Dyspareunia is a medical condition characterized by pain during or after sexual intercourse. The pain can be felt in the vulva, vagina, pelvis, or deep in the abdomen. It can range from mild to severe and can occur with every sexual encounter or only sometimes. In some cases, the pain can be so excruciating that it interferes with a woman’s ability to have sex.
Dyspareunia is a common condition affecting up to 20% of women. It can occur at any age but is more common in postmenopausal women. The condition can be temporary or long-lasting.
Symptoms of Dyspareunia
Dyspareunia differs from ordinary muscle aches that may occur during or after sex; dyspareunia is pain that occurs specifically in the vulva or vagina during or immediately after penetration.
- It may feel like
- Stabbing pains
Or cramps in the pelvic area that radiate to the thighs and lower back.
- Raised bumps on the vulva (the external genital area)
- Dyspareunia may be constant or intermittent; it may come and go depending on
- Certain circumstances (e.g., time of day)
- Activities (e.g., exercise)
- Medications (e.g., birth control pills)
- Stage of life (e.g., menopause)
- Types of Dyspareunia
There are two types of dyspareunia:
Superficial dyspareunia refers to pain that occurs when penetration first begins.
Deep dyspareunia refers to pain that occurs with deeper penetration (e.g., when the penis penetrates past the opening of the vagina)
What Causes Dyspareunia?
There are several potential causes of dyspareunia. The exact cause may not be clear, or multiple factors may be at play. Potential causes include:
This condition often affects postmenopausal women due to the loss of estrogen levels. With vaginal atrophy, the vaginal walls become thin, dry, and inflamed, which can lead to pain during sex.
Vulvodynia is a chronic pain condition that affects the vulva, the external female genitalia. The exact cause of vulvodynia is unknown, but it is thought to be related to nerve damage or sensitization.
Vaginismus refers to when the muscles around the vagina tighten involuntarily, making penetration painful or impossible. Vaginismus is often psychological and can be caused by past trauma, anxiety, or stress.
Certain skin conditions, such as eczema or Lichen sclerosis, can cause the skin around the vagina to crack and bleed, leading to pain during sex.
Pelvic Floor Muscle Spasm:
The pelvic floor muscles support the uterus, bladder, and rectum. If these muscles are tight or in spasm, it can lead to pain during intercourse.
Low estrogen levels can cause thinning and drying of the vaginal walls, leading to painful intercourse. Hormonal imbalance is a common problem during menopause.
Certain infections, such as yeast infections, urinary tract infections, bacterial vaginosis, and sexually transmitted diseases, can cause discomfort or pain during sex.
Dyspareunia is usually treatable. The first step is to visit a doctor who will rule out any underlying medical conditions. To diagnose dyspareunia, your physician will likely ask about your medical history and perform a physical examination. They will also ask detailed questions about your symptoms, including:
- When did they start?
- How long do they last?
- How severe are they?
- What makes them better or worse?
In some cases, further testing may be necessary. Diagnostics might include blood tests, urine tests, cultures, or other exams.
Treatment for dyspareunia depends on its underlying cause. Psychological counseling may be recommended in some cases, including vulvodynia (unexplained vulvar burning) or vaginismus (involuntary tightening of vaginal muscles). Other potential treatments include :
- Local anesthetics
- Vaginal dilators
Hormone Replacement Therapy
If there are no medical causes, your doctor may recommend over-the-counter lubricants or estrogen creams. Physical therapy and sex therapy may also be helpful. In some cases, surgery may be necessary. Hormone Replacement Therapy (HRT) can also be an effective treatment for dyspareunia caused by menopause.
How Does HRT Help?
Since one of the most prevalent causes of painful intercourse is vaginal dryness due to decreased estrogen levels, HRT is an effective treatment option. Hormone Replacement Therapy replenishes estrogen levels in the body, which in turn increases vaginal lubrication and makes sex more comfortable. In relieving pain during sex, HRT can also improve libido and increase sexual satisfaction.
If you’re suffering from dyspareunia, know that you are not alone, and there are treatments available that can help ease your pain and improve your quality of life. One such treatment is Hormone Replacement Therapy or HRT. If you think HRT might be right for you, talk to the experts at Harbor Compound Pharmacy about all the potential risks and benefits so that you can make an informed decision about your care.