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Dyspareunia

 

What is dyspareunia?

Dyspareunia is the medical term for ‘painful intercourse’.
‘Dys’ means bad or difficult
Pareunia: ‘Par’ + ‘unia’ = pairing or sexual union, so, sexual intercourse.
It is a general term used to describe all types of sexual pain.
Sexual pain can occur during or after the sexual intercourse.
It can exist anywhere in the genital area – the clitoris, labia, vagina, or the lower abdomen.
If you experience painful intercourse, you may feel:
– Pain only at sexual penetration (entry)
– Pain with every penetration, even while putting in a tampon
– New pain after previously pain-free intercourse
– Deep pain during thrusting
– Burning pain or aching pain
– Throbbing pain, lasting hours after intercourse
Physical causes of painful intercourse differ, depending on whether the pain occurs at entry or with deep thrusting. Emotional factors can be associated with many types of painful intercourse.

Entry pain:
Pain during penetration may be due to:
– Insufficient lubrication. Mainly as a result of not enough foreplay, after menopause or childbirth or during breast-feeding.
– Certain medications are known to inhibit desire or arousal, which can decrease lubrication and make sex painful. These include antidepressants, high blood pressure medications, sedatives, antihistamines and certain birth control pills.
– Any injury or irritation from an accident, pelvic surgery, female circumcision or a cut made during childbirth to enlarge the birth canal (episiotomy).
– An infection in your genital area or urinary tract can cause painful intercourse. Eczema or Bartholin gland cyst or abscess can give you pain with sexual intercourse.
– Discrepancy between the size of the penis and that of the vagina. A very large penis might cause pain to the partner’s vagina.
– Vaginismus. Involuntary spasms of the muscles of the vaginal wall (vaginismus) can make attempts at penetration very painful.
– Congenital abnormality. A problem present at birth, such as the absence of a fully-formed vagina (vaginal agenesis) or development of a membrane that blocks the vaginal opening (imperforate hymen), could be the underlying cause of dyspareunia.

Deep pain:
Deep pain usually occurs with deep penetration and may be more pronounced with certain positions. Causes include:
– Certain illnesses and conditions: endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, hemorrhoids and ovarian cysts.
– Surgeries or medical treatments. Scarring from pelvic surgery, including hysterectomy, can sometimes cause painful intercourse. Medical treatments for cancer, such as radiation and chemotherapy, can cause changes that make sex painful.
There are also Emotional factors involved:
Emotions are deeply intertwined with sexual activity and may play a role in any type of sexual pain. Emotional factors include:
– Psychological problems. Anxiety, depression, concerns about your physical appearance, fear of intimacy or relationship problems can result in discomfort or pain.
– Stress. Your pelvic floor muscles tend to tighten in response to stress in your life. This can contribute to pain during intercourse.
– History of sexual abuse. Most women with dyspareunia don’t have a history of sexual abuse, but if you have been abused, it may play a role.

It is important to bear in mind that vaginismus can co-exist with any condition that causes dyspareunia. Vaginismus may also continue to be present even after the original cause has been resolved or managed.

Normal sexual intercourse should not cause you any pain. If it does, it can harm your sex life, your emotional intimacy and your self-image. It might also be a sign of life- threatening medical condition. That’s why it’s important to seek medical help if you experience dyspareunia.

I wish you the best of health.

Vaginismus

Vaginismus is a condition where there is involuntary tightness of the vagina during attempted intercourse. The tightness is actually caused by involuntary contractions of the pelvic floor muscles surrounding the vagina. The woman does not directly control or ‘will’ the tightness to occur; it is an involuntary pelvic response. She may not even have any awareness that the muscle response is causing the tightness or penetration problem.
In some cases vaginismus tightness may begin to cause burning, pain, or stinging during intercourse. In other cases, penetration may be difficult or completely impossible. Vaginismus is the main cause of unconsummated relationships. The tightness can be so restrictive that the opening to the vagina is ‘closed off’ altogether and the man is unable to insert his penis. The pain of vaginismus ends when the sexual attempt stops, and usually intercourse must be halted due to pain or discomfort.
Types of vaginismus
When a woman has never at any time been able to have pain-free intercourse due to this muscle spasm; her condition is known as primary vaginismus. Some women with primary vaginismus are unable to wear tampons and/or complete pelvic exams. Many couples are unable to consummate their relationship due to primary vaginismus.
Vaginismus can also develop later in life, even after many years of pleasurable intercourse. This type of condition, known as secondary vaginismus, is usually precipitated by a medical condition, traumatic event, childbirth, surgery, or life-change (menopause).
Vaginismus is a common cause of ongoing sexual pain and is also the primary female cause of sexless (unconsummated) marriages. Sexual pain can affect women in all stages of life; even women who have had years of comfortable sex. While temporarily experiencing discomfort during sexual intercourse is not unusual, ongoing problems should be diagnosed and treated.

Examples of Vaginismus – In the vaginismus condition, as the man approaches the woman, her PC muscle group involuntarily tightens the vaginal entrance making intercourse painfully impossible or penetration may be successful but may result in burning, discomfort, and pain.
So, is this problem t reatable?
Vaginismus is highly treatable and a full recovery from vaginismus is the normal outcome of treatment. Successful vaginismus treatment does not require drugs, surgery, hypnosis, nor any other complex invasive technique. Following a straight-forward program, pain-free and pleasurable intercourse is attainable for most couples.

Here’s a summary of how the treatment works in 4 steps:

Step 1 – Understanding Sexual Anatomy and Vaginismus Women often lack complete information about their body’s sexual anatomy, function, and the causes of sex pain. Confusion regarding problems with inner vaginal areas and vaginal muscles frequently lead to misdiagnosis and frustration. That’s why it’s very important to start solving the vaginismus problem with anatomy and physiology education. Step 2 – Sexual History Review & Treatment StrategiesEmotional reviews help detail any negative events, feelings, or memories that may collectively contribute to involuntary pelvic responses. Topics also include blocked or hidden memories and how to move forward when there have been traumatic events in a woman’s past. In some conservative communities the problem might be more common due to the fact that raising girls with the belief that sex is a taboo will make it more difficult for them to enjoy sexuality after marriage. Step 3 – Vaginal Tightness & The Role Of Pelvic Floor Muscles Learning how to identify, selectively control, exercise and retrain the pelvic muscles to reduce pain and alleviate penetration tightness and difficulties is an important step in vaginismus treatment. Step 4– Graduated Vaginal Insertions When used properly, vaginal dilators are effective tools to further help eliminate pelvic tightness due to vaginismus. Graduated vaginal insertion exercises allow women to comfortably transition to the stage where they are ready for intercourse without pain or discomfort. // The final step toward overcoming vaginismus includes penis entry with movement and freedom from any pain or tightness.
Have patience. Do not rush it. The treatment might take weeks or months but it will eventually help you get a normal sexual life. Use relaxation techniques. Focus on breathing deeply in and out. Listen to music and think of happy things. Keep remembering that sexuality is beautiful and fulfilling and a pure expression of love.
All the best to you.