Dyspareunia is a condition that is characterized by pain during sexual intercourse. When this problem occurs in women, getting investigated is very important because there are many conditions that can give rise to this problem. This may be a sign of some underlying pathology that should be treated early. Neglecting this symptom can lead to complications in some cases, thereby increasing the complexity of treatment.
Atrophic vaginitis is a condition that is characterized by a decrease in the thickness of the vaginal mucosa along with dryness. This lack of lubrication makes sexual intercourse very painful. Chemical vaginitis, which can be caused because of the use of certain contraceptive suppositories, can also cause this problem in some women. Infections of the external genitalia caused by bacteria, fungi, or parasites can lead to vulvovaginitis and give rise to pain.
Acute or chronic pelvic inflammatory disease (PID), endometriosis, fibroids, or adenomyosis can produce deep dyspareunia. In such conditions, the woman usually does not experience much pain when penetrated superficially, but as her partner’s penis goes deeper into her vagina and presses upon or moves her cervix (neck of the uterus), severe pain is experienced and the couple is forced to discontinue the act. The pain typically increases with the man’s thrusts and decreases as he withdraws.
Sometimes, a retroverted and retroflexed uterus or the presence of ovarian cysts or tumors may increase the tenderness of the lower abdomen, thereby adding discomfort during sexual intercourse. Past history of psychological trauma can make a woman very apprehensive about sex, which can lead to dyspareunia. At times, the entire vagina goes into spasm to prevent intercourse. This condition is medically referred to as vaginismus.
Vulvodynia literally means pain in the vulva, i.e. the female external genitalia. The pain may be experienced in the labia, at the entrance of the vagina, or in the clitoris. Infections, mechanical irritation by the use of tampons or trauma during sexual intercourse or masturbation can cause such pain. Lichen sclerosis is a condition that is characterized by scarring of the skin in and around the genital region. While the cause of the condition is unknown, this may cause pain.