Dyspareunia (painful sex)

Dyspareunia is the term that specifically relates to a feeling of pain during or after sexual intercourse. Dyspareunia is extremely common amongst women who have pelvic pain. The underlying cause can vary from woman to woman, and treatment may be frustrating and time-consuming, often requiring a multifaceted approach.

Common causes of dyspareunia include:

• Menopause
• Anxiety
• Postural issues
• Muscle spasms
• Lichen sclerosus
• Sjögren's syndrome
• Cancer treatment
• Cysts, genital warts, genital herpes, or other lesions or abrasions within the vulva or vagina
• Scarring from childbirth, episiotomy (an incision made by surgeons to facilitate birth), laceration repair or other vaginal surgery
• Cystitis or other Urinary Tract Infections (UTIs)
• Resuming intercourse after a prolonged period of abstinence
• Irritation or allergy to some moisturisers, lubricants, spermicidal creams or gels
• Breastfeeding can lead to vaginal dryness and therefore painful intercourse
• Pelvic Inflammatory Disease (PID)
• Endometriosis
• Pelvic organ prolapse
• Psychological factors

Diagnosing dyspareunia involves a physical examination, along with a thorough review of symptoms based on medical and sexual history. It’s important to provide the therapist with details such as the exact location, duration, timing, and frequency of the pain, as well as whether previous intercourse was also painful.

This information helps the therapist identify key factors and determine the appropriate course of treatment.