Family doctor

Overview:

• Physical pain during intercourse is called dyspareunia
• Pain during sexual intercourse can be physical or psychological
• A condition called vaginismus involves a spasm of the pelvic muscles and is a cause of dyspareunia
• Vaginismus can make inserting tampons and penetration impossible
• The use of plastic dilators to relax the vagina has almost a 100 percent success rate in vaginismus
• Dyspareunia can also be caused by other conditions such as vaginal or pelvic infections, endometriosis, or other pelvic conditions
• Treatment depends on what the underlying problem is

What is it?

Pain during intercourse for women can be caused by a number of factors and is called dyspareunia.

Lack of lubrication and vaginal infections like STDs or thrush can cause inflammation of the vagina and make intercourse a painful experience. Pelvic infections, ovarian cysts and endometriosis tend to cause pain on deeper penetration.

Some women experience a spasm of the pelvic muscles at the point of penetration, preventing full sexual intercourse. This condition is known as vaginismus and is relatively uncommon.

Vaginismus is a leading cause of unconsummated marriage and can cause problems within the relationship.

An estimated seven percent of women experience pain during intercourse.

Most causes of sexual pain respond to treatment, and women are encouraged to seek professional help.

What are the symptoms?

Dyspareunia is genital pain that may be from the vaginal entrance, or deeper in the pelvis.

Deep pain may be due to pelvic thrusting irritating pelvic inflammatory disease, previous surgery, irritable bowel syndrome or endometriosis.

Sometimes thrusting by the woman's partner can hit an ovary, causing pain. This can be resolved by changing positions.

Dyspareunia can lead to relationship problems, failure to reach orgasm and avoiding sexual activity.

Vaginismus is an involuntary spasm of the muscles surrounding the vagina, causing it to close and making penetration difficult or even impossible.

Sufferers may not be able to use tampons or have cervical smear tests because of a failure to be able to relax the vaginal muscles.

It may be caused by a traumatic or painful sexual experience.

Women with vaginismus may still be able to achieve orgasm through clitoral stimulation, and like to concentrate on sexual activity without intercourse.

Some women, however, avoid any sexual activity and can even experience the reflex during foreplay.

A pelvic examination can confirm diagnosis. A doctor will observe an involuntary muscle contraction when the vagina is examined.

What can be done to help?

Vaginismus

Treatment for vaginismus involves relaxation exercises for the vagina.

Plastic dilators can be inserted in the vagina of increasing size. At first they may be inserted by the doctor, then the patient, followed by the woman's partner.

This treatment has about a 96 percent success rate if it is completed. Sex education and sex therapy is also helpful for some women.

Dyspareunia

Treatment for dyspareunia involves treatment of any STDs present, treatment of conditions like pelvic inflammatory disease, and using lubrication during sex.

Sex therapy and the use of dilators may also be useful in women with psychological causes for this condition.

How can it be prevented?

Early treatment of STDs and pelvic infections is essential.

Raising children with healthy attitudes to sex and their genitals could help prevent conditions like vaginismus.

Women need to seek help early to prevent the vaginismus reflex becoming an ingrained response to penetration.

Getting help

Your doctor, gynaecologist, sexual health clinic, family planning clinic or a sex therapist will be able to help.