Dyspareunia: Definition, Causes, Symptoms and Treatment

dyspareunia guidelines

Dyspareunia, or painful intercourse as it is most commonly known, is the condition where women complain of intense pain in their genitalia as a consequence of sexual intercourse.

This condition sometimes causes a persistent pain, in other cases, such discomfort can come and go with time. Many women have complained about dyspareunia during some stage of their lives.

Dyspareunia is a medical term that just means ‘painful intercourse.’ It is a general term used to describe all types of sexual pain. Sexual pain can occur when penetrating, during intercourse or after intercourse.

It can happen anywhere in the genital area – the clitoris, the lips or the vagina, etc. Pain can be described as acute, as itchy, like a blow, cramps, etc.

Dyspareunia is part of the so-called sexual disorders caused by pain. This dysfunction features the appearance of some genital pain or discomfort associated with sexual practice with penetration.

Although it is possible this condition affects both men and women, its prevalence in the female population is considerably higher, being uncommon among men.

The possible causes can be of a physical or organic nature, or of psychological origin.

Women who suffer from this symptom of dysfunction do so in a continuous way. This pain impacts their sexuality so that they may become disinterested in sex entirely.

Dyspareunia is considered one of the most frequent female sexual problems after anorgasmia.

The taboo surrounding sexual issues does not help the woman to manifest her dyspareunia, so she internalize the problem and sinks into a state of despair that influences her mood.


The exact cause of this condition can be difficult to pin down as there are a lot of factors that need to take into consideration.

Physical studies of the individuals involved as well as studies of their emotional backgrounds can contribute to pinpoint the cause.

The first and foremost reason behind this as explained by the doctors is the insufficiency of lubrication.

Due to lack of foreplay, menopause or other reasons like the after effects of childbirth, the inner walls of the vulva do not adequately lubricate which can cause pain during intercourse.

Using medicines like antidepressants, antihistamines, and sedatives can lead to a decrease in sexual desire which leads to a deficiency of lubricant.

Allergies, infections or injuries in the vulvar region can also lead to dyspareunia. Patients who have undergone surgeries in that area have often complained about painful intercourse.

Psychological factors such as stress, anxiety and traumatic experiences like sexual abuse can also increase the chances of developing dyspareunia.

Pain in sexual relationships (dyspareunia) can have many causes in the case of women.

The most common triggers are acute or chronic infections of the urinary tract as well as others conditions caused by bacteria, viruses or fungi.

The most common infections are the following:

  • Vaginal inflammation (colpitis)
  • Infection of the fallopian tubes and ovaries (pelvic inflammatory disease, adnexitis)
  • Infection of certain glands of the labia called Bartolino’s glands (bartholinitis)

Sexual diseases, such as, for example,

  • Trichomoniasis, gonorrhea, syphilis
  • Genital warts
  • Candida
  • Some types of cancer

Other causes of pain in sexual relationships are the following:

  • Endometriosis
  • Myoma
  • Scars after delivery, for example, after episiotomy or perineal tear
  • Congenital malformations of internal genital organs
  • Painful reaction to a chemical contraceptive or other intimate product
  • Weakening of the vaginal wall (especially at advanced ages)
  • Vaginal dryness (for example, due to hormonal alterations)
  • Psychic problems related to sexual learning (scarce previous information, feeling guilty), with traumatic factors (past painful or traumatic relationships) and relationship factors (new partner, discomfort with the couple, inappropriate environment)
  • Stress


The most prominent symptom of dyspareunia is pain during sexual intercourse. This pain can occur at several stages of the sex.

Most women complain of severe and sharp pain during the penetration. Continuous ‘thrusts’ have also been known to be triggers of intense discomfort. Whenever pressure is applied, or there is a sudden movement of the vulvar region, burning pain is known to arise.

However, it is important to note here that not all the cases are the same. Some women may experience this pain all the time while some may feel it only under certain circumstances.

Symptoms of dyspareunia include a wide range of sensations associated with genital discomforts, such as pain, stinging, burning and even itching.

This pain or discomfort can appear at any point of intercourse; Either at the beginning, during or at the end of it.

They can also vary depending on the area where the patient experiences the pain or discomfort.

In the external part of the vagina, in the internal section, or the pelvic area in the case of women and the outer section (foreskin, glans or scrotum) or inner regions (testicles, prostate, urethra or bladder) in the case of men.


To carry on with the diagnosis of pain in a woman’s sexual relationships doctors rely on an extensive anamnesis, which means the recollection of medical data through medical history, or even by directly talking to the patient.

These pains are often a taboo, a subject that people do not commonly share with others, but if the pain keeps up over time, then they must necessarily be shared with the doctor.

The most frequent questions of the doctor are the following:

  • Since when do you suffer from these pains during sexual intercourse?
  • At what point of such relationships does it appear?
  • Do they appear regularly or sporadically?
  • How long do they last?
  • What other symptoms are accompanied?

After the anamnesis, he follows a gynecological physical examination.

The gynecologist analyzes the internal and external sexual organs to see if there are abnormalities.

At the same time, take a sample of the vaginal discharge to look for possible pathogens.

Also, it is necessary to perform an ultrasound of the internal sexual organs to look for possible organic causes of these pains or discard them.

Depending on the alleged causes, other complementary tests are carried out, such as the following:

  • Urine and blood tests
  • Tissue samples from areas of the skin and mucosa (biopsy)
  • Analysis of an example of viruses

After the corporal physical examination and after ruling out organic causes, a psychological study of the patient continues.


For treatment purposes, it is essential to determine the cause of dyspareunia before the doctor can proceed any further.

This course of action will help doctors to target the primary cause first, so the patient starts to feel relief from the pain as a result.

For women who have past their menopause, some experts suggest using lubricating creams because their bodies have low levels of estrogen.

Similarly, the doctor can advise the patient against using any medicine that causes a decrease in sexual arousal.

Some doctors suggest that physical therapy is an entirely viable option that has shown positive results in many patients.

Desensitizing methods are used by therapists most of the times. Kegel exercises are carried out to strengthen the muscles in the pelvic region.

These exercises can help the patient in fighting against the pain and raising their tolerance thresholds. Some patients have claimed that sex therapy can also prove to be quite helpful.

It is essential to communicate with your partner; each one of you must be thoughtful and considerate of the other’s feelings.

Continuous painful intercourse can lead to a negative emotional response to any intimate advances which may recur even after treatment.

Consulting a counselor or sex therapist can help you in understanding the situation better which would help you along your road to recovery.

The indicated treatment for dyspareunia will depend on whether the causes are organic or psychological

If the cause is due to natural issues, it will be the doctor who values the most appropriate treatment for each particular case.

Some examples would be the prescription of certain drugs, hormone replacement therapy or surgery, among others.

In the case of any psychological cause, a sexological treatment of dyspareunia will be carried out, consisting of:

To correctly understand the ins and outs of sexuality through sex education, with the goal of knowing our body, our reactions during the sexual response, and getting to see why we are experiencing what we are experiencing.

To dismantle myths and false beliefs associated with sex, creators of fears and insecurities that we must scrap to get rid of its heavy burden.

To perform simple, consistent exercises to achieve adequate and non-demanding sexual arousal to reduce tension, anxiety, and anticipation of pain.

Tips for coping with dyspareunia

If you have discomfort during sex, do not resign and go to professionals who can help you thoroughly enjoy your sexuality.

Grant the importance to the preliminaries and previous games to achieve an optimum state of excitation that favors the penetration.

Choose the sexual positions that favor you most; The posterior and lateral penetration avoid deep penetration, and if the woman places herself on top of her partner she can control it easily.

Use lubricants that facilitate the insertion of the penis and alien the possible lack of vaginal lubrication.

Take care of your vaginal muscles and learn to contract them and relax them to pleasure.