A sexual encounter with a partner, yourself, or your favorite sex toy is a moment for pleasure, interconnectivity, and well-being. Pain should only be a present participant if you are seeking it.
Dyspareunia is the name we give to the unwanted and prolonged pain associated with sexual intercourse. It can afflict all genders, although people with vaginas tend to report it more often.
Vaginal Dyspareunia
Medical reports state that at least 75% of people with vaginas have experienced pain during sexual activities at some point in their lives. In comparison, between 10% to 20% of them report suffering reoccurring pain.
The presence of pain associated with intercourse happens most commonly when the sex is penetrative. You can experience it during entry, even when the penetration is not sexual, like when insert tampons or menstrual cups. Other presentations of dyspareunia occur when the pain is felt during sexual intercourse or encountering pain afterwards.
The kind of pain felt can vary in range: you may feel burning, itchiness, or aching during intercourse, a deep throbbing continuing hours after sex, or a stabbing sensation similar to menstrual cramps.
The pain location can vary as well. Although the most common body organ to suffer dyspareunia is the vagina, the pain can also be present in your urethra, urine bladder, or rectum, even if the anal penetration did not occur. Additionally, it is possible to feel a ripping localized sensation or a deep pain spread across the abdominal area.
If you feel any of these kinds of pain or discomfort during sex, talk about it with your doctor, especially if it is a repeated or prolonged occurrence.
Physiological Causes
In the same way that there are many forms of pain, there is a diverse range in causes for dyspareunia. Some of these pain origins are more easily treatable than others.
Lack of lubrication in preparation for penetrative sex will lead to an uncomfortable experience, and quite possibly a painful one. Vaginal dryness may result from a hurried engagement with insufficient foreplay, but sadly other causes may be present that are not as easily solvable.
Even a slight alteration of the body’s estrogen balance can lead to vaginal dryness. For example, breastfeeding and menopause are two natural stages of the body that alter the normal estrogen levels, resulting in a lowering of vaginal lubrication and uncomfortable sexual intercourse. Certain medications can also upset your endocrine system and complicate estrogen production. Most notable medications include; antidepressants, sedatives, antihistamines, high blood pressure medication, and hormonal birth control.
If you find yourself in need of some extra lubrication, not to worry. Water-based lubes will help you fully enjoy intimacy while dodging one of the most common causes of dyspareunia. We also suggest you try using GoLove Intimate Serum to treat your labia and perineal skin to regular (daily!) moisturizing, hydrating and soothing love. The hyaluronic serum in GoLove introduces extra hydration for this most sensitive skin.
Beyond the previously discussed proper lubrication, there are skin conditions, irritation, and inflammation of the genital tissue that can turn a sexual encounter into a painful one. Traumatic injuries to the area caused by accidents or surgeries can leave scars that may hurt if the nerve tissue did not heal properly. Invasive procedures, like hysterectomy, episiotomy, or other pelvic interventions are examples of that. Even radio and chemotherapy can leave your pelvic tissue tender enough to hurt when you feel arousal or engage in sex.
Congenital malformations can consequently make penetrative sex difficult and painful. Various sex positions that allow deep penetration can also cause pain if you suffer from uterine malformations, like agenesis, prolapse, or tilted uterus. You will find the same risks with conditions like endometrial inflammation, abnormal growth of the uterine tissue, ovarian cysts, or pelvic inflammatory disease.
Conditions seemingly unrelated to your sexual health also can affect your muscular flexibility, making penetration painful. Such conditions as cancer, arthritis, diabetes, or thyroid disease may disturb your sex life without you being aware.
Penile Dyspareunia
For people with penises, sexual dysfunction or discomfort can feel like a cause for embarrassment, making gathering data about them difficult. Even accounting for this trait, dyspareunia seems to be more common in people with vaginas than those born with penises.
In some cases, dyspareunia can manifest itself as painful ejaculation. While this sort of pain mainly affects people above the age of 50, it can appear in much younger patients. The pain can show up in most parts of the penis proper, as well as its surrounding area. It is not uncommon for patients to report painful ejaculations affecting their testicles, perineum, or urethral meatus.
Dyspareunia can also beginning sensations as early as during arousal or sexual contact. While pain restricts to the genital area, rare cases can show an aching rectum or discomfort on the abdomen over the pubic bone.
Chronic prostatitis/pelvic pain syndrome can also be related to dyspareunia. It often manifests as ongoing pain around the prostate, which sometimes worsens when engaging in sexual activities or at the moment of ejaculation.
Physiological Causes
Similarly to pain associated with vaginal sex, penile dyspareunia has an array of causes requiring different medical treatment methods.
Dyspareunia usually appears as a side effect of a sexually transmitted diseases like gonorrhea or herpes simplex. Dyspareunia can develop from bacterial infections or dermatological conditions affecting the genitalia, or a simple case of cystitis by an obstruction of the urethral canal.
A quick visit to your doctor and pharmacist will get rid of the underlying cause of your discomfort. Once the infection has been treated, the pain should subside shortly after.
Sadly, other cases are not so easy to solve. For instance, repair surgery for a groin hernia and other medical interventions can leave your genital area highly sensitive and prone to swelling and ache during erections. Congenital malformations of the penis can make erections painful and sometimes downright impossible.
Consider the case of Peyronie’s disease, in which a scar or band of inelastic tissue forms on the shaft of the penis. This band does not expand during the erection, leaving the penis with a pronounced curvature and sometimes searing pain.
Emotional and Neurological Factors
Perhaps you don't feel comfortable with yourself, your partner, your environment, or the situation itself. This could lead you to not have relaxed your pelvic muscles enough to engage in sex. Self-image issues, stressful environments at home or work, a fear of intimacy, or relationship issues may also reduce your appetite for sexual pleasure and affecting your experience.
It is not uncommon to develop a lack of libido or sexual aversion, which are not health conditions per se, but more like expressions of your true self that you may discover at any stage of your life. Consenting to a sexual encounter while lacking desire may frustrate you and bring you unsolicited pain.
Likewise, traumatic sexual experiences, molestation, and abuse could alter your view of sex as a joyous experience, tainting it for future encounters. An overzealous religious upbringing and specific cultural backgrounds can also imprint the idea of guilt towards sexuality, which can fuel fear and pain around intimacy.
If you've survived one of these, take pride in that. Counsellors and therapists are great resources to help find a path to healing, and perhaps enjoy sexual experiences again.
Some unbalances in your brain chemistry, like chronic anxiety and depression, also affect your neurological response to sexual stimulation. You may not find pleasure in human contact, masturbation, or even play with sex toys. Talk to your neurologist or psychiatrist to evaluate whether a condition may be interfering with your libido, or medication you are taking to help cope with it is causing this these symptoms.
Diagnosis and Treatment
If you have experienced sexual-related pain, contact your doctor as soon as possible. They will ask you several questions to ascertain the nature of your pain and the most suitable treatment moving forward.
These questions will include information about your sexual behaviour, dietary regime, and everyday habits. Be sure to answer them truthfully so the doctor can build your clinical history as accurately as possible. They are there to help, and not judge.
Part of your diagnosis may include a physical exam, in which your doctor will possibly observe the patients genitalia searching for any skin condition, sores, malformations, or anything that may be causing pain. Feel free to ask your doctor health questions regarding your genitals, how to treat and clean them, or how to recognize any causes for alarm.
If the doctor deems it necessary, they may ask for a urine, tissue, or fluid samples. A lab test will help them assess whether your discomfort comes from a sexually transmitted disease or another form of infection. Some cases may require further testing, MRI scans, or ultrasound imaging.
Once the cause of your dyspareunia has been identified, treatment can begin. So make sure you talk to a professional as soon as possible. The proper medication will take care of most cases, dermatologic conditions, infections, and cystitis included. Your doctor will likely prescribe some analgesics to accompany them. Complex cases, mainly those involving vagina or penis malformations, might require physical therapy or corrective surgery.
If the origin of your pain is caused by an emotional or psychological factor, counseling and therapy are the best tools to help you navigate a path towards sexual pleasure.