Dyspareunia refers to the recurring pain, which takes place within the pelvic area or genital area at the time of sexual intercourse.(1)
Dyspareunia may take place in both women and men but is common among women. The pain, in this case, ranges from moderate discomfort to severe, while it takes place in the labial or vulvar area of a woman and after sex.(2)
Women with dyspareunia experience superficial pain at the vaginal entrance and deep pain at the time of penis thrusting or penetration.(3)
How Does Dyspareunia Affect The Body?
Dyspareunia or painful sexual intercourse does not have any big complication. However, the problem leads to a loss of interest in lovemaking activities and other similar types of relationship-related problems. Dyspareunia also causes interpersonal conflicts or distress among sexual partners. In rare conditions, dyspareunia leads to fear or anxiety associated with sexual intimacy followed by infertility condition in females.(4)
What Triggers Dyspareunia?
Dyspareunia takes place because of both physical and emotional factors. However, physical causes of the problem differ according to whether a woman experiences deep thrusting or entry pain i.e. penetration pain.
Entry Pain Physical Factors: Pain at the time of penetration depends on different factors, which include the following-
Inadequate Lubrication: Inadequate lubrication problem takes place because of insufficient foreplay. The problem of lacking lubrication also occurs due to the reduction in the estrogen level post-childbirth or menopause and at the time of breast-feeding. Certain medications may even affect sexual desire, which leads to a decrease in lubrication and thereby, causes painful sex. These are medications for high blood pressure, antidepressants, antihistamines, sedatives, and a few of the birth control pills.
Irritation, Injury, And Trauma: This includes irritation, injury, and trauma caused after pelvic surgery, accident, female circumcision, and episiotomy i.e. a cut made at the time of childbirth for enlarging the birth canal.
Skin Disorder, Infection, And Inflammation: Urinary tract or genital area infection may cause the problem of painful intercourse. Skin problems or eczema in the genital area may even result in dyspareunia.
Vaginismus: Vaginismus refers to various involuntary spasms of various vaginal wall muscles, which make the activity of penetration painful.
Congenital Abnormality: Vaginal agenesis i.e. the absence of full vagina by birth or development of certain membrane, which blocks the imperforate hymen i.e. vaginal opening, may lead to dyspareunia.
Deep Pain Physical Factors: Deep pain during sexual intercourse or dyspareunia takes place with deep sexual penetration and it becomes worse in specific positions. Common causes under this category are-
Specific Conditions And Illnesses: You may suffer from deep pain because of various diseases, like pelvic inflammatory disease, endometriosis, retroverted uterus, uterine prolapsed, uterine fibroids, irritable bowel syndrome, cystitis, pelvic floor dysfunction, ovarian cysts, hemorrhoids, and adenomyosis.
Medical Treatments Or Surgeries: Scarring because of pelvic surgery, such as in the case of hysterectomy may cause dyspareunia i.e. painful sexual intercourse. Besides, medical treatments to cure any type of cancer, like chemotherapy and radiation causes certain changes, which make sexual activity painful.
Emotional Factors To Cause Dyspareunia: Human emotions have close relations with sexual activities and hence, they play a significant role in dyspareunia. Common emotional factors are-
Psychological Problems: Depression, anxiety, concerns related to physical appearance, and fear of relationship or intimacy problems contribute a lot towards low arousal level and thereby, pain or discomfort.
History Related To Sexual Abuse: If you have a history related to sexual abuse, you may suffer from dyspareunia in the later years of life.
Stress: Pelvic floor muscles tend to become tight in response to a high level of stress, especially negative stress in your life, which contributes towards pain at the time of intercourse.
However, doctors cannot determine the exact emotional factor to cause dyspareunia.(5)
Based on the aforementioned points, we should say that dyspareunia causes relationship problems and disinterest in sexual/lovemaking activities. The problem may take place because of both physical and emotional factors, especially the level of stress.
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