The feeling of pain during sexual intercourse is quite common, especially for the female. Painful intercourse is rare and almost non-existent for men. It is not out of place to worry about the occurrences of painful intercourse especially when the condition is persistent in every experience. Should sex be painful?
Why is the pain consistent with every sexual experience? There are a number of factors can make the otherwise pleasurable experience a painful one.
Dyspareunia is the term used to describe painful and recurrent discomfort during sexual intercourse. It can greatly interfere with a couple’s sexual life and can deflate a person’s appetite for sex. It is prevalent in women of any age group.
Dyspareunia can be a distressing health problem and should be addressed as soon as the symptoms surface. Symptoms include :
- Pain at the point of sexual entry
- Excruciating pain following deep penetration
- A burning, throbbing, and aching sensation during and after sex
- Reduced interest in sex
WHAT MAKES SEX PAINFUL?
A number of physical and psychological factors can make sexual intercourse a pain-filled activity. The physical causes of pain during sex varies and locating the exact point of pain can help denote the specific cause of pain. Pain may occur at the point of penetration or during deep thrusting.
Emotional or psychological factors can also contribute to painful sexual intercourse. Some causes of painful intercourse are:
PAIN AT THE POINT OF PENETRATION (Entry Pain)
Pain experienced at the point of entry may be due to a couple of factors that include:
Inadequate lubrication: Adequate lubrication is necessary for an enjoyable sexual experience. Some glands stationed near the opening of the vagina produce fluids that serve as lubricants during sex. Insufficient secretion of these fluids in the vagina can make it dry and cause painful sexual intercourse.
Vaginal dryness can also result from insufficient or complete lack of foreplay during sex, sexual anxiety, or a dip in estrogen levels due to menopause or childbirth.
Also, some medications can affect vaginal lubrication, these may include certain antidepressants, antihistamines, sedatives, hypertension drugs, and some birth control pills.
Genital injury or irritation: Injuries or trauma that affect the genitals can cause pain during intercourse. This may include injuries from an accident, female circumcision, pelvic surgery, and episiotomy( a medical procedure during childbirth that involves making a cut to enlarge the birth canal).
Vaginismus: Involves the involuntary contraction of the muscles surrounding the vagina that occurs when something tries to enter the vagina like a tampon or penis. Vaginismus can cause painful sexual intercourse as the vaginal muscles squeeze shut at the point of penetration causing pain.
Infection, inflammation and skin disorders or irritation: Infections like urinary tract infections or sexually transmitted infections(STIs) can cause pain during intercourse. An inflammation of the vaginal opening called vulva vestibulitis can also contribute to pain.
Skin problems around the genital area like eczema, lichen sclerosis and lichen planus can cause dyspareunia. An allergic reaction or irritation to laundry detergents, clothing, or toiletries can also be a source of pain during sex.
Congenital abnormalities: Although not common, this can be an underlying cause of painful intercourse. An imperforate hymen (a hymen that blocks the entrance of the vagina) and vaginal agenesis(a vagina that is not fully formed) can contribute to painful intercourse.
PAIN DURING DEEP PENETRATION
This is a deep pain that is felt during deep thrusting or penetration. It can be worsened by certain sex positions. Deep pain can be caused by.
Medical conditions and illnesses: Certain medical conditions or illnesses like endometriosis, fibroids, irritable bowel syndrome, cystitis, interstitial cystitis, uterine prolapse, uterine fibroids, pelvic inflammatory disease, and ovarian cysts can all lead to a deep excruciating pain following deep penetration during sex.
Certain medical treatments and surgeries: Some medical treatments like chemotherapy and radiation for cancer patients can cause changes to the body that may bring about dyspareunia. Surgeries including pelvic surgery and hysterectomy can also cause painful sexual intercourse.
PSYCHOLOGICAL AND EMOTIONAL CAUSES
Certain emotional and psychological factors may contribute to the development of dyspareunia. Psychological problems, stress and a history of sexual abuse or violence can cause dyspareunia.
Psychological issues like anxiety and depression or phobia can get in the way of sexual arousal and hamper vaginal lubrication or cause involuntary vagina tightening (Vaginismus).
Chronic stress can cause the pelvic floor muscles of the vagina to tighten leading to pain during intercourse. Negative emotions that arise from having a history of sexual abuse or violence can make a woman develop dyspareunia.
CAN DYSPAREUNIA BE TREATED?
There are a number of treatment options available to alleviate or stop the symptoms of dyspareunia. Treatment is usually determined by the underlying cause. Treatment usually involves therapy, medication or lifestyle and behavioral changes.
MEDICATION: If the cause of dyspareunia is an infection or a medical condition, drugs are usually prescribed to treat the infection and ease the pain associated with intercourse. For example, If the cause of dyspareunia is vaginal dryness, over-the-counter lubricants can be used to increase lubrication.
Your doctor may also suggest increased clitoral stimulation or foreplay increase lubrication and make penetration less painful.
For urinary tract infections, yeast infections and sexually transmitted infections (STIs), antibiotics and antifungal medications will be prescribed to treat the infections which can stop pain during intercourse.
Vulvar vestibulitis can be treated with topical estrogen creams and some drugs. Illnesses like endometriosis may require prescription drugs or surgery. Skin diseases affecting the genital area that contribute to dyspareunia like lichen sclerosis and lichen planus can be controlled using steroid creams.
THERAPY OR COUNSELING: Therapy or counseling is often needed for dyspareunia that seems to have no well defined physical cause and is prolonged and persistent. Counseling can help detect psychological trauma that may have arisen from sexual abuse or other emotional problems, and once detected a solution is proffered accordingly.
It can also help a person cope with the resulting emotional distress that occurs due to dyspareunia. Couple counseling can help couples go through the problems they may be experiencing due to painful intercourse.
LIFESTYLE CHANGES: Making certain lifestyle changes can help with dyspareunia. Maintaining good genital hygiene, practicing safe sex, and going for regular medical check-ups can help keep infections that cause dyspareunia at bay.
Paying attention to foreplay and improving communication with your partner can improve sexual activity by reducing pain during intercourse. Performing kegel exercises can help alleviate symptoms of dyspareunia in women with vaginismus by strengthening the pelvic floor muscles.