“Painful intercourse can occur for reasons that range from structural problems to psychological concerns. Many women have painful…”.1

Umbrella
What may the Sexual Health and Painful Intercourse Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Dyspareunia
  • Pain With Intercourse
  • Painful Intercourse
  • Painful Sex
  • Painful Vaginal Intercourse

Dyspareunia

What is dyspareunia?

DotS the definition of dyspareunia may vary. The (United States) Mayo Clinic’s definition is:

“The medical term for painful intercourse is dyspareunia (dis-puh-ROO-nee-uh), defined as persistent or recurrent genital pain that occurs just before, during or after intercourse”.2

The (Australian) Jean Hailes for Women’s Health’s (JH) definition is:

“Dyspareunia is the term used to describe pain before, during or after vaginal intercourse”.3

Symptoms

What may be symptoms of painful intercourse?

In Painful Intercourse (Dyspareunia): Symptoms & Causes – Symptoms the Mayo Clinic note:

“If you have painful intercourse, you may feel:

  • Pain only at sexual entry (penetration)
  • Pain with every penetration, including putting in a tampon
  • Deep pain during thrusting
  • Burning pain or aching pain
  • Throbbing pain, lasting hours after intercourse”.4

Cause

What may cause painful intercourse?

The Mayo Clinic explain:

“Painful intercourse can occur for reasons that range from structural problems to psychological concerns. Many women have painful intercourse at some point in their lives”.5

In Painful Intercourse (Dyspareunia): Symptoms & Causes – Causes the Mayo Clinic elaborate on:

“Physical causes of painful intercourse differ, depending on whether the pain occurs at entry or with deep thrusting. Emotional factors might be associated with many types of painful intercourse.

  • Entry Pain…
  • Deep Pain…
  • Emotional Factors…”.6

In Painful Sex (Dyspareunia): What Causes Dyspareunia? (+ Image) the JH elaborate on some physical and psychological causes of dyspareunia.

Who

Who can painful intercourse affect?

The JH explain:

Sexual health and Painful Intercourse
“Pain with intercourse affects:

  • Women of all ages, with young women the most likely to be affected
  • Menopausal and postmenopausal women due to decreased elasticity of their vaginal walls, increased vaginal dryness and narrowing of the vaginal opening
  • Women who have surgical menopause (removal of the ovaries because of medical reasons)”.7

Menopause

Is there an association between regular intercourse and menopause?

In Sexual Health & Menopause Online: Changes In the Vagina and Vulva – Vulvovaginal Atrophy the North American Menopause Society (NAMS) elaborate on:

“When a woman doesn’t have intercourse or other vaginal sexual activity on a regular basis following menopause, her vagina may also become shorter and narrower. Then, when she does try to have intercourse, she is likely to experience pain, even if she uses a lubricant. That’s because dry, fragile vulvovaginal tissues are susceptible to injury, tearing, and bleeding during intercourse or any penetration of the vagina. The resulting discomfort can be so great that the woman avoids intercourse and the condition worsens. Sometimes, even women who are not sexually active are bothered by vaginal dryness and the irritation that may accompany it”.8

What can regular intercourse do?

In Menopause FAQs: Menopause Symptoms – Q. How can I counteract vaginal dryness during menopause? the NAMS note:

“A. …Regular sexual activity can help preserve vaginal function by increasing blood flow to the genital region and helping maintain the size of the vagina. Without sexual activity and estrogen, the vagina can become smaller as well as dryer”.9

Prevention

How can painful intercourse be prevented?

The JH explain:

“To prevent painful sex depends on the potential cause. There are things you can do to help prevent some causes of painful sex including:

  • Increase foreplay to increase natural lubrication
  • Use oestrogen preparations if you are postmenopausal and it is appropriate
  • Use water-based lubricants, or olive oil
  • Practise safe sex to prevent the STIs which may cause dyspareunia”.10

The JH also note:

“If dyspareunia is not managed, it may result in a loss of sexual interest, mood changes and other psychological symptoms”.11

What is STIs?

STIs can be an abbreviation for Sexually Transmitted Infections.

Pelvic Floor Physiotherapist

How may a pelvic floor physiotherapist help with painful intercourse?

In the video included in Painful Sex (Dyspareunia): Management & Treatment the JH’s physiotherapist “explains what you can expect from an initial consultation with a pelvic floor physiotherapist, to make you more comfortable and better prepared”.12

Treatment

What are some treatment options for painful intercourse?

In Painful Intercourse (Dyspareunia): Diagnosis & Treatment – Treatment the Mayo Clinic elaborate on:

“Treatment options vary, depending on the cause of the pain”.

  • Medications…
  • Other treatments…
    • Desensitization therapy…
    • Counseling or sex therapy”.13

In Sexual Health & Menopause Online: Effective Treatments for Sexual Problems the NAMS elaborate on:

“Treatment for many sexual problems often combines medications or devices with counseling (sex therapy) and/or self-help measures. Rarely does one problem have a single solution that won’t benefit from other treatments or actions. It’s also not uncommon for a woman to experience more than one type of sexual dysfunction, and therapies often overlap among various sexual problems”.14

Health Care Provider

What if I have painful intercourse?

If you have painful intercourse, it may be in your best interest to choose to talk to your health care provider about this. The JH explain:

“If you are experiencing painful sex it is important to seek help from your doctor and receive appropriate treatment and/or management at the earliest time. Your doctor may refer you on to a psychologist or sex therapist. Seeking help early can also reduce the risk of further impact on your relationship”.15

The JH also note:

“Treatment programs rarely deliver instant results, so it may take some time for you to notice any changes. Meanwhile, focus on fulfilling your needs (and those of your partner, if you have one) in other ways. You can show your affection and be intimate without intercourse. Kissing, cuddling, massage, mutual masturbation and oral sex are all good alternatives and can expand your views on what makes a fulfilling sex life”.16

The Mayo Clinic explain:

“If you have recurrent pain during sex, talk to your doctor. Treating the problem can help your sex life, your emotional intimacy and your self-image”.17

In Vaginal Atrophy: Symptoms & Causes – Symptoms: When To See A Doctor the Mayo Clinic also note:

“Make an appointment with your doctor if you have any unexplained vaginal spotting or bleeding, unusual discharge, burning, or soreness. Also make an appointment to see your doctor if you experience painful intercourse that’s not resolved by using a vaginal moisturizer (K-Y Liquibeads, Replens, Sliquid, others) or water-based lubricant (Astroglide, K-Y Jelly, Sliquid, others)”.18

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Sources

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Sources

  1. Painful Intercourse (Dyspareunia): Symptoms & Causes – Overview. 12 January 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967 Accessed: 03 August 2019
  2. Painful Intercourse (Dyspareunia): Symptoms & Causes – Overview. 12 January 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967 Accessed: 03 August 2019
  3. Painful Sex (Dyspareunia): What Is Dyspareunia? Last Updated 24 July 2017 — Last Reviewed 02 December 2013. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/sex-sexual-health/painful-sex-dyspareunia/ Accessed: 03 August 2019
  4. Painful Intercourse (Dyspareunia): Symptoms & Causes – Symptoms. 12 January 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967 Accessed: 03 August 2019
  5. Painful Intercourse (Dyspareunia): Symptoms & Causes – Overview. 12 January 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967 Accessed: 03 August 2019
  6. Painful Intercourse (Dyspareunia): Symptoms & Causes – Causes. 12 January 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967 Accessed: 03 August 2019
  7. Painful Sex (Dyspareunia): What Is Dyspareunia? Last Updated 24 July 2017 — Last Reviewed 02 December 2013. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/sex-sexual-health/painful-sex-dyspareunia/ Accessed: 03 August 2019
  8. Sexual Health & Menopause Online: Changes At Midlife – Changes In the Vagina and Vulva: Vulvovaginal Atrophy. North American Menopause Society http://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-the-vagina-and-vulva Accessed: 03 August 2019
  9. Menopause FAQs: Menopause Symptoms – Q. How can I counteract vaginal dryness during menopause? North American Menopause Society http://www.menopause.org/for-women/menopause-faqs-menopause-symptoms Accessed: 03 August 2019
  10. Painful Sex (Dyspareunia): How Can You Prevent Dyspareunia Occurring? Last Updated 24 July 2017 — Last Reviewed 02 December 2013. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/sex-sexual-health/painful-sex-dyspareunia/ Accessed: 03 August 2019
  11. Painful Sex (Dyspareunia): What Is Dyspareunia? Last Updated  24 July 2017 — Last Reviewed 02 December 2013. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/sex-sexual-health/painful-sex-dyspareunia/ Accessed: 03 August 2019
  12. Painful Sex (Dyspareunia): Management & Treatment. Last Updated 24 July 2017 — Last Reviewed 02 December 2013. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/sex-sexual-health/painful-sex-dyspareunia/ Accessed: 03 August 2019
  13. Painful Intercourse (Dyspareunia): Diagnosis & Treatment – Treatment. 12 January 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/painful-intercourse/diagnosis-treatment/drc-20375973 Accessed: 03 August 2019
  14. Sexual Health & Menopause Online: Effective Treatments for Sexual Problems – Overview of Available Therapies for Sexual Problems: Pain During Sex. North American Menopause Society http://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems Accessed: 03 August 2019
  15. Painful Sex (Dyspareunia): Seeking Help. Last Updated 24 July 2017 — Last Reviewed 02 December 2013. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/sex-sexual-health/painful-sex-dyspareunia/ Accessed: 03 August 2019
  16. Painful Sex (Dyspareunia): Expand Your Horizons. Last Updated 24 July 2017 — Last Reviewed 02 December 2013. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/sex-sexual-health/painful-sex-dyspareunia/ Accessed: 03 August 2019
  17. Painful Intercourse (Dyspareunia): Symptoms & Causes – Symptoms: When to See A Doctor. 12 January 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967 Accessed: 03 August 2019
  18. Vaginal Atrophy: Symptoms and Causes – Symptoms: When To See A Doctor. 02 May 2019. Mayo Clinic http://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/dxc-20200169 Accessed: 03 August 2019
Topic Last Updated: 03 August 2019 – Topic Last Reviewed: 03 August 2019
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