| Basic Information |
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| Description |
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Recurrent and persistent genital pain associated with sexual intercourse. Dyspareunia and vaginismus (spasm of the pubic muscles of the lower vagina) are often linked.
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| Frequent Signs and Symptoms |
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Pain in the genital area during sexual activity, including foreplay, intercourse or attempted intercourse. Pain may be mild or severe, and it may very with different intercourse positions.
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| Causes |
Physical causes include:
- Infection of the genitals, including herpes and others involving the
vagina, cervix, fallopian tubes or ovaries.
- Pressure against the vaginal wall caused by scarring from
operations or radiation treatment.
- Tight episiotomy scar from vaginal repair after childbirth.
- A fibroid or other uterine tumor.
- Endometriosis.
- A hymen that is imperforate (not opened), torn or thicker than normal.
- A bruised opening to the urethra
- Inadequate vaginal or condom lubrication.
- Allergic reactions to diaphragms, condoms or contraceptive foams and
jellies.
- Dryness and thinness of the vaginal wall after menopause due to
estrogen deficiency.
- Pelvic inflammatory disease.
Psychological and emotional causes include:
- Fear of pregnancy.
- Fear of injury to the unborn child during pregnancy.
- Lack of sexual arousal and vaginal lubrication caused by inadequate
or insufficient sexual foreplay, evasion to a sexual partner, fatigue or
anxiety.
- Lack of sexual experience or information.
- Past sexual injury or psychological trauma.
- Temporary lack of desire for a particular sexual partner.
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| Risk Increases With |
- Pregnancy and the postpartum period.
- Stress, recent illness.
- Fatigue or overwork.
- Alcohol consumption.
- Menopause.
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| Preventive Measure |
- Obtain prompt medical treatment if you have symptoms of infection of the
reproductive organs.
- Discontinue use of contraceptive foams or jellies that produce allergic reactions.
- Discuss the lack of sexual arousal with your partner, including ways to
improve foreplay. Enlist your partner's support and patience to overcome the
problem. Use a water-based non-allergenic lubricant, if necessary.
- Obtain professional counseling to resolve feelings about past sexual trauma.
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| Expected Outcome |
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Depends on the cause. Medical disorders are usually curable with treatment.
Psychological problems can often be cured with therapy, and interpersonal
problems can improve with communication and patience.
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| Possible Complications |
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Damage to personal relationships, permanent inability to enjoy sexual
experiences and loss of self-esteem.
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| Treatment/Post Procedure Care |
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| General Measures |
- Laboratory studies, such as a Pap smear and culture of any vaginal discharge to diagnose any medical problem that can be treated.
- Appropriate treatment will be directed to physical causes or psychological causes.
- Sitz baths frequently relieve tenderness. Sit in a tub of lukewarm water for 10 to 15 minutes. Repeat baths as often as 3 or 4 times a day.
- Use a nonprescription lubricant, such as baby oil or K-Y Lubricating Jelly, during sexual intercourse.
- Instructions for exercises or techniques to dilate the vagina. They may involve use of fingers or dilators to condition the body and mind to the sensation of something being inserted into the vagina.
- Try different positions for sexual intercourse to discover new ones that might reduce penile penetration and be pain-free.
- Treatment for psychological causes will vary depending on the needs of the patient. It can involve education about contraception, counseling to uncover hidden conflicts, sensate focus exercises and teaching of appropriate foreplay techniques.
- In cases of vaginismus or episiotomy scarring, a minor surgical procedure (e.g., perineoplasty) may relieve symptoms.
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| Medication |
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Antibiotic, antiviral, or antifungal medications for underlying infection may be prescribed.
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| Activity |
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No restrictions. A regular exercise program while not a treatment for Dyspareunia, is helpful in promoting general well being.
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| Diet |
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No special Diet
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| Notify Your Healthcare Provider If |
- You or a family member has symptoms of Dyspareunia.
- Pain worsens, despite treatment.
- Symptoms don't disappear after 3 months of treatment.
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