What is Dyspareunia?

Dyspareunia is the medical term for persistent or recurrent pain during sexual intercourse. Though it is more commonly occurs in women. The pain can occur before, during, or after sex and may be felt in the genitals, pelvis, or lower abdomen. Here is a breakdown of what it is, why it happens, and treatment of it keeping it straightforward and useful.

Types of Dyspareunia

Superficial: Pain at the entry point (e.g., vaginal opening or penile shaft).
Deep: Pain deeper inside (e.g., pelvis or lower abdomen) during thrusting.

Primary: Present from the first sexual experience.
Secondary: Develops later after a period of pain-free sex.

In Women

Symptoms of Dyspareunia

Burning, stinging, or aching at the vaginal entrance or deeper in the pelvis.
Pain only during penetration or lingering afterward.

Causes of Dyspareunia

Physical:

• Insufficient lubrication (e.g., from low arousal, menopause, or medications).
• Infections (e.g., yeast, UTIs, or STIs).
• Vaginismus (involuntary muscle spasms tightening the vagina).
• Endometriosis or pelvic inflammatory disease (deep pain).
• Skin conditions (e.g., lichen sclerosus) or injury (e.g., childbirth tears).
  

Psychological:

• Anxiety, past trauma, or stress affecting arousal.
  

Relational:

• Lack of foreplay or emotional disconnect with a partner.
  

Prevalence of Dyspareunia

Affects 10-20% of women at some point, though many does not seek help.

In Men

Symptoms of Dyspareunia

Pain in the penis, scrotum, or perineum during or after sex.
Often at the time of erection, ejaculation, or specific positions.

Causes of Dyspareunia

Physical:

• Phimosis (tight foreskin).
• Peyronie’s disease (curvature of penis from scar tissue).
• Prostatitis (inflammation of prostate) or urethritis.
• Infections (e.g., STIs or balanitis).
• Injury or hypersensitivity (e.g., post-surgery).
  

Psychological:

• Anxiety or guilt amplifying discomfort.
  

Relational:

• Partner issues indirectly contributing.
  

Prevalence of Dyspareunia

Less common than in women, but exact numbers are fuzzy.

Diagnosis of Dyspareunia

• A doctor (usually a Sexologist or gynecologist) asks about pain location, timing, and sexual history.
• Physical exam to check for infections, scarring, or structural issues.
• Sometimes tests (e.g., ultrasound, swab for infections) if the cause is not obvious.
  

Treatment of Dyspareunia

So, treatment Depends on the cause:

Physical Fixes:

• Lubricants or moisturizers for dryness.
• Antibiotics/antifungals for infections.
• Hormone therapy (e.g., estrogen cream) for menopausal issues.
• Surgery for structural problems (e.g., removing scar tissue or treating phimosis).
• Pelvic floor therapy for muscle tension (common in vaginismus).
  

Psychological Therapy:

• Therapy (e.g., CBT) for anxiety, trauma, or body image issues.
• Sex therapy to rebuild comfort and confidence.
  

Lifestyle Changes:

• More foreplay or communication with a partner.
• Stress reduction (e.g., mindfulness or exercise).