Dyspareunia is painful sexual intercourse. It can be due to medical or psychosexual problem. It is any pain experienced any time before, during or following sexual intercourse. The pain can be felt in the genitals or in the pelvis. It is quite normal for women occasionally to have pain during intercourse. This is not true Dyspareunia. A woman who has Dyspareunia often also have vaginismus which is involuntary tightening of the vaginal muscles in response to penetration which can make the intercourse painful or impossible.

Symptoms

• Pain with every penetration, even while putting in a tampon.
• Pain with certain partners or just under certain circumstances.
• New pain after previously pain free intercourse.
• Superficial entry pain.
• Deep pain during thrusting, which is often described as something being bumped.
• Burning or aching pain.
  

Causes of entry pain

• Inadequate lubrication: It is often occur due to inadequate foreplay. Inadequate lubrication is commonly caused by a drop in estrogen levels after menopause, after child birth or during breast feeding. Certain medications decrease lubrication like antidepressants, high blood pressure medications, antihistamines, certain birth control pills.
• Injury, trauma or irritation: Either due to accident, pelvic surgery, female circumcision, episiotomy etc.
• Inflammation, infection or skin disorder like genital tract infection, urinary tract infection. Eczema of genital area.
• Reactions to birth control products.
• Vaginismus.
• Vestibulitis: It occurs die to stinging or burning around the opening of your vagina.
  

Causes of deep pain

• Deep pain occurs with deep penetration and may be more pronounced with certain positions.
• Certain illness and conditions like endometriosis, pelvic inflammatory diseases, fibroids etc.
• Infections of cervix, uterus, fallopian tubes.
• Surgeries: scar from surgeries that involve pelvic area, hysterectomy (removal of uterus) It can also occur with radiation and chemotherapy.
• Emotional factors: like as in case on anxiety, depression, concerns about physical appearance, relationship problems tress, history of sexual abuse.
  

Test and diagnosis

• Medical history.
• Pelvic examination.
• Ultrasound.
  

Treatment

• Hygienic habits: Avoid scented bath products which can irritate genital area.
• Sexual techniques and counseling include switching the positions during intercourse, not rushing to the main event, long foreplay, communication with the partner about what feels good.
• Use lubricants.
• Estrogen therapy.
• Treating the underlying cause.
• Desensitization therapy: By practicing vaginal relaxation exercises to reduce pain.
• Counseling.
• Sex therapy.