Painful sex is referred to as “dyspareunia” in medical terminology, and is a common reason for women to seek treatment from their gynaecologists. As a gynaecologist in Brisbane, Dr Ken Law specialises in diagnosing and treating women with painful intercourse. Men who experience pain on sexual intercourse should seek medical advice from their General Practitioners, who may refer them to a specialist urologist.
Women may experience pain just before, during, and immediately after sexual intercourse. In some women, the pain may linger on for several hours after intercourse, and sometimes even days. The pain may occur in the genital region, often described as pain within the vagina or vulva, anywhere between the Mons Pubis and the anus. The pain may also be experienced in the abdomen and pelvis. Not uncommonly, the pain is mixed and is felt in both areas. In some women, the pain is positional (i.e. it only occurs in certain sexual positions). In others, the pain is only experienced during entry of the penis into the vagina, and there is no pain during sexual intercourse itself. Some women only experience pain occasionally, and it is not uncommon for some women to try to ignore the issue and delay seeking medical attention until it becomes a significant problem in their relationship.
There are many possible causes for painful sex in women. Sometimes there may be more than one cause, and one cause may exacerbate the other, creating a vicious cycle, making the sexual pain even worse. Pain may vary from mild intensity to excruciating pain that may make sexual intercourse impossible. Women vary in the way they experience and describe the discomfort during sexual intercourse, with some describing it as a sharp pain, whilst others may report burning, stinging, irritation, or rawness, or a combination of the above. It can cause varying degrees of physical, sexual and psychological distress, and can significantly affect the relationship with the partner.
It has been estimated that up to 3 in 4 women may experience some form of painful intercourse at some point during their lives. Many women who have this condition may not seek medical attention, either because it is too embarrassing for them, or because the pain is not severe and resolves quickly after intercourse. It has been reported that up to 72% of women who have prolonged and severe pain on sexual intercourse do not report the symptom to their doctor.
What are the causes for Painful Sexual Intercourse?
Pelvic Causes of Painful Sex
Pain that is experienced in the abdomen or pelvis can often indicate that the pain originates from within the abdomen or pelvis, but this is not always the case. A common cause of sexual intercourse pain is endometriosis. Women with endometriosis may have other symptoms, such as painful periods (dysmenorrhoea). Intercourse pain due to endometriosis may be felt as a deep pelvic pain, and may be lateralised to one side of the pelvis. The pain may be experienced specifically only during certain sexual positions, and may be reproducible on physical examination by your gynaecologist.
Dr Ken Law specialises in the treatment of women with endometriosis. For further information, click here to find out more, or contact Dr Ken Law to arrange a consultation at Greenslopes Obstetrics and Gynaecology.
Other causes of painful sex include:
- Pelvic Inflammatory Disease (PID)
- Ovarian cysts
- Adhesions (scar tissue)
- Painful bladder syndrome or Interstitial Cystitis
Vulval Causes of Painful Sex
In women under the age of 50, the most common cause of painful sex is a clinical condition known as “localised vulvodynia” or “vulval vestibulodynia”. This refers to pain that is provoked by touching the vestibule, which is the area at the entrance to the vagina.
In women over the age of 50, especially those who have gone through the menopause, the most common cause for painful intercourse is dryness or atrophy of the vulval and vaginal tissues. Using extra lubrication during sexual intercourse may be an effective solution for these women. Younger women who have painful intercourse may also benefit from using extra lubrication during intercourse, or by increasing foreplay to ensure adequate natural lubrication. In older women, vaginal topical oestrogen therapy may also be useful.
Other causes of painful sex for women include:
- Vaginismus
- Vaginal infections and Genital lesions, including sexually transmitted diseases (STDs)
- Trauma, including episiotomy or perineal tears during vaginal delivery
Dr Ken Law specialises in the treatment of Painful Sex. For more information and to discuss your specific situation, please contact Dr Ken Law to arrange a consultation at Greenslopes Obstetrics and Gynaecology.
