This
problem is so emotional and sensitive that many woman find it difficult to consult
a physician. But it's important to seek treatment, and in many cases the cause
is a physical illness that can be treated.
Painful
intercourse, which a doctor may call dyspareunia, is a burning, tearing, ripping,
or aching sensation associated with penetration. The pain can be at the vaginal
opening, deep in the pelvis, or anywhere in between. It also may be felt throughout
the entire pelvic area and the sexual organs, and may occur only with deep thrusting.
The
most common explanation is irritation of the vagina caused by having intercourse
without sufficient arousal and lubrication. This experience can create a vicious
circle, leading a woman to fear intercourse which in turn makes it more difficult
to become aroused. Women who have had a hysterectomy or mastectomy may have problems
with arousal because of feelings of incompleteness. Stress or problems in your
relationship with a partner can also block arousal. Counseling can help address
these psychological issues, and over-the-counter lubricants (consult your doctor
or pharmacist) can increase lubrication and reduce discomfort.
Another
frequent explanation for painful intercourse is thinning and drying of the vaginal
tissue as menopause begins. This happens because the body is producing less and
less of the estrogen that is needed to maintain moist vaginal tissue. As the vagina's
ability to make its own mucus declines, it becomes dry, itchy, and painful, leading
to discomfort during intercourse. Estrogen creams and lubricating gels can help
restore moisture, as can estrogen replacement therapy taken in pills or through
a patch on the body.
Unintentional
muscle spasms of the thighs, pelvis, and vagina can make penetration impossible.
This condition, called vaginismus, can develop along with any of the other causes
of painful intercourse described here or can result from psychological factors.
A traumatic sexual experience, rape, or an irrational fear of genital injury can
lead to vaginismus. Counseling can be helpful.
Other
causes of painful intercourse include:
Infection—vaginal,
pelvic, herpes, infected cysts or boils Scars, tumors, or anything that narrows
the vagina Endometriosis (uterine tissue growing outside the uterus with bleeding,
pain and scarring) Intact hymen (in virginal young women) Complications
of surgery Diseases that interfere with the physical process of arousal or
orgasm (such as diabetes and multiple sclerosis)
