Dyspareunia - aka Painful Sex

Dyspareunia is incredibly common and has several reasons behind it.  Many women, at some point in their life, will suffer from painful intercourse.

Because there are so many things that can cause dyspareunia, it is very important to see your doctor about it so that they can work with you to uncover the cause and help guide you through treatment!

What does it feel like?

The pain can be before, during or after intercourse.  It can be burning, dull, aching or sharp.  It can happen with penetration or only with deep thrusting.  It can happen with a light touch or with any penetration including digital (fingers) or tampons. 

Causes: 

Let’s review some of the reasons women can experience dyspareunia (men can also experience).

• Skin: Certain skin conditions can cause pain with penetration.  These involve eczema, psoriasis or lichen sclerosis.  These skin conditions can be managed to help decrease pain.

• Nerve:  A condition called vulvodynia is pain from light touch at certain points around the vulva.  The nerves supplying these areas are functioning inappropriately and are super sensitive, resulting in messages going to your brain which are more intense than they should be.  This needs to be treated by a team specializing in this and/or chronic pain.  This team generally includes a physician, physiotherapist and counsellor.

• Muscle:  imbalance in the muscles in our pelvic floor can also lead to painful intercourse. Pelvic Physio can help with these by improving the balance in your pelvic floor muscles.

• Infections: infections of our vulva, vagina or cervix can cause pain with intercourse.  These should be tested for and treated, and your pain should resolve.

• Anatomy: the way your uterus or cervix sits can result in pain with deep penetration, oftentimes changes in positions can help with this.

• Diseases: certain diseases such as abnormal ovarian cysts, endometriosis, fibroids and others can cause pain with intercourse.  Some treatments can be undertaken to help decrease or relieve the pain if these are the issue.

• Hormones:  Estrogen improves both the tissue plumpness within our vagina and the lubrication, in low estrogen states, such as postpartum breastfeeding and menopause, this can lead to painful intercourse.  This can be treated with water-based lubrication or vaginal estrogen prescribed by your doctor.

• Psychological:  Sex is a process that has many factors that play into it.  One of these is psychological.  If you are undergoing relationship challenges, or if you are having non-consensual sex then this can certainly lead to painful intercourse, for many reasons.

So as you can see Dyspareunia is a very complex topic and there is no quick fix!  So please know that you are not alone and that there is help out there for you!

Talk to someone who can properly diagnose your issues and work with you to improve them.  This can take some time, but well worth it in the end!