Dyspareunia: we explain the pain during sexual intercourse

What is dyspareunia?

Dyspareunia is pain experienced by women or men during sexual intercourse.

However, dyspareunia is a medical term more commonly used to describe pain during sexual intercourse in women. Dyspareunia affects 20% of women in France ( Public Health France ).

The actual figure is likely lower, as many women don't report pain experienced during vaginal or even anal penetration . While this is the most common scenario, pain doesn't only occur during vaginal penetration but also before or after.

And most often during painful intercourse, the pelvic floor muscles contract abnormally ( due to secondary vaginismus, for example). In all cases, a consultation with a specialist is necessary to determine the cause of this pain.

Rare physical causes:

• Congenital malformations of the vulva, hymen or vagina;

• The side effects of certain treatments (brachytherapy or radiotherapy);

• Infections: vulvovaginitis caused by fungal infections, inflammation, STIs, etc.

• Diseases affecting the mucous membranes: lichen, for example;

• All psychological causes : psychological and/or physical trauma (related to childhood, adolescence or adulthood), poor body image, harsh sex education, depression, anxiety, sometimes unconscious phobias of sexual intercourse, etc.

The different types of pain

There are two main forms of dyspareunia, superficial dyspareunia and deep dyspareunia .

• Dyspareunia is considered superficial when pain is present from the very beginning of penetration. The pain appears in the vulvar area…

• Dyspareunia is said to be deep when the pain is felt deep inside the vagina or even in the lower abdomen.

Furthermore, there are also 2 types of dyspareunia:

• Primary dyspareunia is defined as pain that has been present since the beginning, from the first sexual intercourse.

• When pain appears at a later point in a woman's life who has already had several sexual encounters previously, it is then referred to as secondary dyspareunia.

It's important to talk about it!

Sexual intercourse is first and foremost a moment of pleasure. It is therefore important that these encounters go well, without discomfort.

If any pain occurs, the first person to inform is your partner so they can adjust or change their behavior. Communication remains essential during sexual intercourse; it's the best way to avoid any misunderstandings.

If the pain persists, it's best to take a short break and make an appointment with a sexual health professional . There's no shame or embarrassment in seeking help, as it's in no way your fault.

Other ways to enrich your sex life with your partner

Having sex without penetration

However, it is perfectly possible to have sexual intercourse without penetration. and have as much fun as possible!

Some couples then develop a sexuality without penetration but lead a sexual life full of pleasure through foreplay, oral sex, massages, caresses … and therefore feel no need to consult.

Using a vibrator can also be an option!

"If it is impossible to insert a sex toy into the vagina, clitoral massagers can be used," Valérie Tasso logically announces.

Be patient with your body, follow your desires, talk to a professional, and lubricate your genitals well . or her anus when trying to use sex toys , that's the secret to a fulfilling sex life, even for people with vaginismus or dyspareunia!

If a couple seeks medical help despite experiencing vaginismus and is otherwise happy in their relationship, it's often because they want to have a baby. Although rare, it is possible for a woman to become pregnant without penetration, using the "syringe" method. However, if you wish to seek help, don't hesitate to do so with your partner!

What are the causes of dyspareunia?

If you experience pain during sexual intercourse, it is essential to identify the cause.

It is therefore important to consult your doctor or a gynecologist to ensure a pleasurable sex life. Dyspareunia can have many causes.

Dyspareunia due to psychological causes

First, there are psychological causes . Dyspareunia can occur following a traumatic event related to the genitals. This disorder can result from sexual violence, a disastrous medical appointment, a fall, strict upbringing, a lack of information, etc. It manifests as vaginismus , which is an unconscious contraction of the perineal muscles.

Dyspareunia for medical reasons

Another reason for dyspareunia can be a medical cause such as endometriosis, pelvic inflammatory disease, an ovarian cyst or even a fibroid.

They are often accompanied by psychological causes.

The pain appears due to stress or apprehension .

Women with pain from penetration may experience intense fear of pain and anxiety before or during vaginal penetration; when women anticipate a recurrence of pain during penetration, their vaginal muscles contract, making attempts at sexual intercourse even more painful.

However, most affected women can enjoy sexual activity without penetration. 

Proof that communication is the key to a successful sexual relationship!

Sexually transmitted infections and dyspareunia

Infections can also cause pain during sexual intercourse. These can include vaginal yeast infections, STIs, and many others …

Besides these causes, there are also less common ones such as malformations of the female genital system.

Depending on the cause, the pain can be more or less intense, as previously mentioned. For example, if the pain results from endometriosis, it will be a deep pain, felt deep inside the vagina or even in the lower abdomen.

What are the symptoms of dyspareunia?

How is dyspareunia expressed?

The pain may correspond to sensations of burning, itching, tingling… however other symptoms may occur.

Indeed, other symptoms exist such as vaginal spasms (vaginismus), a decrease in libido, dryness of the vaginal wall or even a loss of confidence in the woman which can lead to depression.

Management of dyspareunia

Treating dyspareunia is possible!

There are different treatments depending on the cause of dyspareunia . When experiencing pain during vaginal penetration, it is important to listen to your body to better understand the symptoms and discuss them with your doctor or gynecologist.

This way they can give you the treatment best suited to your situation .

However, treatments can be distinguished in two different forms depending on the origin of the pain during sexual intercourse.

• If the pain is psychological in nature, it is commonly advised to consult a sexologist, a physiotherapist, or even a psychologist to help you better understand the origin of this pain.

• Furthermore, if the dyspareunia is physical , it is strongly advised to use an intimate gel if the pain manifests as vaginal burning. You could also spend more time on foreplay... perhaps your body isn't ready for penetrative intercourse.

If this is the case, do not hesitate to communicate openly with your partner; it is a free and very effective treatment.

How to avoid/prevent dyspareunia?

• consult a doctor in case of recurring pain during sexual intercourse in order to determine the cause;

• Use topical lubricants in case of vaginal dryness , especially during sexual intercourse. Hormonal treatments or vaginal laser treatment may be recommended in cases of vaginal dryness related to menopause;

• wear cotton underwear;

• favor period panties (preferably made of cotton) over sanitary pads and tampons;

• Use a suitable soap that respects the genital flora . Avoid deodorants and intimate freshness sprays;

• avoid wearing panty liners too often;

• Do not, under any circumstances, use vaginal douches;

• consult a sexologist or a couples therapist if you are experiencing relationship difficulties with your partner;

• address the psychological problems that contribute to and result from chronic pain;

• Prolonging the time of foreplay can help optimize desire and vaginal lubrication ;

• treat vaginal or urinary inflammations/infections quickly;

• Avoid sexual intercourse if there are lesions in the genital area. Treat these lesions;

• consult a psychologist or psychiatrist in case of post-traumatic psychogenic dyspareunia (history of sexual abuse, intense pain during childbirth...) or vaginismus;

• avoid using latex (or other allergens) if you have an allergy;

• treat chronic stress (yoga, relaxation, meditation, hypnosis, sophrology...);

• maintain a healthy lifestyle (balanced diet, regular physical activity...).

In cases of deep dyspareunia, penetration can be avoided and replaced by other practices ; there are other ways to make love or masturbate, and for that, here is a complete guide.

Know this: you can experience just as much pleasure during sex, or even more, without penetration . Especially since female orgasm is produced not by the vagina but by the clitoris!