What is dyspareunia?
Pain during intercourse is more common than you think. It can stem from a variety of things including infection or illness, muscle dysfunction, and psychosocial factors – but medically speaking, painful intercourse is called dyspareunia (dis-puh-roo-nee-uh). The term encompasses the many conditions, including those listed above, that result in lasting or repeated pain in your genitals either before, during or after sex[1].
The kind of pain you feel can vary from discomfort during any kind of penetration, including inserting a tampon, a burning or aching sensation during intercourse which can feel worse in certain sexual positions, through to severe throbbing that can last for hours after penetration has ended.
What causes dyspareunia?
The causes can be categorised into physical and psychological – though sometimes they can be both[2].
In some cases, dyspareunia can be caused if there isn’t enough lubrication. Slowing down, focusing on foreplay or introducing a sexual lubricant can help to make you feel more relaxed and avoid discomfort.
Physical causes are not so straightforward to remedy. They can be things like infections in the vagina, issues with the cervix, ovarian cysts, or vaginal atrophy – which is when the lining of the vagina loses its typical moisture and density. There are several physical conditions that can lead to dyspareunia, and you should speak to a healthcare professional if you think you have one but are unsure which you might have.
Psychosexual causes can be just as difficult to manage. Vaginismus, which we talk about here, is when the vagina involuntarily cramps, tenses or contracts the muscles around pelvic floor muscles. The reaction is a stress response from the mind and can lead to fear of any penetration[3]. Anxiety, depression and low self-worth can create barriers to intimacy and dilute the connection between your mind and body. Sexual abuse can also have a detrimental effect on how you engage with intimacy. In cases like this, you should speak to a healthcare professional about speaking to a psychologist who can help you through these feelings.
Are there different types of dyspareunia?
The location of the pain you are experiencing can help identify the type of dyspareunia you have. In terms of location, there are two kinds; entry pain (sometimes called superficial), and deep pain (sometimes called collision dyspareunia). Entry denotes pain experienced at the entrance of the vagina during initial penetration. Collision denotes pain in the lower abdomen or cervix felt during deep penetration which can be compounded by certain sexual positions2.
Beyond location, dyspareunia can also be categorised by when you experience the pain. Primary means the pain has started since you have become sexually active. Secondary pain is when the pain begins after previously experiencing pain-free sex. Complete pain happens every time you have sex. Situational pain only occurs at certain times2.
These factors should be communicated to a healthcare professional to contextualise your symptoms and help identify the condition correctly.
How do I treat dyspareunia?
As with any health condition, you should talk with a healthcare professional if you need advice on how to treat it.
Correct diagnosis means you can then seek the appropriate treatment based on your condition. Some pelvic health conditions like vaginismus can coexist with dyspareunia, so identifying them isn’t always straightforward. A medical professional can give you a thorough assessment and diagnosis, which will be invaluable as you begin your treatment journey.
Treatment for dyspareunia often involves vaginal dilators. These can help treat the symptoms by helping you familiarise yourself with your body until you feel able to progress to natural penetration[4].
Amielle Comfort dilators have been designed to help treat painful penetration by promoting progressive desensitisation of your mind and body to gentle touch4. Five incremental sizes allow for self-treatment at a pace that suits you, and accompanying breathing technique videos have been created to promote comfort, confidence and control during your journey. Find out more about Amielle Comfort here.
Remember, you are not alone. Whichever treatment route you take, we are here to support you.
[1] Tayyeb, M., & Gupta, V. (2023). Dyspareunia. In StatPearls. StatPearls Publishing. Available at https://pubmed.ncbi.nlm.nih.gov/32965830/
[2]Cleveland Clinic (US) (2021) Dyspareunia (Painful Intercourse). Available at: https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse
[3] National Health Service (UK) (2024) Vaginismus. Available at: https://www.nhs.uk/conditions/vaginismus/
[4] Melnik, Tamara et al (2012). Interventions for vaginismus. The Cochrane database of systematic reviews vol. 12. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7072531/
