What is Dyspareunia?
What is Dyspareunia? Dyspareunia or painful intercourse is a pain that occurs continuously or at times in the genital area and occurs just before, during, or after sex. Vagina, clitoris, and labia are areas that are generally painful when people with dyspareunia have sex.
The disorders commonly experienced more frequently in women than in men can be triggered by medical or psychological factors. Dyspareunia treatment is based on the underlying cause of the disorder. Immediately see a doctor if you feel pain during intercourse to get the right treatment.
Causes of Dyspareunia
The cause of the perceived dyspareunia early in intercourse can be caused by something different from the one felt during sexual intercourse and can be attributed also to an emotional factor. Here is the translation:
Pain in early sexual intercourse or penetration can be attributed to several factors, namely:
- There is inflammation or skin disordersThe condition of athropic vaginitis (thinning of the vaginal layer due to post menopause) or there is eczema in the pubic area. Skin disorders called lichen planus, and lichen sclerosus that alters the environment around the vagina are also thought to cause dyspareunia.
- The presence of infection in certain organsPainful sex can also indicate an infection in the genital area or urinary tract.
- Lack of lubrication or lubricantPreheating before intercourse can reduce the condition of the vagina dry and useful to make sex feel more passionate and reduce pain. Some medicines used to treat diseases can reduce lubricants, such as high blood pressure medications, antidepressants, tranquilizers, antihistamines, and some types of birth control pills. In addition to painful sex, reduced lubrication may result from decreased postmenopausal estrogen, childbirth, or during breastfeeding.
- Any injury or surgical effectInjury, trauma, or accidental irritation, female circumcision, pelvic surgery, or wounds due to enlargement of birth canal during delivery (episiotomy).
- Vaginismus Disorders in the form of contractions experienced by the muscles of the vaginal wall can cause painful penetration.
- Congenital abnormalities since birth The presence of vaginal abnormalities that do not form completely since birth, called vaginal agenesis, or the growth of membranes that block the opening of the vagina (imperforate hymen).
- Pain in the body when there is deeper penetration. This condition is commonly associated with a position when having sex, can be caused by:
- The impact of surgery or certain medical procedures Such as radiation therapy, chemotherapy, pelvic surgery, and procedures for removal of the uterus or hysterectomy that can cause pain during intercourse.
- Disease or certain medical conditions For example pelvic inflammatory disease, uterine cyst, hemorrhoids, endometriosis, irritable bowel syndrome, uterine fibroids, and descent of the uterus / uterus down.
- Emotional factors also have an impact on sexual intercourse and can be associated with various pain that arise when doing so. Some emotional factors that can be linked, among others:
- The level of stress that is being experienced Stress can cause pelvic floor muscles to trigger pain during intercourse.
- Psychological disorder, Like depression, anxiety about physical appearance, anxiety prolonged, fear in relationship or intimacy can decrease passion and lead to the emergence of discomfort or pain.
- Ever been sexually abused Although not the trigger factor encountered in most women with dyspareunia, sexual harassment can be a risk factor for some women who have experienced it.
Dyspareunia can also be triggered by repeated pain trauma during sexual intercourse, leading to pelvic floor contractions that cause the pain. Therefore, it is difficult to ascertain the psychological factors that cause this condition.
Dyspareunia can also occur in someone who has never or does not have sexual experience, especially if the spouse also does not have that experience. Other risk factors occur in someone who will or has entered menopause.
In men, dyspareunia is commonly felt in the glands around the penis and testes shortly after ejaculation. The causes of dyspareunia in men, among others:
- Infections of the prostate, bladder, and seminal vesicle glands.
- Patients with gonorrhea genital disease.
- Anatomical deformities of the penis, for example in Peyronie’s disease.
- Scarring in the foreskin of the penis due to infection or inflammation, or when attracted so it becomes too tight when having sex or masturbation.
Dyspareunia patients need to spend time specifically to identify the true cause of the symptoms experienced. If the cause is a condition of health or other disorders of the body, it can be started by avoiding activities that cause pain or consult a doctor.
Symptoms of Dyspareunia
The symptoms of dyspareunia vary greatly and differ from one patient to another. In women, symptoms of dyspareunia may be felt on the outer surface of the genital area, vagina, or in the deeper areas, the pelvis.
Here are the signs of dyspareunia that may be felt by the patient.
- Pain resembles heat or pain.
- Pain that arises only when sexual penetration begins.
- The pain that occurs each penetration occurs, even when inserting the tampon into the vagina.
- The internal pain that arises when the movement encourages during intercourse.
- Pain that arises after sexual intercourse that does not hurt.
- A pulsating pain that lasts for hours after sexual intercourse.
Diagnosis of Dyspareunia
Medical evaluation of a physician to obtain a diagnosis of dyspareunia is to interview the patient (anamnesa) about symptoms, health history, and other related evaluations. The doctor will ask whether the pain is felt in all types of sex positions or not, the location of the pain, as well as the history of sexual intercourse, surgical procedures, and past birth experience.
Examination of the pelvic area will be performed to detect if there is a disturbance, such as infection or inflammation, skin irritation or disturbance to the anatomy of the body and location of pain. Mild pressure in the pubic area and pelvic floor muscles can detect the pain common to people with dyspareunia.
An examination of the vaginal area may also be performed using a device called speculum to open the vaginal wall. Patients with dyspareunia will usually feel sick even though the procedure is done slowly so it is reasonable to ask the doctor to stop the procedure if it is very painful. In addition to speculum, pelvic examination can be performed using ultrasound.
Treatment of Dyspareunia
Dyspareunia is treated according to the underlying cause. If the trigger of pain during intercourse is the lack of lubricants caused by the low estrogen hormone, then the drugs to be given are those that work to increase the hormone estrogen. An estrogen ointment for the vaginal area or a potable medicine may be recommended to women with dyspareunia.
Other drugs that may be given to people with dyspareunia according to the trigger, for example are:
- Anti-fungal drugs, if the cause of dyspareunia is a fungal infection in the vaginal area.
Antibiotics, if the cause of dyspareunia is a urinary tract infection or a sexually transmitted disease.
- Steroid creams, if the cause of dyspareunia is a lichen planus or lichen sclerosus disease.
In addition to drugs, surgical procedures may be a consideration of dyspareunia treatment options in patients with endometriosis as well.
The surgical procedure is performed to remove the mass in the pelvis or the infected part, scar tissue, or improve the condition of the inverted uterus that triggers dyspareunia.
Some of the following types of therapies are also available for people with dyspareunia, namely:
- Sex therapy or counseling to talk about certain emotional experiences that can trigger pain when the patient has sex, especially if the condition has been long. Improving the quality of communication and restoring sexual intimacy between dyspareunia and their partners is also another goal of sex counseling.
- Cognitive behavioral therapy can help change behavior patterns and negative thoughts.
- Desensitization therapy may include a variety of techniques that will be tailored to the patient’s condition. Basically, this therapy is done to reduce the pain by learning vaginal relaxation techniques and special exercises pelvic bone or kegel.
Some therapies can also be done at home with a partner, that is by changing some sexual routines to reduce pain during intercourse, such as:
- Exercise each other in talking about each other’s feelings about sexual comfort, such as what position suits your condition or whether you want your partner to slow down the rhythm of making love.
- No hurry when intercourse can stimulate the production of natural lubricants and passions that also reduce pain during penetration.
- Choose a brand of lubricant that really fits and you like to have sex comfortably and not painful.
Alternatively, people with dyspareunia are advised to try exchanging positions, for example with women at the top to prevent the penis from touching or putting pressure on the pelvic floor and avoiding pain or cramps. The position of having sex with a woman above a man also gives freedom for a dyspareunia woman to control a comfortable penetration for her.
Prevention of Dyspareunia
Some ways can be done to prevent the emergence of pain when making love, for example by giving each other kisses, sensual massage, and masturbation to each other. These activities can make sex more comfortable and fun. Some other precautions, namely:
- To prevent vaginal dryness, use lubrication, or appropriate treatment measures if the vaginal dryness is caused by atrophic vaginitis conditions.
- To prevent urinary tract infections, get used to wipe the pubic area from front to back after urination, and urinate after each intercourse.
- To prevent sexually transmitted diseases, avoid free sex with multiple sexual partners. For men, always use condoms every intercourse.
- To reduce the risk of fungal infections, wear cotton clothing and not too tight. Keep clean by frequently changing clothes when sweating or swimming. Also prioritize personal hygiene with bathing regularly.
- If you have endometriosis, avoid penetration in or by having sex two weeks before menstruation (ovulation period) to relieve pain.