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(Painful Sexual Intercourse)
- Postpartum period after childbirth
- Vaginal infections, such as yeast vaginitis
- Postmenopausal atrophic vaginitis—irritation of the vaginal mucosa due to lack of estrogen
- Herpes or genital warts
- Pelvic inflammatory disease —serious infection of the female reproductive organs
- Urinary tract infection
- Problems affecting the pelvic bones
- Abnormal orientation of the uterus called retroversion
- Chronic constipation
- Previous sexual trauma, such as rape or abuse
- Feelings of guilt
- Negative attitudes toward sex
- Being postmenopausal
- Taking medications that produce a vaginal dryness
- Occur during or after sex
- Be itching, burning, stabbing, or aching
Be located in the:
- Occur during all phases of sexual contact or only with deep thrusting
- May also occur with tampon use—fabric absorbs natural vaginal lubricant
|Female Reproductive System|
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Your vaginal wall will be checked for:
- Signs of dryness
- Genital warts
An internal pelvic exam will be done to look for:
- Abnormal pelvic masses
- Signs of endometriosis
- Your doctor may suggest more tests. They may include cultures to find infections. Imaging studies like an ultrasound may also be used.
- You may be referred to a counselor. This will help to determine whether psychological issues may be a cause.
- Your doctor may recommend that you use water-soluble lubricants or creams that contain estrogen. Other medications may be prescribed, as well.
- Infections may be treated with antibiotics or antifungal medication.
- Inflammation and dermatitis may be treated with topical or injectable corticosteroids.
- Viral infections like herpes and genital warts will need to be treated.
- Endometriosis may be treated with medications. In some cases, surgery may be necessary.
- Antibiotic treatment
- Sitz baths—soaking the hip and buttocks area in warm water
- Avoiding alcohol and caffeine, which may be helpful for prostatitis
Men and Women
- Inner conflict
- Unresolved feelings about past abuse
- Need for self-punishment
- Wait at least six weeks before having sexual relations after childbirth. It may be necessary to use a lubricant because of hormonal changes causing vaginal dryness.
- Use proper hygiene and get routine medical care.
- Practice safe sex to prevent sexually transmitted diseases .
- Adequate foreplay and stimulation will help to ensure proper lubrication of the vagina.
- Use a water-soluble lubricant. Vaseline should not be used as a lubricant. It is not water-soluble, and it may encourage vaginal infections.
American Congress of Obstetricians and Gynecologists http://www.acog.org
FamilyDoctor.org—American Academy of Family Physicians http://familydoctor.org
Sex Information and Education Council of Canada http://www.sieccan.org
Sexuality and U—Society of Obstetricians and Gynaecologists of Canada http://www.sexualityandu.ca
Dyspareunia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 4, 2014. Accessed October 28, 2014.
Female sexual dysfunction. The American Congress of Obstetricians and Gynecologists, Practice Bulletin No. 119. April 2011.
Heim LJ. Evaluation and differential diagnosis of dyspareunia. Am Fam Physician. 2001;63(8):1535-1544.
Lightner DJ. Female sexual dysfunction [review]. Mayo Clin Proc. 2002;77:698-702.
- Reviewer: Andrea Chisholm, MD
- Review Date: 10/2014
- Update Date: 01/15/2014