Painful Sexual Intercourse (Dyspareunia)

What Is It?

Pain during or after sexual intercourse is known as dyspareunia. Although this problem can affect men, it is more common in women. Women with dyspareunia may have pain in the vagina, clitoris or labia. There are numerous causes of dyspareunia, many of which are treatable. Common causes include the following:

  • Vaginal dryness

  • Atrophic vaginitis, a common condition causing thinning of the vaginal lining in postmenopausal women

  • Side effects of drugs such as antihistamines and tamoxifen (Nolvadex and other brands)

  • An allergic reaction to clothing, spermicides or douches

  • Endometriosis, an often painful condition in which tissue from the uterine lining migrates and grows abnormally inside the pelvis

  • Inflammation of the area surrounding the vaginal opening, called vulvar vestibulitis

  • Skin diseases, such as lichen planus and lichen sclerosus, affecting the vaginal area

  • Urinary tract infections, vaginal yeast infections, or sexually transmitted diseases

  • Psychological trauma, often stemming from a past history of sexual abuse or trauma

Symptoms

Women with dyspareunia may feel superficial pain at the entrance of the vagina, or deeper pain during penetration or thrusting of the penis. Some women also may experience severe tightening of the vaginal muscles during penetration, a condition called vaginismus.

Diagnosis

Dyspareunia typically is diagnosed based on your symptoms. Your medical and sexual history and your physical examination will help your doctor to determine the cause of your symptoms.

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