You may not hear many people talking about dyspareunia, or painful intercourse, but it’s a common and distressing problem that affects nearly three out of four women. Dr. Anna Le and the team at Annandale Ob-Gyn have talked with and successfully treated many women with dyspareunia. Please don’t hesitate to call one of the offices in Annandale or Alexandria, Virginia, or book an appointment online if you struggle with pain during sex. They can help you regain a healthy and satisfying sex life.

What causes dyspareunia?

Painful sex, or dyspareunia, has many possible causes. Vaginal dryness, vaginismus (involuntary vaginal muscle spasms), tight muscles due to stress, and emotional issues such as relationship problems, depression, and anxiety are some of the most common reasons sexual intercourse becomes painful.

Pain during or after sex can also be a symptom of a gynecological problem. A few conditions that may cause dyspareunia include:

  • Endometriosis
  • Vaginitis
  • Uterine fibroids
  • Pelvic inflammatory disease
  • Ovarian cysts
  • Urinary tract infection
  • Vulvodynia
  • Skin disorders of the external genitalia

How does vaginal atrophy cause dyspareunia?

Estrogen is essential for maintaining healthy vaginal tissues. When estrogen levels decline at menopause, or for any other reason like cancer treatment, vaginal tissues thin out, become dehydrated, and lose elasticity. This condition is called vaginal atrophy. Due to vaginal atrophy, almost eight out of 10 postmenopausal women experience painful intercourse.

Where do you feel pain during sex?

Dyspareunia causes pain in locations you may not associate with sexual intercourse. While you’d expect to feel pain outside or deep inside the vagina, you may also experience pain in your uterus, bladder, the pelvic region, or lower back. The location of your pain may help your doctor narrow down the cause.

How is dyspareunia diagnosed and treated?

Before treatment can be started, the underlying cause of your dyspareunia must be determined. Your doctor at Annandale Ob-Gyn & Primary Care reviews your medical history, talks with you about the type of pain you feel, including its severity, where it’s located, and when it started.

A pelvic exam is done to check for signs of skin irritation, infection, or anatomical problems. Depending on the cause of your dyspareunia, you may find that a pelvic exam is uncomfortable, so don’t hesitate to let your doctor know if you have any discomfort. An ultrasound may be performed, depending on the results of your exam.

If an underlying health condition is diagnosed, a treatment plan is developed that’s specific to the problem. Vaginal atrophy, for example, may be treated with lubricants, vaginal estrogen, or hormone replacement therapy to restore estrogen back to normal levels.

The FDA has approved one medication to treat dyspareunia, which acts like estrogen and improves the health of your vaginal lining. This medication isn’t the best choice for all women though, because it can cause hot flashes and potentially serious side effects.