What Is Dyspareunia?

Dyspareunia refers to persistent or recurrent pain during or after sexual intercourse. The pain can be superficial, occurring at the vaginal opening, or deep, felt within the pelvis during deeper penetration. It can be classified as:

• Primary Dyspareunia: Pain experienced from the first sexual intercourse.
• Secondary Dyspareunia: Pain that develops after a period of pain-free sexual activity.

Prevalence and Impact

Dyspareunia is more common than many realize. Studies indicate that:

• Approximately 10% to 20% of women in the United States experience dyspareunia.
• The prevalence can be as high as 35% in postpartum women within the first year after childbirth.
• Globally, the prevalence ranges from 3% to 18%, varying by region and population studied.

The condition not only affects physical health but also has psychological implications, leading to anxiety, depression, and strained relationships.

Common Causes of Dyspareunia

Understanding the underlying causes is crucial for effective treatment. Common causes include:

1. Physical Causes

• Vaginal Dryness: Often due to decreased estrogen levels during menopause, breastfeeding, or certain medications.
• Infections: Yeast infections, urinary tract infections, or sexually transmitted infections can cause pain.
• Skin Disorders: Conditions like eczema or lichen sclerosus affecting the genital area.
• Pelvic Floor Disorders: Tight or spasming pelvic floor muscles can lead to pain.
• Endometriosis: A condition where tissue similar to the uterine lining grows outside the uterus.
• Vaginal Atrophy: Thinning and inflammation of vaginal walls due to decreased estrogen.
• Vulvar Vestibulitis: Chronic pain at the entrance of the vagina without an identifiable cause.

2. Psychological Causes

• Anxiety and Depression: Mental health conditions can affect sexual function.
• History of Sexual Abuse: Past trauma can lead to pain during intercourse.
• Stress: High stress levels can cause muscle tension and decreased libido.

Diagnosis

If you're experiencing pain during intercourse, it's essential to consult a healthcare provider. Diagnosis may involve:

• Medical History: Discussing symptoms, sexual history, and any underlying health conditions.
• Physical Examination: A pelvic exam to check for signs of infection, skin conditions, or anatomical issues.
• Additional Tests: Urine tests, cultures, or imaging studies if necessary.

Effective Treatment Options

1. Medical Treatments

• Lubricants & Moisturizers: To relieve dryness
• Topical Estrogen Therapy: For vaginal atrophy
• Antibiotics or Antifungals: If infection is the cause
• Pelvic Floor Physical Therapy: For muscular-related pain
• Pain Medications or Nerve Blocks: For chronic discomfort

2. Non-Surgical Vaginal Rejuvenation (ThermiVa)

One of our most popular solutions for post-childbirth and menopausal discomfort is ThermiVa—a non-invasive radiofrequency treatment that:

• Improves vaginal laxity
• Increases natural lubrication
• Reduces urinary leakage
• Enhances sexual sensation and satisfaction

It's safe, effective, and performed in-office with no downtime.

3. Psychological Support

• Counseling or therapy for anxiety, trauma, or relationship stress
• Sex therapy to address communication and emotional healing

When to Seek Help

It's crucial to consult a healthcare provider if:

• Pain during intercourse is persistent or worsening.
• You experience bleeding, unusual discharge, or other concerning symptoms.
• The condition affects your emotional well-being or relationship.

Coping Strategies

In addition to medical treatments, consider the following strategies:

• Open Communication: Discuss concerns with your partner to foster understanding and support.
• Foreplay: Extended foreplay can enhance arousal and natural lubrication.
• Alternative Positions: Experimenting with different sexual positions to find comfort.
• Regular Exercise: Physical activity can improve blood flow and reduce stress.

Conclusion

Painful intercourse is a common issue that many women face, but it's essential to remember that help is available. By understanding the causes and seeking appropriate treatment, you can regain comfort and confidence in your sexual health. Don't hesitate to reach out to a healthcare provider to discuss your symptoms and explore the best treatment options for you.