Dyspareunia or Painful Vagina

Pelvis | Obstetrics and Gynaecology | Dyspareunia or Painful Vagina (Symptom)


Description

Dyspareunia is an abnormal pain during sexual intercourse due to a spasm. Dyspareunia can be classified upon the time elapsed since the woman first felt it : (1) During the first two weeks or so of symptoms, dyspareunia caused by penis insertion or movement of the penis in the vagina or by deep penetration is often due to disease or injury deep within the pelvis. (2) After the first two weeks or so of symptoms, the original cause of dyspareunia may still exist with the woman still experiencing the resultant pain. Or it may have disappeared, but the woman has anticipatory pain associated with a dry, tight vagina.

Causes

It may result from abnormal conditions of the genitalia, dysfunctional psychophysiologic reaction to sexual union, forcible coition, or incomplete sexual arousal. Dyspareunia is also associated with hormonal changes of menopause and lactation that result in drying of the vaginal tissues as well as with endometriosis.

It is a common condition that affects up to one-fifth of women at some point in their lives. A medical evaluation of dyspareunia focuses initially on physical causes, which must be ruled out before psychogenic or emotional causes are considered. In the majority of instances of dyspareunia, there is an original physical cause. An extreme form, in which the womans pelvic floor musculature contracts involuntarily, is termed vaginismus.

When pain occurs, the woman experiencing dyspareunia may be distracted from feeling pleasure and excitement. Both vaginal lubrication and vaginal dilation decrease. When the vagina is dry and undilated, thrusting of the penis is painful. Even after the original source of pain (a healing episiotomy, for example) has disappeared, a woman may feel pain simply because she expects pain.

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