It's our sexual health Thursday. So let's talk about painful intercourse(sex) . Painful intercourse is given the medical term Dyspareunia. Dyspareunia is very common in women but it is often under reported.

Many a time, women will come to clinic. They will tell you every other symptoms as their problem other than Dyspareania, unless you ask specifically. I don't really know where the problem lies. Is it that they feel sex and anything about it is too sacred to be discussed or they don't know they are supposed to enjoy sex instead of feeling pain.

This pain could be felt on the surface, during entrance, following a deep thrust or on the lower abdomen. It could occur during or after sex. So long the pain is associated with the Vaginal sex, it is Dyspareania.

The pain could also have varying character. It could be in the form of peppery or burning sensation, it could also be in the inform of sharp or dull ache or even cramp-like pains from muscle spasm. The pain can last only during the action or might persist few minutes or hours afterwards.

Causes of painful sex

Pain can originate from any part of the structures ranging from vulva to vagina, cervix, the womb, the tubes, the ligaments or of the pelvis. Some of the common causes of these pains include :

• Vaginal dryness / inadequate lubrication

This could result from inadequate foreplay and arousal, low estrogen and atrophic changes as seen in menopausal women or from effect of medications. It could also result from psychological problems like stress and depression.

• Infections

Infection is a very common cause of dyspareania. It might be associated with other symptoms like vaginal itching, discharge or abnormal bleeding which will help you doctor suggest it as a cause. Common infections causing Dyspareania include vulvo-vaginosis, candidiasis and bacterial vaginosis.

• Vaganismus

This is a term for painful spasm of the muscles if the vagina. It could result from painful entrance, previous sexual abuse or unpleasant sexual experience(s). Fear and other ill beliefs about sex can as we trigger it.

• Inflammation and irritation of the genital tract

Erosions, irritations or inflammation of the genital tract can cause painful sex. This could result from atrophic changes/excessive dryness or infections.

• Urinary tract infections

Because of the close proximity of the urinary opening (urethara) to the genitals, infections and irritation of the urinary system can cause painful sex.

• Endometriosis

This is the term used for abnormal presence of endometrial tissues( tissue of inner lining of the womb) outside their normal location. It could cause chronic inflammation and adhesion of the structure in the pelvis which might result to painful sex. This pain is usually felt/worse during sex around your period.

• Other causes

Other things that can can cause painful sex include vulvodynia, uterine prolapse, malignancies like cervical cancer, local tumors or genital tears.

Treatment of painful sex

Most causes of painful sex are treatable with very good outcomes. Treatment varies from individual to individual depending on the cause.

Visiting your doctor to explain you problem(s), after which he will do proper physical examination and make out the possible cause(s) which will guide his choice of investigations.
Some of the treatments options that might come in handy include :

• Use of lubricants
• Use of topical oestrogen / oestrogen pessary.
• Antibiotics
• Analgesics
• Psychological therapy
• surgery

Visit your doctor for proper evaluation and treatment of your pain. Sex should be enjoyed and pain free.

Thank you for reading.