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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 medicines 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 doctor will check your vaginal wall to look for:
- Signs of dryness
- Genital warts
Your doctor will also do an internal pelvic exam 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 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 medicines may be prescribed, as well.
- Infections may be treated with antibiotics or antifungal medicine.
- 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 medicines. 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 Academy of Family Physicians http://familydoctor.org
American Congress of Obstetricians and Gynecologists http://www.acog.org
Sex Information and Education Council of Canada http://www.sieccan.org
Sexuality and U The Society of Obstetricians and Gynaecologists of Canada http://www.sexualityandu.ca
Dambro M. Griffith's 5-Minute Clinical Consult . Philadelphia, PA: Lippincott Williams & Wilkins; 2001.
Dyspareunia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated February 28, 2013. Accessed March 12, 2013.
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.
Ryan K, Kistner R. Kistner's Gynecology & Women's Health . 7th ed. St. Louis, MO: Mosby, Inc; 1999.
- Reviewer: Andrea Chisholm, MD
- Review Date: 12/2013
- Update Date: 00/11/2014