Dear Daughters,

Dyspareunia is the medical term for pain experienced during sexual intercourse.

For both men and women, pain can occur in the pelvic area during or soon after sexual intercourse. It can happen at any time during sex or after sexual activity.

Eventually, ongoing pain may cause a person to lose interest in any sexual activity.

• Cause
• Treatment
• Diagnosing the Disease
• Prevention
• Resources

Cause

• A diaphragm that does not fit properly
• Endometriosis
• Genital irritation from soaps, detergents, douches or feminine hygiene products
• Hemorrhoids
• Herpes sores, genital warts, or other sexually transmitted infections (STIs)
• Intercourse too soon after surgery or childbirth
• Menopause
• Ovarian cysts
• Prostatitis ― inflammation of the prostate
• Reaction to the latex of a diaphragm or condom
• Sexual abuse or rape
• Urinary tract infections
• Use of certain medications
• Vaginal dryness or too little lubrication
• Vaginal infection
• Vaginismus ― a sexual dysfunction

Treatment

For painful intercourse in women after pregnancy:

• Wait at least six weeks after childbirth before resuming sexual relations
• Be gentle and patient
• Use lubrication as needed

For vaginal dryness/inadequate lubrication:

• Try water-based lubricants
• If you are going through menopause and lubricants do not work, talk to your doctor about estrogen creams or other prescription medications

For painful intercourse caused by prostatitis:

• Soak in a warm bath
• Drink plenty of fluids, but avoid alcohol and caffeine
• Take acetaminophen or ibuprofen
• Take antibiotics as prescribed

For hemorrhoids, try stool softeners. Antibiotics may be required for urinary tract infections, sexually transmitted infections or vaginal infections.

Other causes of painful intercourse may require prescription medications or, rarely, surgery.

Sex therapy may be helpful, especially if no underlying medical cause is identified. Guilt, inner conflict or unresolved feelings about past abuse may be involved which needs to be worked through in therapy. It may be best for your partner to see the therapist with you.

Diagnosing the Disease

Call a doctor if:

• Home remedies are not working
• You have other symptoms with painful intercourse, like bleeding, genital lesions, irregular periods, discharge from penis or vagina or involuntary vaginal muscle contraction

A doctor will take your medical history and perform a physical examination.

Medical history questions may include:

• When did the pain begin and has intercourse always been painful?
• Is intercourse painful every time it is attempted?
• Is it painful for your partner as well?
• At what point during (or after) intercourse does the pain begin? Upon entry or penetration? During ejaculation?
• Where, specifically, is the pain?
• Does anything make the pain better?
• Do you have any other symptoms?
• What are your attitudes towards sex in general?
• Have you had a significant traumatic event in the past (rape, child abuse or similar)?
• What medications do you take?
• What illnesses, diseases and disorders are you being treated for?
• Have you had a significant emotional event recently?
• Have you ever had pain-free sex with this partner? With any partner?

It may be best to see the doctor together with your partner. Physical examination may include a pelvic examination (for women), a prostate examination (for men) and a rectal examination. If a physical problem is suspected, appropriate tests will be ordered.

Antibiotics, painkillers or hormones are among the treatment options that may be considered.

Prevention

• Good hygiene and routine medical care will help to some degree.
• Adequate foreplay and stimulation help to ensure proper lubrication of the vagina.
• The use of a water-soluble lubricant may also help. Vaseline should not be used as a sexual lubricant because it is not compatible with latex condoms (it causes them to break), it is not water soluble and it may encourage vaginal infections.
• Practicing safe sex can help prevent sexually transmitted infections.

As Always,

Love mom

Resources

Some content on this page was gathered from the United States National Library of Medicine (NLM). The NLM is part of the National Institutes of Health, an agency of the Department of Health and Human Services: www.nlm.nih.gov.