Pain During Sex - Dyspareunia and Vaginismus

Dyspareunia is the medical term used to describe the sensation of discomfort or pain during sex. To be more exact, dyspareunia is defined as a constant or persistent pain or discomfort that begins at the moment of penetration during sexual intercourse or after its end.

Pain during intercourse
Pain during intercourse

The vaginismus is a major cause of dyspareunia and is characterized by involuntary contraction of the muscles of the vagina, making it difficult to penetrate and cause pain during sex. Vaginismus may be either the cause or a consequence of pain during sex.

In this article we do a quick review of dyspareunia and vaginismus.

Dyspareunia can occur in both sexes, but is much more common in women. In this paper we will stick only to pain during sex in women. The dyspareunia in men will be addressed in a separate article to be written briefly.

What is dyspareunia

As mentioned in the introduction of the article, dyspareunia is the term used to describe cases of recurrent pain during sex. In fact, pain can come up with any kind of penetration, either in the sexual act, the introduction of the speculum during pelvic examination or even the time to use a tampon.

Dyspareunia is considered primary when it arises from the first sexual intercourse and persists throughout life. In turn, when a woman starts to feel pain during sex after years of satisfactory relations and painless, dyspareunia is called secondary. Dyspareunia may also be called situational when it occurs only with certain partners.

Pain during intercourse is very common and can occur frequently form in up to 20% of women. The incidence peak seems to occur between 20 and 30 years. After menopause, with the dryness of the vagina by the lack of estrogen, the incidence of dyspareunia grows back.

Causes of pain during sex

The dyspareunia may have physical causes, such as gynecological inflammation, urinary tract infection, skin lesions around the vulva, uterine myoma, etc. In these cases, treatment is often directed to solve the problem dyspareunia.

But the pain during intercourse can also be caused by psychological factors, without which it may be possible to identify an obvious cause for the pain the woman feels during sex.

The main risk factors for dyspareunia psychological origin are:
  • Depression.
  • Anxiety.
  • Stress.
  • History of sexual abuse.
  • Repressive education.
  • Very strict religious belief.
  • Low self-esteem.
  • Guilt regarding sexuality.
  • Lack of sexual desire for the partner.

Since the main causes of dyspareunia in which there is an identifiable physical component are:

Every woman who has pain during intercourse, whether new or old, should seek your gynecologist so that he can make a detailed investigation of their causes.

Symptoms of dyspareunia

The most typical symptom of dyspareunia is a stabbing or burning pain which soon comes at the beginning of penetration. Some women complain of pain in the vagina, but others report that the hassle is well deep in the pelvis, especially during the back and forth movements of the penis. Pain in multiple sites of gynecological anatomy is also a possible complaint.

Pain upon penetration is the most common complaint, but some women also complain of pain during or after sex. If the woman is always "sore" after sex, it is also characterized as dyspareunia.

If beyond the pain there is also bleeding or vaginal discharge during or shortly after intercourse, the most likely cause is trauma or gynecological infections.

If dyspareunia may be associated with vaginal dryness. In these instances, menopause, medications, estrogen deficiency, changes in libido or simple lack of sexual interest in the partner may be the cause.

What is vaginismus

The vaginismus is a separate chapter on the subject pain during sex. This change occurs by involuntary contraction of the muscles surrounding the vaginal entrance, making it difficult to penetrate and cause pain during sex.

We do not know the true prevalence of this problem in the population because many women do not feel comfortable discussing sexual issues with their doctors. Some studies, however, suggest that up to 40% of women may suffer this evil to some degree.

Vaginismus can be closely related to other forms of dyspareunia, and may be a consequence of these. Women who have dyspareunia for other causes can trigger episodes of vaginismus due to the fear of having pain during a sexual act that is about to start. In these cases, therefore, vaginismus becomes a cause of pain beyond the original question. In many women, even if the initial cause of dyspareunia is resolved, fear can perpetuate pain episodes vaginismus, causing dyspareunia persists.

We do not know exactly why vaginismus happens. In general, it is an acquired reflex, which is usually linked to anxiety and / or fear of having sex. But it is not always clear which came first, vaginismus or anxiety.

Some women have vaginismus in every situation and with any object that penetrates the vagina, be the partner's penis, a tampon, a vaginal suppository or speculum gynecologist. Others have vaginismus in some circumstances, but not in all. Generally, sexual penetration and pelvic exam are the most related to vaginismus factors.

Some situations that may trigger vaginismus are:
  • Have had a very painful first intercourse.
  • Find that the vagina is too small for the partner's penis.
  • Sexual abuse history.
  • Negative thoughts about sex.
  • Fear of getting pregnant.
  • Having other causes of dyspareunia.

Symptoms of vaginismus

Vaginismus may cause from mild discomfort to a burning sensation or severe pain at the time of penetration. Unlike other causes of dyspareunia, vaginismus occurs specifically at the time of penetration.

Man can find it difficult to penetrate the woman with vaginismus and often has the feeling that his penis is being kicked out of the vagina during intercourse.

Vaginismus may have periods of worsening or spontaneous improvement without a cause can be found. Generally, it gets worse when a woman goes too long without having sex.

Treatment of dyspareunia and vaginismus

Treatment of dyspareunia obviously depends on its origin. If vaginal dryness, lubricants, hormone replacement or a longer time in the preliminaries can help. If a gynecological infection such as candidiasis, treatment should be done in order to deal with the germ causing inflammation.

When there is no clear cause for the pain during sex, origin probably in psychological factors. In these cases, treatment involves sex education of patients, preventive measures, proper exercises for the pelvic muscles, behavior modification, emotional support and sometimes medication.

Most of the time, dyspareunia be cured, it just takes patience and proper treatment, which is usually obtained with specialized gynecologists in sexual problems.

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