Dyspareunia: we explain the pain during sexual intercourse

What is dyspareunia?

Dyspareunia is pain felt by women or men during sexual intercourse.

However, dyspareunia is a medical term that is more commonly used to refer to pain during sexual intercourse in women. Dyspareunia affects 20% of women in France.

A figure that is surely lower since many women do not mention the pain they feel during vaginal or even anal penetration. Although this is the most common case, pain does not only appear during vaginal penetration but also before or after.

And most often during these pains, the muscles of the pelvic floor contract abnormally ( due to secondary vaginismus for example). In all cases, a consultation with a specialist is necessary to determine the origin of these pains:

Rare physical causes:

• Congenital malformations of the vulva, hymen or vagina;
• Side effects of certain treatments (brachytherapy or radiotherapy);
• Infections: vulvovaginitis caused by mycoses, inflammations, STIs, etc.
• Diseases affecting the mucous membranes: lichen, for example;

All physiological causes: psychological and/or physical trauma (related to childhood, adolescence or adulthood), poor body image, harsh sex education, depression, anxiety, sometimes unconscious phobias of sexual intercourse, etc.

The different types of pain

There are two main forms of dyspareunia, superficial dyspareunia and deep dyspareunia .

Dyspareunia is said to be superficial when the pain is present from the beginning of penetration. The pain appears at the vulvar level…

Dyspareunia is said to be profound when the pain is felt deep in the vagina or even in the lower abdomen.

Furthermore, there are also 2 types of dyspareunia :

• We speak of primary dyspareunia when the pain has always been present, from the first sexual intercourse.
• When the pain appears at a later point in the life of a woman who has already had several previous sexual intercourses, we speak of secondary dyspareunia.

It's important to talk about it!

Sexual intercourse is above all a moment of pleasure. It is therefore important that these relations go wonderfully!

If any pain occurs, the first person to report it to is his/her partner so that he/she can adapt/change his/her behavior. Communication remains essential during sexual intercourse, it is the best tool to ensure that there is no confusion.

If the pain persists, it is better to take a short break to make an appointment with a sexual health professional. There is no shame or embarrassment in consulting because it is in no way your fault.

Other ways to nourish your sex life with your partner

However, it is entirely possible to have sex without penetration and have maximum pleasure! 😊

Some couples then develop a sexuality without penetration but lead a sexual life filled with pleasure through foreplay , oral sex , massages, caresses , etc. and therefore feel no need to consult.

Using a vibrator can also be an option! 🔥

"If it is impossible to insert a sex toy into the vagina, you can use clitoral massagers," Valérie Tasso logically announces.

Being patient with your body, following your desires, talking about it with a professional and lubricating your genitals or anus well when you try to use sex toys is the secret to a fulfilling sex life , even for people with vaginismus or dyspareunia!

If a couple consults while fulfillment is present despite vaginismus, it is usually to have a baby. Although this remains rare, it is possible for the woman to become pregnant without penetration and this by the so-called "syringe" method. However, if you wish to consult, do not hesitate to do so with your partner!

What are the causes of dyspareunia?

If you experience pain during intercourse, it is essential to identify the cause.

It is therefore important to consult your doctor or a gynecologist to subsequently lead a "normal" sexuality filled with pleasure. Many causes can be at the origin.

First of all, psychological causes. Dyspareunia can occur following a traumatic event related to the genital system. This sudden disorder can be the cause of sexual violence, a disastrous medical appointment, a fall, a strict education, a lack of information… This results in vaginismus, therefore an unconscious contraction of the perineal muscles .

Another reason for dyspareunia can be a medical cause such as endometriosis , pelvic inflammatory disease , ovarian cyst or even fibroid .

There are also psychological causes .

Pain occurs due to stress or apprehension.

Women with pain on penetration may experience intense fear of pain and anxiety before or during vaginal penetration, and when women anticipate a recurrence of pain during penetration, their vaginal muscles contract, making attempts at intercourse even more painful. However, most affected women can enjoy non-penetrative sexual activity. In these cases, the easiest way is often to communicate with your partner.

Proof that communication is the key to successful sex! 😊

Infections can also be the cause of pain during sexual intercourse. These can be vaginal mycoses, STIs or many others…

Besides these causes, there are also less common ones such as malformations in the female genital tract.

Depending on the origin of the cause, the pain can be more or less deep as seen previously. For example, if the pain results from endometriosis, it will be a deep pain so the pain will be felt at the bottom of the vagina or even in the lower stomach. However, if it is a psychological cause, the pain will be superficial.

What are the symptoms of dyspareunia?

Although it was previously said that the symptoms of dyspareunia are pain felt from the first contact during vaginal penetration, deep in the vagina or even in the lower abdomen and even before or after penetration, but what are the types of pain?

The pain may correspond to burning sensations , itching , tingling … however other symptoms may occur.

Indeed, other symptoms exist such as vaginal spasms (vaginismus), a decrease in libido , a drying of the vaginal wall or even a loss of confidence in women which can lead to depression. 😕

Treating dyspareunia is possible!

There are different treatments depending on the origin of dyspareunia. When pain is felt during vaginal penetration, it is important to listen to your body to better understand the symptoms and discuss them with your doctor or a gynecologist. They will then be able to give you the treatment best suited to your situation.

However, we can distinguish treatments in two different forms depending on the origin of the pain during sexual intercourse. If it is psychological pain, it is commonly recommended to consult a sexologist , a physiotherapist or even a psychologist to help you better understand the origin of this pain.

On the other hand, if it is a physical dyspareunia, it is highly recommended to use an intimate gel if the pain results in vaginal burning. You can also spend more time on foreplay ... maybe your body is not feeling enough pleasure yet.

If so, do not hesitate to use communication treatment with your partner, a free and very effective treatment 😊.

How to avoid/prevent dyspareunia? 

• consult a doctor in case of recurring pain during sexual intercourse in order to detect the cause;
• use topical lubricants in case of vaginal dryness , especially during sexual intercourse. Hormonal treatments or the use of vaginal laser may be recommended in case of vaginal dryness linked to menopause;

• wear cotton underwear;
• favor period panties (preferably cotton) over sanitary towels and tampons;
• use a suitable soap that respects the genital flora. Avoid deodorants and intimate freshness sprays;
• avoid wearing panty liners too often
• do not do vaginal douches;
• consult a sexologist or couples therapist in the event of relationship difficulties with your partner;
• address psychological issues that contribute to and result from chronic pain;
• extending the time of foreplay can help optimize desire and vaginal lubrication ;
• quickly treat vaginal or urinary inflammations/infections; 
• avoid sexual intercourse if there are lesions in the genital area. Treat these;
• consult a psychologist or psychiatrist in the event of post-traumatic psychogenic dyspareunia (history of sexual abuse, intense pain during childbirth, etc.) or vaginismus;
• avoid the use of latex (or other allergens) if allergic;
• treat chronic stress (yoga, relaxation, meditation, hypnosis, sophrology, etc.);
• maintain a healthy lifestyle (balanced diet, regular physical activity, etc.).

In case of deep dyspareuria, penetration can be avoided and replaced by other practices, there are other ways to masturbate, and for that, here is a whole guide. 😍

Know this : you can have just as much pleasure during sex, if not more, without penetration. Especially since the female orgasm is not produced by the vagina but by the clitoris.