Sexual Intercourse Pain (Dyspareunia)

Dyspareunia is a sexual problem which negatively affects sexual life in women.  There are psychological and physical reasons. In this section, you will have detailed information about pain and other complaints during sexual intercourse.

What is sexual intercourse pain? Definition 

Pain in sexual intercourse is the general name given to complaints of pain, stinging and inflammation during sexual penetration. Pain in sexual intercourse is referred to ‘dyspareunia’ in medical literature.

According to DSM V classification by the American Psychiatric Association in 2013, it is included in the same class with vaginismus, ‘Genitopelvic Pain and Penetration Disorder’.

What are the reasons for pain during sexual intercourse?

The origin of pain problems during sexual intercourse is about 70% physical (organic) and 30% psychological.

1- The psychological aspect of the pain problem in sexual intercourse, ie ‘dyspareunia’, is mostly composed by vaginismus disease.

While almost all vaginismus patients cannot have intercourse, some of them can get in painful sexual intercourse. But, when there are complaints such as burning, stinging, pain and ache during sexual intercourse, woman contracts and withdraws her, or the sexual intercourse continues painfully.  On the other hand, the problem of sexual arousal disorder and sexual reluctance may also cause pain in sexual intercourse depending on the lack of lubrication.

2- Physical reasons: Physical reasons may appear on the surface (entrance) or in the deep (inguinal area).

a) Superficial physical reasons for dyspareunia:

• Vaginitis (Vaginal infection),
• VVS (Vulvar Vestibulitis Syndrome),
• Vulvitis (infection in the external genital area),
• Vaginal surgical interventions (Vaginal tightening surgery, vaginal hysterectomy),
• Poor healing of post-partum stitches,
• Congenital hymen anomalies (such as the hymen is hard, high-edged and septate),
• Bartholin's gland and cysts,
• Condylomas due to HPV infection, HSV infection,
• Vaginal dryness problem due to hormonal changes in menopause period.

b) Physical reasons in the inguinal area for dyspareunia:

• Some pathological conditions related to uterine, ovaries and tubes; cyst, infection and abscesses
• Past abdominal surgery (postoperative appendicitis surgery, cesarean section, myoma surgery)
• Endometriosis disease.

How is dyspareunia treatment?

Dyspareunia problem can now be resolved with scientific treatment methods which are targeted for the reason. For this purpose, the final diagnosis should be made with a good gynecological examination at first.