Painful intercourse or penetration, a condition called dyspareunia, occurs in nearly one-third of all women at some point during their lifetime. However, despite the fact that it’s such a common problem, many women hesitate to discuss their concerns with their gynecologist.
“Sexual activity is something that should be enjoyed. It is rarely acknowledged that it can sometimes be painful, so it’s easy for women to feel alone in their symptoms,” says Beverly Vaughn, MD, gynecologist with Main Line HealthCare Gynecology at Lankenau Medical Center. “This feeling of isolation and sometimes embarrassment can discourage women from speaking up.”
But speaking up is important, says Dr. Vaughn, because dyspareunia is a condition women don’t have to live with.
“There are treatment options to help lessen or alleviate the pain associated with penetration, but the first step is finding a treatment option that addresses the underlying cause of your pain, of which there are many,” explains Dr. Vaughn.
Below, she explores some of the common physical and psychological contributors to dyspareunia.
Physical causes of dyspareunia
The physical causes of dyspareunia can vary greatly. The most common cause is vaginal dryness, which can occur for a number of different reasons.
“Insufficient lubrication is often a result of a drop in estrogen levels, so women most commonly experience it after menopause or childbirth or during breastfeeding,” says Dr. Vaughn. “But lubrication can also be affected by certain medications, so it’s important to check your prescriptions to see if that could be a factor.”
Pain during intercourse can also be a result of short-term health issues, like a urinary tract infection or inflammation, or chronic conditions like uterine fibroids, ovarian cysts, interstitial cystitis, and irritable bowel syndrome. Women with a history of pelvic surgery or injury from an accident or childbirth may also experience pain as a result of the injury.
A lesser-known cause of dyspareunia is called vaginismus, or vaginal muscle spasms. Vaginismus can make penetration of any kind, whether during intercourse or a pelvic exam, very painful. It can be a result of a number of different factors, including trauma, past surgery, and gastrointestinal and urological problems.
Psychological causes of dyspareunia
Dyspareunia can also be a result of psychological factors, too.
“Pain can be as much psychological as it is physical. Women who have a history of sexual abuse may experience pain that is linked to their past experiences, but it can also be brought on by other behavioral factors like fear of intimacy, stress, and depression,” says Dr. Vaughn.
For women whose pain is psychological, certain therapies may be effective in helping to lessen or alleviate pain.
Regardless of the cause of your pain, Dr. Vaughn reminds women that the first step in seeking treatment is speaking up about your symptoms.
“If you’re experiencing pain or burning during penetration or during intercourse, it’s important to make your gynecologist aware of your symptoms. Pain is often treatable, and your gynecologist can work with you to determine the right course of treatment, based on the cause of your pain.”
Although sexual health can be an embarrassing topic for many women, it’s important to talk to your physician about your concerns. Visit our website to make an appointment with a Main Line Health physician or to learn more about our women's health services.