Dyspareunia or Pain During Intercourse – How to Treat It?

Lack of intimate lubrication can be one of the reasons women complain about dyspareunia. Dyspareunia is nothing more than discomfort or pain during sexual intercourse for various reasons and can affect both women and men; however, women suffer much more from this problem¹.

In these situations, the vagina can become extremely dry, and sexual intercourse turns into a torment! The woman may start avoiding her partner for fear of pain during intercourse.

Affected Age Group

Dyspareunia can affect women of reproductive age, from 20 to 45 years old, for various reasons, and one of them is low estrogen and sometimes testosterone. Estrogen is the main hormone responsible for natural female lubrication.

But the issue mainly affects women who are going through menopause, or even during the climacteric phase (pre-menopause), precisely due to the sharp drop in estrogen.

After a certain age, hormonal levels of the reproductive system begin to fall, which causes thinning of the cervix, also leading to pain during sexual intercourse. However, dyspareunia is a very serious problem for couples who want to get pregnant.

Pain during sexual intercourse can interfere with these plans. Besides pain during intercourse, there are problems such as burning after intercourse, pain in the lower abdomen afterwards, and other unpleasant symptoms. Moreover, lack of sexual desire will make the couple’s sex life tense due to the woman’s low libido.

Causes and Symptoms of Dyspareunia

Cystitis or Urinary Tract Infection

Women with recurrent urinary tract infections or even isolated cases may feel lower abdominal pain after intercourse. That’s because the bladder is a very close organ to the uterus, being “pushed” during sexual intercourse. Treating cystitis tends to eliminate pain during intercourse².

Vulvovaginitis

Candidiasis and other fungi cause uncomfortable symptoms for women, such as itching and burning after intercourse, which are quite common³. Treatment for this problem is simple, but should be prescribed by a gynecologist. Usually, it involves creams or antifungals such as metronidazole, for example.

Fissures

Vaginal fissures are one of the main complaints of pain during sexual intercourse⁴. Friction during intercourse becomes painful, especially if there is not enough lubrication, and can even worsen the fissures.

These fissures can cause some infections and worsen the problem. These infections can interfere with conception for couples of reproductive age, so the ideal is to treat the fissures according to medical advice and also use an appropriate gel to help vaginal lubrication during intercourse and even day-to-day, to help with daily movements and when exercising.

Endometriosis

Endometriosis is nothing more than part of the endometrium (menstrual blood) coagulated outside the uterus. This causes intense pain during penetration in sexual intercourse, but also during the menstrual period⁵.

Women with endometriosis also commonly have fertility problems. Women with endometriosis face the opposite problem of low estrogen: the excess of this hormone leads to abnormal menstrual production which causes pain during intercourse due to blood accumulated outside the uterus.

Treatment for endometriosis is with medication; the doctor may opt to stop the woman’s menstruation with medication, and in more severe cases, surgically remove the clots accumulated outside the uterus. These treatments can help natural pregnancy happen.

Infections

Uterine, tube, or ovarian infections can cause pain, and this is the main symptom. That’s because the infection itself makes the woman extremely sensitive, especially if she has sex during this time.

Diagnosis of infections is through tests such as Pap smear, oncotic cytology, and MRI, and in more severe cases, a biopsy. Treatment involves creams or, at times, specific antibiotics for the type of bacteria causing the infection.

Low Vaginal Lubrication

A woman’s natural cervical mucus helps make intercourse pleasurable for both her and her partner. The stimulation she receives in foreplay leads to vaginal wetness, swelling, and readiness for penetration.

However, some women, either due to low hormonal levels or other reasons, do not have this lubrication in sufficient quantity or do not have it at all, leaving the vagina very dry and without the swelling that facilitates penetration and female orgasm.

This hormonal drop can happen at any time in reproductive life for several reasons, but especially in women who are prone to irregular menstruation due to lack of stimulation from fertility hormones:

• FSH
• Progesterone
• Estrogens

A drop in these hormones will reduce the partner’s sexual appetite, cause poor lubrication, and consequently pain during intercourse. There are some tricks to overcome poor lubrication during sexual intercourse.

How to Overcome Lack of Lubrication

Change sexual position: The couple should look for a more comfortable position for the woman during intercourse. Usually, it is one where the woman feels more at ease or can control penetration speed and intensity.

Vaginal elasticity exercises: Pompoir (vaginal muscle exercises) is a technique that helps with vaginal elasticity. There are many exercises, including inserting pompoir balls. Training with these balls, over time, strengthens the muscles and allows the woman to control vaginal elasticity during sex to avoid pain during intercourse.

Using Proper Lubricants

Using lubricants similar to a woman’s natural vaginal lubrication will ease pain and vaginal dryness. Before intercourse or even during daily life, it brings greater comfort to the woman. For sexual intercourse, intimate lubricant offers comfort and also reduces penetration friction, and consequently, pain in the lower abdomen after intercourse.

Lubricant for Getting Pregnant

60% of couples who want to get pregnant and have some problem with dyspareunia also suffer from issues with female lubrication. That’s because a woman who wishes to get pregnant can become tense and anxious for sexual intercourse to result in pregnancy, and therefore may not have ideal lubrication or the right conditions for sperm to survive until they reach the tubes, and consequently feel pain during intercourse. If you choose to use a lubricant while trying, always prefer a water-based lubricant.

See also: Vaginal Pain – Main Causes and Treatment