Dyspareunia is a condition that has many causes and is not a diagnosis of itself.(1)
Also, as women age, the lining of the vagina thins and can become dry because estrogen levels decrease and the condition is called atrophic vaginitis.(2)
Is Dyspareunia A Progressive Disease?
Dyspareunia also is known as female sexual dysfunction /genito-pelvic pain disorder/penetration disorder is not a disease in itself but a pain syndrome that may occur due to many causes. These etiologies may or may not be progressive and based upon it the presentation and progression of dyspareunia also vary so that it cannot be labeled as a single entity that is progressive.
In many of the etiologies, it is well supported that dyspareunia is a progressive condition such as fibroid of the uterus, cysts in the ovary, pelvic inflammatory disease, endometriosis, retroverted uterus, cancer of the genitourinary tract, interstitial cystitis, etc. These all are such conditions that do not get regressed automatically and go on increasing which will in turn increase the symptoms associated with dyspareunia.(3)
In a few of other etiologies, it can also be shown that dyspareunia is not a progressive disease but a self-limiting one such as urinary tract infection, vaginismus, childbirth injuries, hymenal remnants, psychosocial factors, etc. These causes can get cured automatically and do not progress for a longer period except for the urinary tract infection so the symptom of dyspareunia also disappears.
Alternative Treatments For Dyspareunia
Treatment methodology for dyspareunia largely relies upon the causative factor and varies with it significantly. The cases in which the responsible cause is an organic one, it can be cured by medical or surgical treatment whichever is best fitted for the scenario. It may include antibiotics for urinary tract infections, pain killers to provide relief symptomatically, hormonal therapies in case of lack of estrogen, etc.
Surgical procedures such as removal of the fibroid, radiotherapy on cancer, suturing of the tears occurred after childbirth, repair of anatomical defects, etc. would not only cure the problem but also the symptoms.
The psychological etiologies which do not have any organic cause such as vaginismus, phobia from sexual intercourse, child abuse, marital rape, sexual assault, etc. cannot be cured by medical treatment are to be dealt with psychiatric help. The most common psychological therapy which is used to help such patients is cognitive and behavioral therapy and acts as an alternative form of treatment.
Counseling on the techniques of sexual act, other forms of intimacy in absence of sexual intercourse, change of position for intercourse to reduce the painful experience, etc. can be given by the expert usually a sexologist which can help the person to understand the dynamics of the body and also creates a sense of responsibility in the partner. Individual talking and talking to the partner about the condition is encouraged so that the partner can understand the condition better and help in the due course.(4)
It is very difficult to say whether dyspareunia is a progressive condition or not because it largely depends upon its etiology and not upon the symptoms. Is the etiology is a progressive one then the symptoms of experiencing pain during sexual intercourse would rise and progress but if the etiology is a self-limiting one then the condition will cure automatically.
Consulting a specialist for this condition is necessary and should be done without any embarrassment because it may not be a simple pain and maybe concealing some form of a dangerous condition. Alternative treatment is generally required when the cause is not organic but a psychological one.