Statistics show that 3 out of 4 women will experience pain during intercourse at least once in their lifetime. This symptom, known medically as dyspareunia, manifests as persistent or intermittent pain that occurs before, during, or after sex.
Causes of Dyspareunia
Pain during intercourse can stem from psychological or organic causes.
Psychological Causes:
- Depression
- Fears and anxieties: worry about unwanted pregnancy, sexually transmitted infections (STIs), or inability to satisfy a partner.
- Negative sexual experiences in the past
- Psychological trauma: sexual abuse and other traumas.
Addressing psychological factors involves discussing concerns with your partner, choosing effective contraceptive methods to reduce the fear of unwanted pregnancy, using barrier methods if you are unsure about your partner, and consulting a psychologist or sexologist if needed. Ignoring the psychological aspects can lead to associating sex solely with pain, which may result in avoidance.
Organic Causes:
- Insufficient lubrication: this may be due to a lack of or inadequate foreplay, a drop in estrogen levels after childbirth, during breastfeeding, or during menopause, as well as the use of certain medications (antidepressants, antihypertensives, sedatives, antihistamines).
- Trauma: childbirth, surgical.
- Infections and inflammatory conditions: vulvitis, vaginitis, cervicitis, endocervicitis, adnexitis, STIs.
- Other conditions: cervical erosion/ectopia, ovarian cysts, endometriosis, congenital anomalies of female genital organs.
Diagnosing Dyspareunia
Diagnosis starts with a thorough medical history. The doctor will ask about how long you have been experiencing pain, where it is located (superficial or deep), in which positions the pain intensifies or lessens, whether there is a connection with your sexual partner, and other details. It is important to answer these questions as precisely as possible.
After taking the history, a gynecological examination is performed to identify possible infections, erosions, tumors, and other pathologies. In some cases, imaging methods such as ultrasound, colposcopy, MRI, CT, or diagnostic laparoscopy may be required.
Treating Dyspareunia
To alleviate the pain, it is necessary to identify and address its underlying cause. Dyspareunia is a symptom that accompanies a primary condition. Treatment for infections involves using appropriate medications: antifungals for candidiasis, antivirals for herpes, and so on. In postmenopausal women, dyspareunia is often caused by low estrogen levels and insufficient lubrication; in these cases, estrogen replacement therapy and the use of artificial lubricants may be recommended.
For vaginal dryness and mucosal atrophy, gels and lubricants are also prescribed. It is important not to self-medicate with hormones, antibiotics, or other drugs without consulting a healthcare professional.
Conclusion
Dyspareunia is a common issue, but with proper diagnosis and treatment, it can be resolved. The key is to find a good gynecologist (or psychologist/sexologist) and work together to address discomfort and pain during sex. May your intimate life bring you only pleasure!