Painful Sex

Dyspareunia is the medical term used to describe pain experienced by women before, during or after vaginal intercourse. Unfortunately, many women brush it off as normal or feel uncomfortable seeking professional help due to the sensitive nature of the topic. This can result in loss of sexual interest, emotional stress and can be a strain on relationships.

How do I know if the pain I am experiencing is normal?

Like any other medical condition, pain before, during or after sex is your body’s way of telling you that something is not quite right. The pain might occur at the point of entry or deeper in the vagina, and it may hurt before, during or even after intercourse.

Don’t just accept it as a normal part of the experience! Talk to your GP or consult with a gynaecologist directly if you experience pain with sex on more than one occasion. Make sure to provide them with as much information about your experience of pain as possible. This includes the type of pain, potential triggers or timing, any accompanying symptoms, and anything that makes it better or worse. This will help your specialist identify the potential cause.

What causes painful sex?

There could be any number of causes that are contributing to the pain. Some of the most common are:

• Insufficient lubrication – from insufficient arousal, hormonal changes or medication.
• Inflammation or infection – irritation of the skin around the vulva might be due to eczema, thrush, or contact dermatitis from soaps, creams or certain garment materials.
• Vaginismus – involuntary muscle spasms of the vaginal wall during penetration are one of the most common causes of pain. There are many different underlying reason that may be contributing to Vaginismus such as tight pelvic floor muscles, recurrent UTIs or genital infections, endometriosis, prior trauma or emotional distress.
• Vulvodynia – a pain disorder affecting the vulva, often experienced as burning pain despite the absence of any identifiable infection or irritation to the area.
• Endometriosis – deposits of endometriosis in the pelvic region may become inflamed during vaginal intercourse can cause pain to be felt deeper in the pelvis (as opposed to in the vagina).

Some of these causes are temporary, e.g. pain caused by a small tear in the vagina wall, but others may be more long-term and chronic such as painful sex caused by illnesses like ovarian cysts, endometriosis, uterine prolapse and pelvic inflammatory disease.

A specialist gynaecologist can help diagnose the source of the pain and provide you with options to either treat the underlying issue, or manage the pain.

Treatment and pain management

Treatment for painful sex focuses on identifying and addressing the causes of painful sex. For example, if the cause is insufficient lubrication, your specialist might suggested extended foreplay, the use of lubricant creams or changing your contraceptive method. If the cause is a skin disorder, treatment may be medication, or simply removing the source of irritation. If the cause is another underlying illness, the treatment is likely to focus on treating or managing that illness. For example, if your dyspareunia is caused by endometriosis, a laparoscopy may be a good option for treatment.

There is also often a strong psychological or emotional component to painful sex, so your specialist may also refer to a psychologist, counsellor or sexual therapist. Other treatment plans may also include physiotherapy, massage or relaxation therapy.

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