Dyspareunia: Pain During Sex

Dyspareunia is pain during sex. It is very common challenge expressed by many of our female patients. It primarily affects two age groups: women ages 20-30 years of age and those 50-60 years old.

Common causes of dyspareunia include:

• Atrophic vaginitis
• Urinary tract infection
• Interstitial cystitis
• Erosion of implantable mesh
• Tissue damage from radiation
• Organ prolapse
• Urethral abscess / vaginal cysts
• Sexual transmitted diseases
• Vaginismus

Confirming dyspareunia, and ruling out other possible concerns, includes:

• A detailed history and a thorough examination
• Urinalysis and urine culture
• Blood and vaginal swabs to screen for sexually transmitted diseases
• Cystourethroscopy

Treatment for dyspareunia varies tremendously. If a direct cause of the pain is identified, such as a urinary tract infection or a urethral abscess, then treatment for the specific disorder will usually resolve the condition.

Otherwise, it may require a multimodality approach depending on the circumstances:

• For women who are pre-menopausal, the solution may be pelvic floor relaxation with the help of a physical therapist along with the use of water-based lubricants.
• For others who are post-menopausal, the use of supplemental estrogen (if appropriate) along with the use of water-based lubricants has been proved effective.

If there is significant vaginal and/or pelvic organ prolapse then repair of this condition may be necessary to address.