Introduction

Dyspareunia means feeling pain during sex. This kind of pain can happen before, during, or after sexual activity and keeps coming back. Though it happens more often in women, anyone might deal with discomfort during sex. Women may notice this pain on the outside of their vulva such as in their labia (the lips around the vagina) or near the opening of their vagina. Others might feel it deeper inside in areas like:

• Pelvic floor muscles
• Vaginal canal skin
• Uterus
• Uterus-supporting ligaments
• Lower abdomen
• Men may feel discomfort in areas such as the head of their penis, the shaft, the testicles, or their pelvis.

Dyspareunia is a frequent condition that can cause emotional and psychological challenges. Physical pain aside, it might lead to reduced intimacy or tension between partners.

What are the Different Types of Dyspareunia?

Where the pain happens can help figure out the kind of dyspareunia you have. The types are:

• Entry pain (introital or superficial dyspareunia): Pain happens at the opening of the vagina when penetration begins. It might be caused by hormone changes, vaginal or vulvar dryness, ongoing irritation, an infection or some kind of injury.
• Positional pain: This pain often ties to issues with your pelvic floor muscles, vaginal dryness or infections.
• Deep pain (collision dyspareunia): Pain during deep penetration often happens. Certain sexual positions can make it feel stronger. Conditions like pelvic floor problems, endometriosis, issues with the bladder or bowel or even pelvic congestion syndrome may cause this.
• Discomfort during sex can be classified as primary, secondary, complete, or situational:
• Primary pain refers to pain that has been present since the start of sexual activity.
• Secondary pain appears after having sex without any previous pain.
• Complete pain happens every single time you have intercourse.
• Situational pain occurs under certain circumstances.

Possible Causes of Discomfort During Sex

Most women who feel pain during sex often have an understandable reason behind it. Some common causes of painful sex are:

• Sexual transmitted diseases (STDs): STDs like chlamydia or gonorrhea often irritate the vagina, which can make sex hurt.
• Genital herpes: The blisters and sores from herpes often make penetration painful.
• Vaginitis: Vaginitis happens when there’s inflammation in the vagina. Bacterial infections or yeast overgrowth (caused by candida fungus) may cause itchiness, discharge, soreness, and irritation.
• Past injuries: Women who have delivered large babies might experience small tears in the vaginal tissue. These happen more often when forceps are used during delivery. These tears tend to heal over time, but sometimes may remain unhealed. This results in discomfort or irritation during sexual intercourse.
• Lower oestrogen levels: Some women after menopause may see a drop in oestrogen. This can make the vaginal lining thinner and less elastic. In these cases, sex could cause tiny cuts that lead to discomfort or irritation.
• Lichen sclerosus: Some postmenopausal women may have lichen sclerosus where the skin on the genitals becomes itchy, flaky, and swollen.
• Past sexual trauma or harm: Women who went through sexual abuse might connect sex with pain. This can result in their muscles becoming tight.

Diagnosis

The doctor will ask about your sexual history and do an internal exam to check for issues. If the doctor thinks you might have a yeast infection or bacterial vaginosis, they will collect a sample of your vaginal discharge. Doctors also test vaginal pH levels since a high pH suggests vaginosis. In contrast, a normal pH level is more common with a yeast infection. During the exam, the doctor inspects both the vagina and the vulva, which is the outer area of the genitals, to identify any lesions that might be causing discomfort. You may also need to take a urine test or provide a vaginal swab to check for transmitted diseases.

Steps to Reduce Pain During Sex

Options to address painful sex depend on its cause. Some common treatments include:

• Topical oestrogen creams: To rebuild vaginal skin's thickness and flexibility when thinning or inflammation, like vaginal atrophy is present.
• Antibiotics: To treat bacterial vaginosis or STDs Antifungal creams or tablets: For yeast infections