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Wednesday, November 22, 2023

Dyspareunia

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Dyspareunia is a discomfort in the form of pain, stinging, or tightness that appears during sexual intercourse. It can cause a lot of fear and panic and affect the ability to enjoy sex, as well as impede climax.

It most commonly seen in women but can also affect men. It is thought to be caused by an unresolved emotional, psychological, or physical trauma and should be addressed with the appropriate care.

What are the symptoms?

The patient usually speaks of pain when having intercourse, which can be exacerbated by certain positions. Other symptoms include pain while using a tampon or during a medical examination, pressure in the pelvic area, and/or itching.

Vaginal dryness is another symptom, more common in women during menopause due to the decrease in estrogens, making intercourse more difficult. 

Usually, the discomfort disappears after intercourse,  but it is not unusual for the discomfort to continue for a few hours and even a couple of days after.

If symptoms persist, medical consultation should be undertaken.

How is it diagnosed?

Often reaching the diagnosis is complicated. After a range of physical investigations have been done, including uterine fibroids, infections, specific types of cancers, or weakness of the vaginal walls, a diagnosis of a psychological nature may be given.

The woman usually goes to the gynecologist as the first option in search of a medical reason. On the other hand, male patients usually take longer to consult a doctor. It is thought that this is due to a fear that there’s no solution and social stigma attached to seeking help for these types of medical issues.

Since the diagnostic tests will be diverse and may not include a physical issue, the final recommendation may be to consult a sexologist and/or a psychologist or counselor.

The fact that the sexual act causes pain will directly affect the person who suffers, generating a justified fear of having sexual relations, which, in turn, will negatively influence the couple’s relationship, creating, in most cases, serious marital problems. Since the problem may take time to resolve, it is advisable to have pleasant sexual relations without penetration, keeping the sexual life of the couple intimate.

Treatment

If the cause is physiological, the solution is to cure the disease with a specific treatment, eg. surgery for fibroids, antibiotics for infections, etc. Endometriosis is a common cause of pain in sexual intercourse, however, not all women who suffer from endometriosis have pain.

 Problems due to a lack of lubrication are easily solved by using lubricating creams before intercourse.

There are medications that actually cause a decrease in lubrication and sexual desire and the problem is solved by stopping their usage, usually under medical supervision.

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