Causes, Diagnosis and Treatment of Dyspareunia

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.

woman with dyspurenia overlooking ocean with husband

Causes of Dyspareunia

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

Diagnosing Dyspareunia

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

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.