Dyspareunia (dis-puh-ROO-nee-uh), or painful sexual intercourse, is more common than most people think. Although both men and women suffer from this condition, far more women than men experience painful intercourse because of the female anatomy and physiology.

Dyspareunia pain can occur before, during or even after intercourse. The pain occurs anywhere in the genital area (surface pain) or inside the pelvis (deep pain). Dyspareunia pain has been described by women as sharp, stinging, burning, jolting or cramping.

Dyspareunia pain is treatable, but it’s one of those medical problems that no one talks about. Sex is supposed to be enjoyable, not painful. When some people, especially women, experience dyspareunia pain, they often blame themselves for some kind of shortcoming. "It must be all in my head," many women think.

Causes of Dyspareunia Pain

Psychological and emotional factors do indeed contribute to dyspareunia pain in some women. But certain medical conditions and outside contributing factors also cause dyspareunia pain.

Psychological Factors

• Stress

• Depression

• Anxiety over one’s physical appearance, one’s sexual performance or getting pregnant

• Fear of intimacy

• Negative attitudes about sex in general or about one’s sexual partner

• Posttraumatic stress triggered by sexual abuse or rape

• Lack of information or understanding of sex or of one’s own body

Standard treatments for dyspareunia pain caused by psychological factors include talk therapy and sex therapy.

Medical Causes

• Vaginismus (vaj-i-NIZ-muhs), involuntary contractions of vagina muscles

• Endometriosis (en-doh-mee-tree-OH-sis), abnormal growth of uterine tissue

• Inflammation of the area surrounding the vaginal opening

• Vaginal dryness

• Ovarian cysts

• Urinary tract infections

• Vaginal yeast infections

• Menopause and aging

• Sexually transmitted diseases

• Hemorrhoids

• Skin disorders

• Irritable bowel syndrome

• Adhesions (scar tissue) from surgeries in the pelvic region

Treatment for dyspareunia pain caused by a medical condition depends, naturally enough, on the condition. The first step is to relieve the pain with nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen, or with topical ointments for such conditions as hemorrhoids and skin disorders. Certain gels and creams are effective in helping with vaginal lubrication. Antibiotics are usually prescribed for urinary tract infections and antifungal medications for vaginal yeast infections. Specialized types of physical therapy, such as the Wurn Technique, have proven effective in relieving muscle tension in the pelvic region and in breaking up painful scar tissue resulting from surgery in the pelvic region.

Outside Factors

• Injury

• An ill-fitting diaphragm

• An adverse reaction to latex or other materials in birth-control devices

• Side effects from medications

• An allergic reaction to spermicides or douches

• Having intercourse too soon after surgery or childbirth

The most direct treatment for dyspareunia pain caused by outside factors is simply eliminating the irritating substance or activity, but always with guidance from medical professionals.