Pain felt during or after sex is known as dyspareunia pronounced dys- par- eu- nia. Occasional dyspareunia is normal, with deep penetration for example. It may also be one of the most difficult gynaecological problems to assess and treat successfully. Dyspareunia may be classed as superficial felt in the tissues around the entrance of the vagina or deep felt deeper within the pelvis on penile thrusting , depending on the site of the pain.
Dyspareunia may have been present from the time a woman first started having sex or it may have developed later in life. What are the causes? These may be physical in the body , psychological in the mind or a mixture of both. Physical causes of superficial dyspareunia include: Psychological issues Regardless of the cause, if sex is painful, it is likely to cause you emotional as well as physical distress. How is it diagnosed?
Many symptoms of dyspareunia are non-specific, which means they may be caused by a number of different conditions not all of which are included in this factsheet. It is therefore important that you see your doctor, so they can try and find out what is causing the problem and plan the best treatment approach.
They may apply pressure to certain areas to see where you feel the pain. You may also need an internal examination of the inside of your vagina. If your doctor is not confident in diagnosing or treating you, or they think you require more tests, they may refer you to a gynaecologist or other specialist at your local hospital.
More about the causes and how they are treated Skin conditions If you are allergic to something that touches your skin, you may get localised symptoms e. But some people have more serious reactions that affect their whole body they may develop hives, swelling, difficulty breathing and anaphylaxis, which can be life threatening.
If you have an allergy to, or are irritated by latex, plastic or spermicide, you should be able to get condoms that are less likely to cause a reaction. Ask your pharmacist for advice on this.
If you are allergic to latex or spermicide, you will not be able to use a contraceptive diaphragm, as these are made of latex and should be used with a spermicide. If you have an allergy to semen, you should not get any symptoms when you use a condom.
If you have eczema as a result of allergy or irritation contact dermatitis , you and your doctor will need to identify what may be causing the problem and remove it. If the problem is internal, you may need steroid suppositories inserted into the vagina.
These products should be prescribed by a doctor. Infectious conditions Thrush may be passed on through sexual contact or it may develop for other reasons e. Antifungal treatment for thrush can be taken orally as a tablet e. These products are available on prescription or over-the-counter at the pharmacy. If your partner has thrush, they will need to be treated too.
The infection often chlamydia is usually transmitted during sex. Remember that using a condom can reduce your risk of catching an STI. Your doctor can test your urine to see if you have an infection. If a UTI is mild, it may clear up within a few days without the need for antibiotics.
If you suffer from frequent UTIs, you may be able to reduce these by: Drinking cranberry juice or taking cranberry tablets Drinking plenty of bland fluids e. Vaginal dryness is common during and after the menopause due to reduced levels of the hormone oestrogen. Thyroid problems resulting in high or low levels of the hormone thyroxine have also been associated with lubrication problems. Thyroid problems can be treated with medication or surgery.
Some prescription medicines may reduce vaginal lubrication. Examples include oral contraceptives, some antidepressants and some medicines for treating high blood pressure.
If you are worried about this, talk to your doctor as alternatives may be available. A lack of vaginal lubrication may also be associated with psychological issues, such as relationship worries, depression, anxiety and low self-esteem. If this is the case, you may benefit from sex therapy see the following section on this. Vulvodynia There are two types of vulvodynia. Unprovoked vulvodynia is where the pain occurs spontaneously i. Provoked vulvodynia also known as vestibulodynia commonly occurs around the entrance to the vagina vestibule , where the pain is caused by sexual or non-sexual touch by sexual intercourse, inserting tampons, tight clothing, cycling etc.
Urinary tract or bowel problems, such as interstitial cystitis or irritable bowel syndrome are often associated with provoked vulvodynia. Medical treatments include topical preparations which are applied to the affected area e. Surgery may be required as a last resort.
Making small changes in your life may reduce the likelihood of vulvodynia. It is not caused by infection and can be difficult to treat. Lifestyle changes are usually tried first.