What is Dyspareunia?

Dyspareunia is a broad term referring to any recurrent genital pain with sexual intercourse.  When a woman experiences pain, a cycle can develop in which the anticipation of pain causes physical tension that maintains or increases pain.  Then avoidance begins — the woman avoids sex to avoid the pain.   Possible causes of dypsareunia include functional, medical, and psychological conditions.

Functional Causes of Sexual Pain (Dyspareunia)

"Functional" means that there is nothing structurally wrong with the organs.  Functional causes of sexual pain and discomfort are often easily understood and treated.  For example, if a woman is not sexually aroused, she may lack adequate vaginal lubrication.  This can cause friction or burning that is uncomfortable.  Often this pain disappears after the woman becomes aroused and lubricated.  It is usually an indicator that more sex play is needed before intercourse is started.  Some women may find that use of a lubricant makes genital contact more pleasurable.  Others may feel fully aroused and yet have inadequate amounts of natural lubrication.  This is not unusual after menopause but can occur in younger women as well.  Personal lubricants, available at most drugstores, are designed for sexual intercourse, and will likely provide relief.  Some menopausal women may need a prescription for an estrogen cream or hormone replacement therapy.

Another common cause of sexual pain is vaginismus, or tension in the vaginal muscles.  Click here to learn more about vaginismus.

Physical or Medical Problems

Diseases, such as vulvar vestibulitis,  injuries, and pelvic muscle tension are just a few of the possible problems dyspareunia and pelvic pain.  A gynecologist or physical therapist may be the primary provider of treatment for these problems, but while the underlying condition may be physical, sex therapy is often helpful in addition to medical or physical therapy treatment.  

Psychological Causes

Physical and emotional trauma, relationship problems and depression can cause or contribute to dyspareunia.  When the couple’s relationship is a source of stress, sexual symptoms may be but one facet of more general relational problems.

Diagnosis and Sex Therapy for Dyspareunia  

Sexual pain can stem from several sources at the same time, so a multidisciplinary team is often required for appropriate diagnosis and treatment.  Evaluation by a knowledgeable gynecologist should be an early part of the evaluation. Click on the links below to read about treatment of specific problems.

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