Dyspareunia
What is this Condition?
Genital pain associated with intercourse may be mild, or it may be severe enough to affect enjoyment of intercourse. Painful intercourse is commonly associated with physical problems; less commonly, with psychological disorders. The prognosis is good if the underlying cause can be treated successfully.
What Causes it?
Painful intercourse may result from either physical or psychological causes.
What are its Symptoms?
Painful intercourse produces discomfort, ranging from mild aches to severe pain before, during, or after intercourse. It also may be associated with vaginal itching or burning.
How is it Diagnosed?
A physical exam and lab tests help determine the underlying cause. Diagnosis also depends on a detailed sexual history to elicit physical and temporal factors contributing to the pain.
How is it Treated?
Treatment of physical causes may include creams and water-soluble gels for inadequate lubrication, appropriate medications for infections, excision of scars on the hymen, and gentle stretching of painful vaginal scars. The woman may be advised to change her position during intercourse to reduce pain on deep penetration.
Treatment of psychologically based painful intercourse varies with the particular person. Sensate focus exercises deemphasize intercourse itself and teach appropriate foreplay techniques. Teaching contraception methods can reduce the fear of pregnancy; teaching about sexual activity during pregnancy can relieve fear of harming the fetus.