Dyspareunia or painful sexual intercourse can occur for a variety of reasons ranging from structural problems to psychological concerns. Many women experience painful intercourse at some point in their lives. It could occur just before sex, during or after. It could occur in men and women. It could occur on the surface, deep. It could affect a small portion of the genitals or more generalized. Understanding the duration, location, and nature of the pain is important to doctors in identifying the causes of the pain.


Causes
1.First time : it is normal and common for a woman having intercourse for the first time to feel pain because the hymen is stretched. It can be very painful too.
2.Infections : infection of the female upper genital tract, including the womb, fallopian tubes and ovaries. It makes intercourse painful
3.Injury – from surgery or following birth
4.Anatomic variations : Hymenal remnants, narrow vaginal canal,
5.Space-occupying-masses – Ovarian cysts, Fibroid, Polyp,
6.Pain from bladder irritation
7.Hormonal causes : Disturbances in hormonal levels may affect production of natural lubricants in the vaginal leading to frictional pain.
8.Vaginal dryness
9.Psychological : Sexual intercourse could be painful when the woman is not 100% ready for it. She needs to be emotionally and physically involved for it to feel good.
10.Vaginismus : this is a condition where muscles in or around the vagina shut tightly and make penetration very painful or even totally impossible
11.Menopause: when a woman reaches the menopausal age, her changing hormone levels can make her vagina dry (atrophic vaginitis), leading to painful intercourse. Lubricants or hormone replacement therapy may come handy

SOLUTIONS

The treatment for pain with intercourse depends on what is causing the pain. After proper diagnosis one or more treatments for specific causes may be necessary.

For example:

For pain thought to be due to infections, a clinician may prescribe a medications to clear the infections.

For pain thought to be due to post-menopausal vaginal dryness, hormonal treatment can be used or lubricants may be recommended

For women with endometriosis, medications or surgery are possible options.

These may reduce discomfort with intercourse:

- Knowing that in almost all cases, pain disappears over the time or at least will be greatly reduced especially with first timers.

- Encouraging your partner to learn about your body, to explore your anatomy and learn how you like to be caressed and touched.

- Addition of pleasant, sexually exciting experiences to your regular interactions, such as bathing together (in which the primary goal is not cleanliness), or mutual caressing without intercourse. Such activities tend to increase both natural lubrication and vaginal dilation, both of which decrease friction and pain. Prior to intercourse, MouthAction may relax and lubricate the vagina (providing both partners are comfortable with it).

- Use of water-soluble lubricants during intercourse. Oil based lubricants are discouraged. Lubricant should be liberally applied (two tablespoons full) to both the penis and the orifice. A folded bath towel under the receiving partner’s hips helps prevent spillage on bedclothes.

- For those who have pain on deep penetration because of pelvic injury or disease: A change in position to one admitting less penetration may help. In women receiving vaginal penetration: maximum penetration is achieved when the woman lies on her back with her pelvis rolled up off the bed, compressing her thighs tightly against her chest with her calves over the penetrating partner’s shoulders. Minimal penetration occurs when a the woman lies on her back with her legs extended flat on the bed and close together while her partner’s legs straddle hers. A device has also been described for limiting penetration.

- The bottom line is that painful intercourse is not normal and can be treated once you reach the health experts and explain. You doctor is your best friend

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