Dyspareunia

This is an abnormal pain during sexual intercourse. It may result from abnormal conditions of the genitalia, dysfunctional psychophysiologic reaction to sexual union, forcible coition, or incomplete sexual arousal.

Dyspareunia is pain that occurs only (or primarily) during sexual intercourse. It is not a disease, but rather a symptom of an underlying physical or psychological disorder.

The pain, which can be mild or severe, may appear in the genitals, the pelvic region, or the lower back. The condition is much more common among women.

For women, causes include vaginismus, a psychological condition characterized by spasms of the vaginal muscles and insufficient vaginal lubrication; scars from an episiotomy (an incision made to facilitate childbirth); thinning and dryness of the vaginal wall due to estrogen deficiencies accompanying menopause, or breastfeeding; and inadequate foreplay.

Disorders that may cause pain upon deep vaginal penetration include:

• Pelvic inflammatory disease
• Ovarian cysts
• Endometriosis
• Varicose veins in the pelvis
• Ectopic pregnancy

Other causes include:

• Infections, such as sexually transmitted diseases, which may irritate the vaginal walls or the skin of the penis
• Bladder or other urinary tract disorders such as cystitis or urethritis
• Cancer in the sex organs or the pelvic region
• Arthritis, especially in the lower back
• Allergies to spermicides or to the latex in condoms and diaphragm

For men, the condition can result from such disorders as irritation of the skin of the penis due to an allergic rash; physical abnormalities of the penis, like a tight foreskin or a bowed erection; and infections of the prostate gland or testes.

Another frequent explanation for painful intercourse is thinning and drying of the vaginal tissue as menopause begins. This happens because the body is producing less and less of the estrogen that is needed to maintain moist vaginal tissue. As the vagina's ability to make its own mucus declines, it becomes itchy, dry, and painful, leading to discomfort during intercourse.