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Painful Sex In Women (Dyspareunia): Symptoms, Causes and Treatment

Dyspareunia is a condition that occurs when a patient feels unusual pain in the genital or pelvic region during or after sex. 

Women commonly experience dyspareunia, and the pain can fluctuate or vary from minimal to moderate or very severe. 

The pain experienced due to this condition keeps the act of sex non-pleasurable for the woman and causes a strain in couples’ intimacy and sexual life.



Several factors such as physical, emotional, and medical conditions can result in painful sex in women. Some of these factors are: 

  • Low oestrogen levels: Oestrogen is one hormone that maintains women’s reproductive and sexual development. When the body is low on estrogen, it interferes with sexual development and functions. 
  • Menopause: Menopause refers to the period of natural cessation or stopping of a woman’s menstrual cycle. During menopause, women usually suffer vaginal atrophy, which may cause pain during sex.
  • Endometriosis: Endometriosis is a disorder in which tissue that lines the inside of the uterus or womb grows outside the uterus. During sex, women with this condition often suffer pain, as penetration can pull or stretch irritated endometrial tissues. 
  • Insufficient vaginal lubrication: Vaginal dryness in women caused by several factors such as low libido, insufficient arousal, douching and declined estrogen cause pain during sex.
  • Vaginal atrophy: A condition characterised by the thinning and drying of the walls of the vagina, vaginal atrophy result in painful sex in women. 
  • Uterine Fibroids: Uterine fibroids are growths in the uterus. Depending on their size and location, they pressure the uterus and cause pain during sex.
  • Vaginal Infections or Injuries: When the vagina is inflamed or infected, sex can be excruciating for the woman. Examples of vaginal injuries are tears during childbirth, pelvic surgeries, e.t.c.
  • STDs: Sexually transmitted diseases such as chlamydia and gonorrhoea also cause painful sex
  • Vaginismus: Vaginismus is a subconscious reaction to the fear of being hurt. This fear might be caused or influenced by internal sexual beliefs, religion, physical or sexual trauma.
  •  Stress.
  • Cystitis: A urinary tract infection, cystitis causes inflammation and pain during sex.

Other causes include

  • Psychological trauma: Stressful events and experiences (mental or physical) affect our bodies and minds’ ability to relax and enjoy sex. 
  • Vaginitis: An inflammation of the vagina, vaginitis is a condition that can result in pain during sex.
  • Anxiety: Over worrying during or about sex can also cause pain during sex.
  • Use of medications that cause vaginal dryness. Examples include antihistamines and benzodiazepines.
  • Sex immediately after delivery, etc.

How To Know Which Pains Are A Symptom

To ascertain whether a pain you are experiencing during sexual activity could indicate dyspareunia, you will need to answer questions like:

1.    When the pain started.

2.    Where you feel pain.

3.    Whether the pain is limited to sexual activities.

4.    If you possess any other conditions that could be causing the pain.

For an accurate diagnosis, you will also need to see your gynaecologist, who might recommend any of the following:

1.    A pelvic examination. 

2.    Ultrasound.

3.    Culture test.

4.    Urine test.

5.    Pap smear.

6.    Counseling (when your doctor thinks your symptom(s) psychological).

Treatment For Painful Sex

Treatment of dyspareunia or painful sex in women is dependent on the underlying causes and symptoms of the prognosis. 

While medical treatment is required to treat prognosis caused by medical conditions like fibroids, STDs, etc., it’s unnecessary for all treatments. An example is a pain caused by sex immediately after pregnancy.

After determining your prognosis through an analysis of your sexual history, pelvic exam, or tests, a doctor may recommend medications, lifestyle changes, or sex therapy. Should the underlying cause be an infection, a doctor will prescribe antibiotics and antifungal medications to relieve symptoms. Asides from these, when the cause of the condition is low oestrogen, tablets and creams might be prescribed by your doctor to increase oestrogen. 

Other treatments commonly recommended include:

1.    Adequate foreplay.

2.    Use of lubricants, predominantly water-based lubricants.

3.    Pain medications before sex.

4.    Sex counselling and therapy.

5.    Pelvic/vaginal exercises.

How Can I Enjoy A Happy Sexual Life While Waiting For My Symptoms To Subside?

An essential step to enjoying sex and improving your sexual life is by identifying and treating your condition. However, while you work on treatment, you and your partner can explore non-penetrative sex to build your intimacy. There are quite a number of alternatives available for you may choose to embrace.

Note From Afriglobal Medicare

Please shun all embarrassment and speak to your healthcare provider about your sexual health. If uncomfortable with any of your healthcare providers for any reason, you can talk to a different healthcare provider or a higher staff.

Also, read more about STIs here to protect yourself and reduce your chances of suffering dyspareunia. You can also book your STI tests with us online or walk into any Afriglobal Medicare centre to carry out your tests. 

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