Painful sex, or dyspareunia, is discomfort during or after sexual intercourse. It’s a common issue affecting many women and can stem from physical, emotional, or hormonal causes.
Common symptoms
- Burning, stinging, or sharp pain at the vaginal opening or deeper in the pelvis.
- Bleeding or spotting after intercourse.
- Vaginal dryness or tightness.
- Anxiety, stress, or avoidance of intimacy.
Possible causes
Physical Causes
- Infections: Yeast infections, UTIs, or STIs.
- Hormonal Changes: Menopause, breastfeeding, or hormonal contraceptives (causing vaginal dryness).
- Medical Conditions: Endometriosis, pelvic inflammatory disease (PID), vulvodynia, or vaginismus (involuntary muscle spasms).
- Skin Disorders: Lichen sclerosis or eczema.
- Scar Tissue: From childbirth, surgery, or trauma.
Emotional/Psychological causes
- Stress, anxiety, or depression.
- Past trauma or relationship difficulties.
Diagnosis
- History: Your gynaecologist with discuss symptoms, medical background, and emotional well-being.
- Pelvic Exam: To check for infections, muscle tension, or abnormalities.
- Tests: Swabs, urine tests, or ultrasounds may be needed.
Treatment options
Medical Treatments
- For Infections: Antibiotics or antifungals.
- For Dryness:
- Water-based lubricants (e.g., KY Jelly).
- Vaginal oestrogen creams/tablets (for menopause-related dryness).
- For Muscle Spasms: Pelvic floor physical therapy.
Psychological Support
- Counselling or sex therapy to address anxiety, trauma, or relationship concerns.
eGynaecologist Advice
- You should consult a gynaecologist if pain persists for weeks or worsens and if you experience bleeding or unusual vaginal discharge.
- Pelvic floor exercises or yoga helps to reduce tension while good hydration can help maintain vaginal moisture.
Frequently Asked Questions
Is painful sex normal?
While common, it’s not something you should endure. Treatment can help!
Can lubrication alone fix the problem?
Sometimes, but persistent pain needs medical evaluation.
Will this affect my fertility?
Not directly, but underlying conditions (e.g., endometriosis) might. Your doctor can advise.
How long until I feel better?
Many see improvement within weeks of treatment. Chronic cases may take longer but are manageable.
