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Dyspareunia is the medical name for painful intercourse. It describes all types of pain during sex, including during penetration or afterwards. It happens to both women and men, and can occur anywhere in the genital region.

Dyspareunia is common and can be caused by a number of different things, including short-term infections or an injury. Sex shouldn’t be painful. If you start to feel pain, stop, and speak to your doctor if it persists.

What does dyspareunia mean?

Dyspareunia (pronounced dis-puh-roo-nee-uh) just means ‘painful sex’. It is a medical term that refers to painful intercourse, which can happen at several different stages:

  • during foreplay or from general physical contact

  • at the point of penetration (entry)

  • with every penetration (including putting in tampons, physical examinations, etc.)

  • after sex finishes

If you’re feeling pain during sex, your body is trying to tell you that something’s up. Don’t ignore the signs, and don’t try to carry on if you’re in pain because this can make things much worse.

What causes dyspareunia?

Pain during or after sex can be caused by a number of things.

Generally, these include:

  • a temporary or long-term illness

  • an infection

  • allergic reaction

  • physical trauma or impact

  • psychological factors

In women, specifically, causes might be:

  • skin conditions around the genitals (like lichen sclerosis, eczema or psoriasis)

  • vaginal dryness (especially after menopause)

  • vaginismus

  • lack of sexual arousal or proper stimulation

  • vulvodynia/vestibulodynia

  • PID (pelvic inflammatory disease)

  • UTI (urinary tract infection)

  • cystitis

  • yeast infection

  • endometriosis

  • physical injury to the vulva or vaginal areas (including childbirth)

  • irritation or allergy caused by perfumed sanitary products, soaps or shampoo

What dyspareunia treatments are there?

Dyspareunia isn’t a diagnosis in itself, as it can have many different causes. Because of this, your doctor will tailor your treatment specifically to your situation. Tell your doctor as much as you can about the type of pain you are feeling, and how and when it started.

Your doctor will first treat any medical conditions (like an infection, or an STD) that could be causing you pain during sex. Once this is treated, they will focus on any other factors that could be making sex painful.

This could involve: using a lubricant during sex, avoiding certain hygiene products that could irritate your genitals, or visiting a psychosexual counsellor to discuss any emotional issues or anxieties you might be having around sex.

Communication is key throughout the whole process of treating dyspareunia. Try to be as open as possible with both your doctor and your sexual partners so that they can help as much as possible.

What does ‘Dyspareunia ICD-10’ mean?

‘Dyspareunia ICD-10’ is just the way that dyspareunia is medically classified by the World Health Organisation (WHO). ICD-10 is the 10th version of WHO’s classification system for diagnoses.

What is the difference between ‘superficial dyspareunia’ and ‘deep dyspareunia’?

There are two different types of dyspareunia.

  1. ‘Superficial dyspareunia’ is pain felt at the entrance of your vagina upon penetration. This is usually the result of an infection, physical bruising or trauma, or psychological factors.

  2. ‘Deep dyspareunia’ is when pain is felt more deeply inside the pelvis during sex, usually with penile thrusting. This is associated more with conditions like endometriosis, or inflammation of the pelvis.

Is dyspareunia more likely after the menopause?

The menopause is when a woman stops getting her period and isn’t able to get pregnant naturally. Women usually reach menopause between the ages of 45 and 55 years of age.

25-45% of all women experience dyspareunia after the menopause. The most common cause for dyspareunia in women after the menopause is ‘vulvovaginal atrophy’. This is the name for what happens when oestrogen levels drop in your body. Less oestrogen means your vagina is less able to grow new cells, and produces less natural lubricant. Dryness is one of the primary reasons for painful sex in women.

Luckily, there are a number of medical and natural treatments available to help. These usually include:

  • HRT (hormone replacement therapy)

  • oestrogen creams applied to the vagina

  • Lubricants or pessaries

In mild cases, there is also evidence to show that having more sex also helps improve vulvovaginal atrophy. Sex increases the blood flow to your genitals, helping to keep them healthy and stimulated.

Is dyspareunia more likely if you have endometriosis?

Endometriosis is when the type of tissue that normally grows in your womb (uterus) grows outside the womb, elsewhere in the body. This is usually in the upper pelvic region.

Endometriosis makes sex uncomfortable or painful in around half of all women with the condition.

Pain during sex can even be an early sign of endometriosis. This is why it’s so important to communicate with your doctor as soon as you experience pain during intercourse.

Whilst it is more likely that you’ll have dyspareunia if you’ve got endometriosis, there are things you can do. Discuss pain management with your doctor, try new positions during sex, and keep an open and frank dialogue with your sexual partner. Often stress or the anticipation of pain plays a big role in painful sex.

What’s the difference between dyspareunia and vaginismus?

In women, Vaginismus is when the muscles inside your vagina tighten involuntarily. This can make penetrative sex difficult or impossible. Vaginismus is just one cause of pain during sex, and it is generally considered as a type of dyspareunia.

The two are very closely related. Any form of pain during sex (dyspareunia) can trigger vaginismus. Vaginismus can often become a complication of sexual pain, even after the original condition (e.g. thrush) has cleared. This is what can make the diagnosis difficult. Forms of sexual pain sometimes have overlapping causes.

In terms of treatment, your doctor will treat the initial medical condition first. Vaginismus is then usually treated with a combination of psychosexual counselling (like CBT) and physical training. Physical training usually involves the use of vaginal dilators, allowing you to take an active role in treatment.

Can men have dyspareunia?

Because ‘dyspareunia’ is just a general term for painful sex, anyone can have it, including men.

In men, dyspareunia is usually caused by:

  • infections (like thrush)

  • STIs (like herpes)

  • a tight foreskin

  • tears to the foreskin (often too small to see)

  • an inflamed prostate (prostatitis)

  • torn or inflamed anus

  • swollen testicles (caused sometimes when you get aroused but don’t ejaculate, but also the sign of a possible infection) 

If you’re ever getting pain during or immediately after sex, ask your doctor for advice. They’ll be able to assess what’s causing the pain and give you the appropriate treatment.

As with women, dyspareunia in men can have a physical or psychological root cause. Sometimes, it’s a combination of both. Your doctor will match the treatment of your dyspareunia to the cause and find ways to help you manage your pain.

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