(Painful Sexual Intercourse)
by Rosalyn Carson-DeWitt, MD
Dyspareunia is recurrent or persistent genital pain experienced just before, during, or after sexual intercourse. Although this condition can occur in both men and women, it is more common in women.
Menopause is one of the main causes of dyspareunia. It can also be caused by not having enough lubrication because of a lack of sexual arousal and stimulation. Certain medication, such as antihistamines, may also cause dyspareunia as a side effect.
Other causes in women include:
The cause of dyspareunia may also be related to psychological factors, although this is less common. Some examples include:
These factors may lead to a condition called vaginismus. This is painful and involuntary contractions of vaginal muscles. It is usually a response to past sexual trauma or other painful circumstances, but it can also be the result of chronic irritation from a physical cause.
The most common causes of pain in men are:
Pain occurs at the time of ejaculation.
Pain that occurs while obtaining an erection may be associated with:
Factors that may increase your chance of dyspareunia include:
In men and women, viral or bacterial infections may also increase the chance of dyspareunia.
Pain associated with dyspareunia may:
A medical and sexual history will be taken. A physical exam will be done. The diagnosis is often made based on your symptoms.
For men and women:
To treat prostatitis and urethritis, the doctor may recommend:
Sometimes, surgery may be done to treat foreskin and other erectile problems.
Men and Women
When no physical cause of the pain can be found, sex therapy may be helpful. Some concerns need to be worked through in counseling. These may include:
American Congress of Obstetricians and Gynecologists
Family Doctor—American Academy of Family Physicians
Sex Information and Education Council of Canada
Sexuality and U—Society of Obstetricians and Gynaecologists of Canada
American Congress of Obstetricians and Gynecologists Committee on Practice Bulletins—Gynecology. Female sexual dysfunction. Obstet Gynecol. 2011;117(4):996-1007. Reaffirmed 2015.
Female sexual dysfunction. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated February 10, 2017. Accessed December 7, 2017.
Heim LJ. Evaluation and differential diagnosis of dyspareunia. Am Fam Physician. 2001;63(8):1535-1544.
Lightner DJ. Female sexual dysfunction. Mayo Clin Proc. 2002;77(7):698-702.
Last reviewed November 2018 by Beverly Siegal, MD, FACOG
Last Updated: 12/11/2015
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