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Health

Painful Intercourse (dyspareunia).

Pain during or after (dyspareunia) can be caused by many things such as;

1. Illness

2. Infection

3. A physical problem

4. A psychological problem

If you get pain during after sex, your body may be trying to tell you something is wrong, so do not ignore it. Pain during sex can affect both men and women. Many women have painful intercourse at some point in their life. The medical term for painful intercourse is dyspareunia defined as persistent or recurrent genital pain that occurs just before, during or after intercourse.

Symptoms.

If you have painful intercourse, you might feel:

1. Pain only at sexual entry (penetration)

2. Pain with every penetration, including putting in a tampon

3.  Deep pain during thrusting

4.  Burning pain or arching pain

5. Throbbing pain, lasting hours after intercourse

Causes of dyspareunia.

1. Vaginal dryness from menopause, child birth, breastfeeding, medications or too little arousal before intercourse.

2. Infections such as yeast or urinary tract infections (UTI).

3. Vulvodynia, a pain centered in vulva area.

4. Injury from childbirth, an episiotomy, a hysterectomy, or pelvic surgery.

5. Vaginitis, or inflammation of the vagina.

6. Veganism’s, or spontaneous tightening of the muscles of vaginal wall.

Diagnosis of dyspareunia.

Medical History.

When evaluating a patient with dyspareunia, thorough medical,  surgical, reproductive, psychiatric, sexual and social information should be sought. This should be supplemented with prior medical and reproductive history, current health status, thyroid and endocrine system review, as well as psychiatric evaluation.

Physical Examination.

Physical examination involves a mandatory visual inspection of both external and internal genital structures to determine potential etiology of pain. The mucosal surfaces have to be inspected in detail for areas of discoloration or redness, which may point to certain dermatological conditions.

Psychological Evaluation.

As dyspareunia may include both sensorial and effective aspects, there is need for meticulous psychological evaluation. This often supplements physical examination and provides useful information about potential predisposing factors such as family influence, sexual experiences, and potential history of sexual abuse or trauma.

                       Treatment of dyspareunia.

Medications.

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: antibiotics, antifungal or topical or injectable corticosteroids.

If a long term medication is causing vaginal dryness your doctor may change the prescription.

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.

Alternative therapies.

Your doctor may also recommend therapy. This can include desensitization therapy or sex therapy. In desensitization therapy, you will learn vaginal relaxation techniques, such as kegel exercise that decrease pain.

Home care.

Home care remedies can also reduce the symptoms. They include:  use of soluble lubricants, have sex when you and your partner are relaxed, empty your bladder before sex, take a warm bath before sex etc.

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