Painful sex, or dyspareunia, is discomfort during or after sexual intercourse. It’s a common issue affecting many women and can stem from physical, emotional, or hormonal causes.
Common Symptoms
- Burning, stinging, or sharp pain at the vaginal opening or deeper in the pelvis.
- Bleeding or spotting after intercourse.
- Vaginal dryness or tightness.
- Anxiety, stress, or avoidance of intimacy.
Possible Causes
Physical Causes
- Infections: Yeast infections, UTIs, or STIs.
- Hormonal Changes: Menopause, breastfeeding, or hormonal contraceptives (causing vaginal dryness).
- Medical Conditions: Endometriosis, pelvic inflammatory disease (PID), vulvodynia, or vaginismus (involuntary muscle spasms).
- Skin Disorders: Lichen sclerosis or eczema.
- Scar Tissue: From childbirth, surgery, or trauma.
Emotional/Psychological Causes
- Stress, anxiety, or depression.
- Past trauma or relationship difficulties.
Diagnosis:
- History: Your gynaecologist with discuss symptoms, medical background, and emotional well-being.
- Pelvic Exam: To check for infections, muscle tension, or abnormalities.
- Tests: Swabs, urine tests, or ultrasounds may be needed.
Treatment Options
Medical Treatments
- For Infections: Antibiotics or antifungals.
- For Dryness:
- Water-based lubricants (e.g., KY Jelly).
- Vaginal oestrogen creams/tablets (for menopause-related dryness).
- For Muscle Spasms: Pelvic floor physical therapy.
Psychological Support
- Counselling or sex therapy to address anxiety, trauma, or relationship concerns.
Frequently Asked Questions
Q: Is painful sex normal?
A: While common, it’s not something you should endure. Treatment can help!
Q: Can lubrication alone fix the problem?
A: Sometimes, but persistent pain needs medical evaluation.
Q: Will this affect my fertility?
A: Not directly, but underlying conditions (e.g., endometriosis) might. Your doctor can advise.
Q: How long until I feel better?
A: Many see improvement within weeks of treatment. Chronic cases may take longer but are manageable.
eGynaecologist Advice:
- You should consult a gynaecologist if pain persists for weeks or worsens and if you experience bleeding or unusual vaginal discharge
- Pelvic floor exercises or yoga helps to reduce tension while good hydration can help maintain vaginal moisture.
