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Painful intercourse?

Published:Saturday | July 26, 2014 | 12:00 AM

Sex is a very important part of an intimate relationship, not just for procreation, but also for pleasure and bonding. Therefore, when sexual intercourse is painful for a female, it can put significant pressure on the relationship.

There are a few who actually derive pleasure from this pain, and may deliberately elicit it, but most persons do not have positive feelings about painful sexual intercourse.

Painful intercourse (dyspareunia) is by no means rare, in fact, it is estimated that about 20 per cent of women are afflicted by this problem. Pain during intercourse can come from the entrance of the vagina, the passage of the vagina or from deep penetration involving the top of the vagina.

It may also occur before, during or after intercourse, with one partner and not another, using certain positions, and may be a recent or a long-standing issue.

Insufficient lubrication is a fairly common cause of dyspareunia. It is usually a result of inadequate arousal, menopause, breastfeeding and certain medications. These medications include antidepressants, antihistamine (allergy medications), some antihypertensives, birth control pills (occasionally) and some anti-anxiety medications.

The pain caused is usually at the vaginal entrance. Vaginal candidiasis (yeast infection) is another common cause. If there is scarring, injury or irritation of the vaginal entrance, or around it, this can also cause dyspareunia. An inflammatory condition called vestibulitis can also cause vaginal entrance pain.


Vaginismus, a condition where there is involuntary spasm of the muscle at the entrance of the vagina - can cause this problem as well.

Problems in the pelvis or abdomen can cause pain on deep penetration. These include infection in the pelvic structures (uterus, fallopian tubes, ovaries or the urinary bladder), pelvic tumours (uterine fibroid, ovarian cysts etc), endometriosis, prolapsed uterus (low womb), retroverted uterus (uterus tilted backwards rather than forwards) and irritable bowel syndrome (a disorder of the intestines that cause constipation, abdominal pain and bloatedness).

Some medical treatments may also result in dyspareunia such as scarring from surgery and radiotherapy as well as chemotherapy. Women with a history of sexual abuse, especially rape, and sexual phobias often have dyspareunia.

To have dyspareunia properly assessed, one must be seen by a doctor, either a general practitioner or a gynaecologist. Sometimes affected persons may even need to be seen by a psychotherapist if there are psychological factors at play.