Dyspareunia is pain in the genital area that occurs continuously or repeatedly during, during, or after sexual intercourse. Although more experienced by women, men can also experience this condition.
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| Dyspareunia, Causes, Diagnosis, Treatment, Prevention, Complications |
Generally, pain in dyspareunia will feel sharp, hot, or like menstrual cramps. Apart from the vagina, pain can also be felt in the bladder, urethra, lower abdomen and pelvis.
Apart from having a physical impact, dyspareunia can also have an emotional and psychological impact. Dyspareunia sufferers may feel tense during sex. This will result in a loss of intimacy between sufferers and their partners.
Dyspareunia or painful intercourse should be treated immediately. If not, this condition can interfere with the quality of the sufferer's sexual relations.
Causes of Dyspareunia
Dyspareunia can be caused by physical factors or emotional factors. The causes of physical factors are divided into two types, namely pain when the penis enters the vagina and pain when the penis is in the vagina.
Pain when the penis enters the vagina
Pain when the penis enters the vagina generally occurs due to lack of lubrication in the vagina. This can occur as a result of a lack of foreplay or foreplay before sexual intercourse.
Some other physical factors that can cause this type of dyspareunia are:
- Vaginal atrophy, which is a condition in which the vagina loses moisture and thickness, so it becomes dry, thin and inflamed
- Use of medications that can reduce vaginal lubrication, such as antidepressants, antihistamines, sedatives, or birth control pills
- Injury, trauma, or irritation of the vagina from an accident, pelvic surgery, or vaginal enlargement during childbirth
- Inflammation or infection in the genital area or urinary tract
- Disorders of the skin in the genital area, such as eczema
- Vaginismus, which is a condition when the vaginal muscles and pelvic muscles are tense and painful when something is entered
- Congenital abnormalities, such as an imperfect shape of the vagina or the hymen completely covering the vaginal opening (imperforate hymen)
- Sex that is done too soon after surgery or childbirth
- Sexually transmitted infections (STIs), such as the human papillomavirus or herpes
- vaginal infection (vaginitis)
- Vulvodynia, which is a condition that causes persistent pain on the outside of a woman's genitals (vulva)
Pain when the penis is in the vagina
This type of pain occurs when the penis is in the vagina. This pain can get worse if you have sex in certain positions. Causes include:
- endometriosis
- Pelvic inflammatory disease
- Myoma
- Ovarian cyst
- Impact of surgery or medication, such as surgery on the uterus, radiotherapy, or chemotherapy
In men, dyspareunia can be caused by sores on the skin of the penis, sexually transmitted infections, Peyronie's disease, or priapism.
In addition to physical factors, emotional factors can also have an influence on a person's sexual activity, causing dyspareunia. These emotional factors can be:
- Psychological problems
Anxiety, depression, worries about physical appearance, and fears of intimacy can all contribute to dyspareunia.
- stress
The stress response that a person feels can make the pelvic floor muscles tighten, causing pain during sex.
- History of sexual abuse
Someone who has had a history of sexual harassment or violence in the past can experience trauma that can lead to dyspareunia.
Symptoms of Dyspareunia
Dyspareunia is characterized by persistent or recurring pain, which can occur during, during, or after sexual intercourse. Symptoms that may occur can include:
- Sharp pain during penetration
- Pain during or after sex
- Pain accompanied by a throbbing sensation that lasts for hours after sex
- Pain accompanied by a burning or itching sensation
- Pelvic cramps
Symptoms of pain due to dyspareunia can vary for each individual. In some cases, pain can also be felt outside of sex, for example when sufferers use tampons.
When to see a doctor
Check with your doctor if you experience repeated pain during sexual intercourse. Apart from being caused by dyspareunia, pain during sex can also be a sign of other serious medical conditions.
With proper diagnosis and treatment, complaints of pain during sex can be overcome. This will improve the sufferer's quality of life, both sex life (intimacy with a partner) and increase in self-confidence.
Diagnostics of Dyspareunia
Diagnosis of dyspareunia begins by tracing the symptoms that appear and the patient's medical history. The doctor will ask about the symptoms you are feeling, such as the location where the pain appears, or the sex position when the pain appears.
After that, the diagnosis can be continued with a pelvic examination, to detect abnormalities in the pelvis, such as infection or injury. The examination is carried out by gently pressing the muscles in the genitals and pelvis, so that the location of the onset of pain can be identified.
In addition to a pelvic examination, the doctor can also carry out a vaginal examination using a speculum or cockerel. If needed, the doctor will also do a pelvic ultrasound.
Several other tests can also be used to diagnose dyspareunia, namely:
- Scanning with a CT scan or X-ray
- rectal examination
- PAP smear
- Vaginal fluid culture test
- Urine test
- Allergy test
If the doctor suspects that dyspareunia is caused by emotional factors, the patient will be referred for counseling with a psychiatrist.
Dyspareunia Treatment
Dyspareunia treatment is based on the cause. Methods of treatment can be in the form of drug administration, surgery, or therapy. Patients can also carry out independent treatment accompanied by instructions from a doctor.
Drugs
Some of the drugs used to treat dyspareunia are:
- Antibiotics, such as penicillin or cephalosporin groups, to treat bacterial infections
- Antifungals, such as fluconazole or ketoconazole, to treat yeast infections
- Vaginal estrogen creams, such as estriol, to treat low estrogen levels, for example
- Local corticosteroid injections, to help deal with inflammation due to dyspareunia
Operation procedure
The surgical method is performed when dyspareunia is caused by certain conditions, such as endometriosis. To treat this condition, the doctor will perform surgery to remove the problematic tissue.
Therapy
Doctors can also perform several types of therapy to treat dyspareunia, namely:
- Cognitive behavioral therapy, to change behavior patterns and negative thoughts that can trigger dyspareunia
- Desensitization therapy, to relieve pain during sex through vaginal relaxation techniques (such as Kegel exercises), or pelvic floor muscle exercises
- Sex therapy or counseling, to overcome negative emotions that trigger dyspareunia, rebuild intimacy, and improve communication between patients and their partners
Independent handling
Patients can also make independent efforts with partners to relieve pain that arises during sex, including:
- Be open and convey to your partner if you are uncomfortable during sex, both regarding position and rhythm
- Extend the time of foreplay or foreplay until you feel fully aroused, to trigger the release of natural lubricants
- Using water-based or silicone-based lubricants during sex
- Change positions if a sharp pain appears in a certain position
It is important to remember, consult with your doctor about the right method of handling dyspareunia. It is feared that inappropriate methods can exacerbate the dyspareunia experienced.
Dyspareunia complications
Untreated dyspareunia can cause the following complications:
- Sexual pain that gets worse
- Bleeding
- Wounds in the vaginal area
- Menstrual cycle disorders
- vaginal discharge
- Disharmonious relationship with partner
- Depression due to anxiety and tension
- Difficult to get pregnant
Dyspareunia Prevention
Dyspareunia cannot be prevented, but there are several efforts that can be made to reduce the risk of this condition, namely:
- Practice safe sex to avoid sexually transmitted infections, for example by using condoms and avoiding free sex
- Maintain good hygiene of the genital area
- Avoid using products that can trigger allergies or irritation around the genitals
- Use a water-based lubricant if the vagina is dry
- Waiting at least 6 weeks to return to sex after giving birth
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