What is dyspareunia and what treatment for pain during intercourse?

Pain is never a good symptom, and when it is linked to an activity that should be pleasurable, it becomes an even more unpleasant condition. And, as a sex expert, I say that it is not uncommon to hear reports of women who experience pain during sex, and that, therefore, they are unable to have a healthy sex life. Have you heard of dyspareunia ? That’s what we’re going to talk about today!

Pain is never a good symptom, and when it is linked to an activity that should be pleasurable, it becomes an even more unpleasant condition. And, as a sex expert, I say that it is not uncommon to hear reports of women who experience pain during sex, and that, therefore, they are unable to have a healthy sex life. Have you heard of dyspareunia ? That’s what we’re going to talk about today!

To learn more about dyspareunia, see the video below:

A study, done in 2008 and published by the magazine Menopause, revealed that 40% of women suffer from dyspareunia, a condition that makes penetration extremely painful. But these numbers are inaccurate, since most women who feel discomfort during sex end up not looking for help out of shame or because they think they have an unsolved problem. Therefore, the incidence of dyspareunia tends to be even greater than we imagine.

Although it is a very frequent disorder, little is said about it, which is a tremendous mistake, since it prevents women from developing a pleasurable sex life.

Have you ever thought of associating sex with pain, to the point of having no desire to have sex? With that in mind, I have prepared three topics that will help put dyspareunia on the agenda.

  • Demystifying dyspareunia
  • How to treat this dysfunction?
  • At what age does dyspareunia usually manifest?

In the end, I am sure that if you experience these frequent pains during sex, you will be much safer to seek medical help, in the same way that, if you do not live with the dysfunction, you will be able to help close friends who may be going through this situation.

Demystifying dyspareunia

As we have already seen, dyspareunia is the name given to frequent pain during sex, which can be classified in two ways: superficial, when discomfort is felt at the entrance of the vagina, at the opening of the urethra or in the clitoris, or deep, when there is the presence of pelvic pain.

But more important than knowing its meaning is to understand what leads women to live with dyspareunia.

The main causes of dyspareunia

As it can manifest itself with different intensities, from mild discomfort to acute pain, and causes suffering and relationship difficulties, medicine divides this dysfunction according to two distinct causes: the physical ones, caused by some problem in the body, and the psychological ones , when the woman presents pictures that lead to a sexual block.

Physical causes of dyspareunia

Among the physical causes, the most common are infections in the vulva and vagina, such as those caused by candidiasis, genital herpes, trichomoniasis, for example, problems of lubrication of the vaginal mucosa due to hormonal imbalance, allergic reactions, such as those caused by certain lubricants and condoms, inflammatory processes such as endometriosis, urinary infections and vaginal narrowing.

In these cases, 95% of the episodes are considered to be transient and only 5% can be considered as originating from a specific physical cause. The important thing is to be able to identify when the pain or discomfort exceeds the expected limit, and begins to significantly interfere with sexual life.

Psychological causes of dyspareunia

In addition to physical issues, many women end up experiencing pain during sex due to emotional problems. And we know very well how much the psychological has the power in the most varied sectors of life, right? With the sexual, it would be no different.

Among the most frequent emotional and psychological causes that lead to dyspareunia are the experience of having experienced sexual abuse at some stage of life, which causes a mechanism to associate sex with something wrong and that hurts, past relationships traumatizing or without any pleasure, especially when the woman is conditioned to maintain a sexual life just to satisfy the man, in order to sustain a relationship without seeing a particular meaning in the act itself, a repressive education in childhood, without dialogues about sex , diagnoses such as depression and anxiety, which can act directly on the libido and cause a lack of sexual appetite, vaginismus and a lack of knowledge about sexuality itself, especially when viewing sex as a taboo.

Dyspareunia symptoms

The symptoms of dyspareunia include a long list of sensations associated with genital discomfort such as pain, burning and even itching.

These discomforts can appear at any time during intercourse; whether at the beginning, during or at the end of it.

They can also vary depending on the area in which they are experienced; on the outside of the vagina, on the inside or in the pelvic area.

Types of dyspareunia

Dyspareunia can be classified according to where the pain is present:

  • Superficial: it occurs in the vulva, on the lips or in the external area of ​​the vagina, just before the introduction of the penis.
  • Vaginal: consists of the sensation of burning or burning in the entire vaginal canal, when penetration occurs and which becomes more intense due to the movements of the penis.
  • Deep pain is felt when the penis penetrates deep into the vagina (cervix). There are sexual postures that can cause this discomfort produced by a pain that is felt in the lower part of the belly.

Consequences in the relationship

Dyspareunia can prevent a woman from enjoying sex. Over time, she may end up avoiding them completely in order not to be forced to face the pain.

Many women endure this situation and resign themselves, but of course the medium-term effects on the relationship and complicity between the couple are devastating. The man also suffers because he feels guilty about the pain he causes in his partner, when what he wants is the exact opposite.

Dyspareunia x Vaginismus

The vaginismus is involuntary spasmodic contraction and the perineum ( the muscles surrounding the vagina) that prevents penetration.

Dyspareunia, on the other hand, is the term by which we define the pain that appears at the time of penetration. Unlike vaginismus, dyspareunia does not prevent the relationship, but it makes it painful. Over time, the meetings between the couple end up spreading due to the apprehension of the pain that this causes in the woman (or in the man) until the end of a complete rejection of sex.

Although both disorders are different, sometimes they go hand in hand. A woman who initially suffers from vaginismus may also end up suffering from dyspareunia, as she assumes that the pain that prevented penetration (vaginismus) is intrinsic to the sexual relationship itself, which prevents her from relaxing and enjoying the moment.

How is dyspareunia treated?

f it is a dysfunction experienced by most women, it goes without saying that the diagnosis is the first step to be able to treat it, right?

When observing frequent pain during intercourse, it is important to consult a trusted gynecologist. The diagnosis is made from the analysis of three aspects: the patient’s report about the episodes and symptoms, the clinical and laboratory exams.

After talking to the patient about where the pain is, when it appeared, whether it is frequent in relationships, on the clinical examination, the doctor will be able to identify possible physical causes. In addition to this, other laboratory tests, such as secretion analysis and ultrasound, may be necessary.

Once the causes of dyspareunia are identified, if these are clinical, the gynecologist will prescribe the most appropriate approach and treatments to solve the problem, and, consequently, pain during sexual intercourse.

Now, if after this analysis, nothing physical is diagnosed, the doctor refers the patient to a consultation with a psychologist, to assess the condition and what leads to pain.

Types of treatment


If an infection or medical condition is contributing to your pain, treating the underlying cause can resolve your problem. Changing medications that are known to cause lubrication problems can also eliminate symptoms.

For most postmenopausal women, dyspareunia is caused by insufficient lubrication as a result of low estrogen levels. This can often be treated with a cream, pill or flexible ring that releases very small amounts of estrogen directly into your vagina.


Different types of therapy can also be useful, including:

  • Desensitization therapy – During this therapy, you will learn vaginal relaxation exercises that can lessen the pain. Your therapist may recommend pelvic floor exercises (Kegel exercises) or other techniques to decrease pain during intercourse.
  • Sexual counseling or therapy – If sex has been painful for a long time, you may experience a negative emotional response to sexual stimulation, even after treatment. If you and your partner have avoided intimacy due to painful intercourse, you may need help to improve communication with your partner and restore sexual intimacy. Talking to a sex therapist can help solve these problems.

At what age does dyspareunia usually manifest?

As we have seen, pain during sexual intercourse can happen for different reasons, from physical to psychological, but is there a time in life when they are more frequent? Yes!

In addition to the onset of sexual life, dyspareunia is more frequent in women who are in the post-menopausal phase , or in those who have undergone an episiotomy delivery.

That’s because older women, at this stage of life, go through a hormonal decline, mainly from estrogen, responsible for intimate lubrication. In addition, over time, the vagina loses its elasticity, which can also cause pain during intercourse.

Some recommendations

  • Don’t be ashamed and look for a professional: if you have discomfort during your sexual relations, don’t resign yourself and look for professionals as soon as possible so that they can help you fully enjoy your sexuality. Painful intercourse can end up associating pain with sexual intercourse, which can cause a loss of libido.
  • Use lubricants that facilitate intercourse.
  • Make sexual positions that are more pleasurable for you and do not force you so much.
  • Give importance to the preliminary games to reach an ideal state of excitation and lubrication.
  • Take care of your vaginal muscles and your pelvic floor and do pompoir exercises


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