There dyspareunia is defined as pain felt during sexual intercourse. It is a reality that affects many women, having a profound impact their intimate life and general well-being. Dyspareunia may be an element hindering sexual development, but the term itself is much less known than the libido disorders Or of the perineum. So what to do when the desire is present, but that we have pain during certain sexual practices?
What is dyspareunia?
According to a BJOG study – British Journal of Obstetric and Gynecology – conducted on more than 7,000 women, one in ten women reported dyspareunia during certain relationships. Other studies even report higher figures.
These statistics are potentially below reality, since, in the same way as the urinary leakage or other supposedly “shameful” disorders, these pains are unfortunately little mentioned with a doctor, gynecologist or midwife and are sometimes not even discussed with the partner.
Symptoms of dyspareunia: pain during intercourse
Very occasional discomfort or pain can occur during intercourse. However, in the event of persistent or recurring pain, we then speak of dyspareunia. These pains can be felt in the external genital region, at the entrance or inside the vagina, at the level of the perineum or lower abdomen.
THE symptoms of dyspareunia vary from one person to another, but we very often find:
- burning sensations;
- cramps;
- deep pain during or after sexual intercourse.
This disorder, often taboo, can transform a moment of pleasure into a anxiety-inducing and uncomfortable experience.
The different types of dyspareunia
Depending on the location of the pain 📍
The different types of dyspareunia in women can be broadly divided into two categories:
1/ Vulvar dyspareunia, or superficial, which concern the vulva, that is to say the external part of the genital organs, most often linked to a vulvodynia.
2/ Vaginal dyspareunia. These are the most common dyspareunias. They are divided according to their location in the vagina.
Intromission dyspareunia
If pain occurs from the entrance to the vagina, we then speak of intromission dyspareunia. The most common cause is vaginismus, that is to say the involuntary and unconscious reflex contraction of the perineal muscles.
This has the effect of making any attempt at penetration painful, if not impossible, whether with a finger, an object or a penis.
Deep dyspareunia
Dyspareunia occurring deep in the vagina (also called ballistic dyspareunia), has the main origin endometriosis or retroverted uterus.
Global vaginal dyspareunia
Let us cite, finally, the global vaginal dyspareunia, which concern the entire vaginal mucosa. They are generally linked either to a lubrication not very important, either due to an imbalance in the vaginal flora, or to a yeast infection or vaginosis.
Anal dyspareunia
THE anal dyspareunia or anodyspareunia can occur in both men and women. There are also penile dyspareunias specific to men, linked to erection or upon ejaculation.
Depending on the context of onset of pain 💭
Dyspareunia can be primary (from the first reports), or secondary (after normal and satisfactory intercourse).
Primary dyspareunia
Primary dyspareunias are more common in cases of negative vision of sexuality or apprehension of sexuality.
We also see these dyspareunias in cases of clumsiness or inexperience of a partner.
Secondary dyspareunia
THE secondary dyspareunia sometimes manifest themselves after childbirth, or trauma, such as sexual assault.
There menopause can also lead to this type of secondary pain, linked in the majority of cases to a decreased lubrication and to a imbalance of vaginal flora.
What treatments for dyspareunia?
Whether it is linked to physical causes such as endometriosis, vaginismus, or psychological factors generating tension, dyspareunia requires a global and caring approach.
Dyspareunia: natural treatments
1️⃣ Physical and psychological care
Dyspareunia is a physical pain, it’s never “in the head”. On the other hand, dyspareunia causes negative emotions – guilt, helplessness, apprehension of relationships, self-devaluation, fear of being abnormal – which can increase apprehension, then the pain and thus form a vicious circle. The recommended treatment is therefore both physical and psychological.
2️⃣ Communication with your partner
In women, the majority of dyspareunia is the result of penetrative sexual practices, particularly during vaginal penetration.
The first step will therefore consist of inform your partner, to avoid practices that cause pain, as long as the cause has not been identified and taken care of.
Continuing painful intercourse can not only worsen this pathology, but also lead, logically, to a decreased libido and interest in sexuality. When an activity results in pain, individuals are, in fact, not attracted to that activity.
3️⃣ Consult a health professional
If changing sexual practices is not enough to have a satisfying sexuality, you should not hesitate to consult a gynecologist, midwife or sexologist, to identify the source of these dyspareunia and be able to offer appropriate care. This comes in many options depending on the origin of the pain.
In case of vaginismus, work with a physiotherapist specializing in perineology is central, in order to become aware of these perineal muscles and to be able to contract and release them voluntary manner.
In cases of vulvodynia, physiotherapy work will often be associated with treatment by a dermatologist specialized in vulvar pathology.
Drug treatments to manage pain
Furthermore, a additional treatment with a psychological aim can be done through psychological therapy, sophrology, EDMR, hypnosis or acupuncture.
These methods are an interesting option for treat negative psychological consequences of these pains, especially when they have lasted for a long time.
And my partner in all this?
The partner must be the first person to contact on these dyspareunias. Sexuality is very vast and with each new partner, we must discover the sexual practices and the ways of carrying them out which are source of pleasure for this person.
Talking to your partner about your pain also helps to reassure them by clarifying that lack of libido, or loss of interest in sexuality, are not not related to the relationship, but rather to an unsatisfactory or even painful sexuality.
In terms of sexuality, whether there is pain or not, the communication between partners is in any case always a central element to enable a fulfilling sexuality !
