysfunction and personal problems or worsen when sexual pain occurs or persists during sexual intercourse.

Among them we can have:

  • Libido disorders;
  • Childhood sexual abuse and violence;
  • Sexual phobia education and staying in the family because it is difficult to connect with the body and sexuality;
  • Generalized anxiety disorder because it can interfere with promiscuity and, in some cases, interfere with your fear of disliking your partner. It can also lead to changes in lubrication and increased vaginal muscle tone.
  • Psychosexual immaturity, characteristic of younger women, is also due to insufficient sexual information, which leads to false expectations about sexual relations (fear of illness or fear of unwanted pregnancy);
  • Hypercontrol attitudes.

Although this disorder is rare, in humans it can occur as a result of ongoing mental illness due to organic conditions that have been resolved for some time.


Physical causes

Biological triggers affecting both superficial and non-superficial dyspareunia can be infectious, hormonal, iatrogenic, or caused by drugs.

As for vaginal infections, we can consider candida which, in addition to dyspareunia, causes a decrease in libido and arousal that sometimes affects partners.

In particular, superficial dyspareunia can result from induction of the vestibular line, atrophic vaginitis, vulvar pathology, congenital malformations, or genital herpes.

But also from vaginismus or vulvodynia or from persistent pain in the area around the vulva.

Instead, the insides can result from hypertension in the pelvic or uterine muscles or from ovarian pathologies such as fibroids or infections such as endometritis and cystitis.

But also from uterine fibroids, that is. benign tumours in the muscle tissue of the uterus or from radiculopathy affecting the inner innervation of the vagina.

On the other hand, mixed dyspareunia can be caused by inadequate vaginal lubrication, which in turn can be caused by disorders of sexual arousal or chronic vaginal dryness.

The final causes include a variety of hormonal, vascular, neurological and immunological disorders. But also the use of hormonal contraceptives.


In men, sexual pain is mainly caused by genitourinary disorders, especially sexually transmitted diseases such as gonorrhoea, syphilis, chlamydia, and yeast infections.

Other situations that can cause dyspareunia in men can include urethritis, prostatitis, or an allergy to certain creams or foams.



Relational causes

Relational causes are also important. The latter refers to decreased libido, problems with partners, and expressed sexual dissatisfaction.

But what could cause a disturbance of this magnitude, whose aetiology we have seen is quite complex?


Consequences of dyspareunia

Sexual pain during intercourse is a disorder that is not limited to the act itself. It can have a negative impact on a woman’s mental and physical health and her relationship with her partner.

Therefore, although it is impractical to talk about the intimate-sexual realm, it should not be underestimated.

Because, in turn, it can cause other disorders in the sexual sphere of women including:

  • decreased libido
  • less passion
  • Anorgasmia (inability to reach orgasm).

So what did I do to get out of there?


How to deal with sexual pain

Tip: The psychological origin of the disorder

You need to inquire

If there are psychological factors behind this disorder, attempts to avoid sexual intercourse or possible situations of intimacy with a partner are certainly useless or critical. In fact, constant procrastination can only increase discomfort and frustration.

In order to overcome this psychological barrier, you must first admit that you have it. Try to understand what is holding you back and what scares you, then try to solve the problem.

Like? Through correct and comprehensive information about the anatomy and physiology of the genitals, as well as the mechanisms of sexual intercourse.

With that in mind, it would be wise to talk to people who know better than you: relatives or friends you trust or seek information about certain material. Or it is also useful to take the psycho-educational route with a sexologist.

But be informed, because sometimes we are just afraid of what we don’t know.


Tip: The physical origin of the disorder

Inflammation needs to be eradicated

Conversely, if we experience sexual pain due to inflammation, it is advisable to avoid penetration until the inflammation is gone.

To combat inflammation and pain, you can not only treat the right people, but you can also take small steps, such as:

  • Avoid clothes that are too tight, such as jeans.
  • Use only cotton underwear.
  • Avoid overly aggressive or scented soaps.
  • Avoid deodorants.

In this case, to speed up recovery from dyspareunia, it can also help improve our diet. For example, avoid yeast and sugar (which promote the spread of Candida) or spicy foods, but especially by drinking lots of water and consuming milk enzymes.

If that’s not enough? We have to deal with pain in a different way and rely on professionals.




Treatments for sexual pain during intercourse, as shown above, depending on the cause.

For this reason, it is important to identify the causes, as we have seen, there are various underlying, psychological, physical, or relational disorders. Each patient with dyspareunia is his own case, so the use of general therapeutic interventions is not possible.

In general, neither medication nor other psychological, behavioural, or rehabilitation treatments can be prescribed for intervention or even surgery if necessary.

If muscle contractions around the vagina are the cause of sexual pain (as in the case of vaginitis), some simple muscle relaxation exercises, such as B. Stretching, help.

Women with pelvic hypertension, including women with an induced vestibular line, may also benefit from pelvic physiotherapy by exercising the pelvic floor muscles.

On the other hand, if this disorder appears to have a different psychological origin, special sex therapy is required so that:

  • Knowledge of the anatomy and physiology of the genitals can be increased;
  • It is quite possible to overcome a phobia that causes involuntary muscle contractions.
  • human body awareness increases;
  • increase understanding of the physiological and psychological factors involved in sexual intercourse;
  • Anxiety can be treated through relaxation techniques that aim to improve control of the vaginal muscles and relieve pain, as their health and well-being play an important role in sexual arousal.

Of course, it is important to rule out physical causes before intervening in psychological treatment.

In menopausal women whose dyspareunia due to vaginal atrophy can be given estrogen, which is also useful if the type of dyspareunia is psychological.

To challenge the automatic thoughts and beliefs associated with control problems, brief sexological psychotherapy, preferably drug-free, can be helpful, as verbal psychotherapy, individually and in pairs, has been reported to help:

  • “Restores” the woman’s mind
  • to get rid of someone’s worries and fears
  • to encourage and teach partners to develop a satisfying form of impenetrable sex.

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