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Dyspareunia is the term for recurring pain in the genital area or within the pelvis during sexual intercourse. The pain can be sharp or intense. It can occur before, during, or after sexual intercourse.
Dyspareunia is more common in women than men. It has many possible causes, but it can be treated.
Several conditions can cause dyspareunia. For some women, it is a sign of a physical problem. Other women may experience pain as a result of emotional factors.
Common physical causes of dyspareunia include:
Factors that reduce sexual desire or affect a person’s ability to become aroused can also cause dyspareunia. These factors include:
Both men and women can experience dyspareunia. But the condition is more common in women. Dyspareunia is one of the most common problems of postmenopausal women, and a majority of women have painful intercourse at some time (FDA). You are at an increased risk if you:
Dyspareunia pain can vary. Pain may occur:
Several tests help identify and diagnose dyspareunia. A doctor will start by creating a complete medical and sexual history. Possible questions include:
A pelvic examination is also common in diagnosis. During this procedure, a doctor will look at the external and internal pelvic area for signs of:
The internal examination will require a speculum, a device used with a Pap smear. A doctor also may use a cotton swab to apply slight pressure to different areas of the vagina. This will help determine the location of the pain.
The initial examinations may lead a physician to request other tests, such as:
Dyspareunia treatments are based on the cause of the condition. If your pain is caused by an underlying infection or condition, your doctor may treat it with:
If a long-term medication is causing vaginal dryness, your physician may change your prescription. Trying alternative medications may restore natural lubrication and reduce pain.
Low estrogen levels cause dyspareunia in some women. A prescription tablet, cream, or flexible ring can deliver a small, regular dose of estrogen to the vagina.
A new, estrogen-free drug, called ospemifene (Osphena), acts like estrogen on vaginal tissues. It is effective in making the tissues thicker and less fragile. This can reduce the amount of pain women experience with sexual intercourse.
These home remedies can also reduce dyspareunia symptoms:
Your doctor may also recommend therapy. This can include:
Options to sexual intercourse may be useful until underlying conditions are treated. You and your partner can use other techniques for intimacy until penetration is more comfortable. Sensual massage, kissing, oral sex, and mutual masturbation may be satisfying alternatives.
There is no specific prevention for dyspareunia. But you can do the following to reduce the risk of pain during intercourse:
Written by: Anna Zernone Giorgi
Medically reviewed on: Sep 23, 2013: George Krucik, MD, MBA
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