Pain during intercourse, in medical terms - dyspareunia, occurs regardless of experience, age and gender. It is very difficult to diagnose and does not tolerate delays in examination and subsequent treatment. In addition, pain during intercourse can form a negative attitude towards sex and develop frigidity, which is absolutely unnatural for a psychologically healthy person.
Causes of pain during intercourse
Pain during intercourse is properly divided by gender, since the symptoms in men and women speak of completely different problems.
If pain during intercourse occurs in a man, then this may be due to:
- Organic causes (too tight foreskin or Peyronie's disease - curvature of the penis).
- Infections and inflammation of the penis.
- prostatitis.
Much more difficult in the case of pain during intercourse is the case in women. Range possible causes wider:
- Psychological problems (fear, aversion to sex).
- Inflammatory processes and infections (vaginitis, cystitis, endometriosis, adhesions, cervicitis, inflammation of the hymen, uterine fibroids, cysts, etc.).
- Change hormonal background, during which the vaginal mucosa becomes thinner.
- Varicose veins in the pelvis.
- Curvature of the uterus.
- Previous surgical interventions.
Symptoms of pain during intercourse
Pain of any nature during intercourse, whether it be sharp or aching, is the most main feature that it is time to seek medical attention.
In addition to the main reason, you should think about health if:
- The pain is not one-time, but occurs every time you have sex.
- In women, pain is accompanied by such concomitant symptoms as burning, itching and redness of the genital organs, general weakness.
- In men - involuntary and painful urination, pain in the canal and radiating to the anus.
Pain during first intercourse
Pain during the first sexual intercourse is the norm, not a pathology. Very rarely, defloration is painless. When the partner's penis enters, the walls of the vagina are compressed, which creates discomfort. In addition, often the hymen does not break after the first sexual intercourse, but only stretches due to its elasticity. Therefore, in the future, during sex, the girl may feel discomfort.
There are no medications for pain during first intercourse. The most important thing is to be mentally prepared, and at the crucial moment to relax as much as possible in a warm comfortable environment.
Pain before and after intercourse
Often, the pain that occurs at the beginning of sexual intercourse is ignored, believing that this is the norm. In fact, this may indicate the incompatibility of partners or diseases such as vaginismus, congestion in the veins, adhesions.
If the pain does not go away after intercourse, then most likely you are faced with a problem such as sexually transmitted diseases, a cyst, or inflammation of the cervix.
The nature of pain during intercourse and disease
Pain of any nature during intercourse, extending into the anus in men, is a sign of prostatitis. In addition, a sharp pain in the scrotum during sex can be the cause of varicocele (dilated veins) and infectious diseases. If the pain bothers you for some time after intercourse, then this may be a sign of unemptied testicles.
In women, the list of diseases associated with pain of this kind is much wider.
Pulling and sharp pain in the lower abdomen during intercourse is a sign of cystitis. The disease is accompanied by frequent urination.
Sharp pain and burning speaks of fungal diseases or thrush.
If you feel a sharp pain as soon as your sexual partner enters you, then you are most likely dealing with vaginal dryness. This problem usually arises due to hormonal failure, previous drug treatment, or - most often - due to the partner's inattention and neglect of foreplay.
A dull aching pain during intercourse on the right or left lower abdomen speaks of a cyst.
Severe unbearable pain during intercourse, which is accompanied by burning and vaginal discharge, means that a woman has vaginitis.
The pain of the external genital organs speaks of such a gynecological disease as vulvodynia.
Dull, but annoying pain is a symptom of diseases of the genitourinary organs.
Sharp shooting, radiating to the leg pain during intercourse indicates neuralgia of the pelvic nerves.
The cause of pain can also be a psychological factor (unsuccessful first sexual experience, fear of sex, dissatisfaction with yourself and your partner).
Severe pain during intercourse is felt by women after childbirth. This may be due to inflammation that has not yet passed or in the case when the seams and cracks and the new mother have not yet healed. But this does not mean that you need to wait until the pain recedes on its own. You need to go to the doctor, because sometimes in such cases surgical intervention is required.
But pain during intercourse during pregnancy is partly a myth. More precisely, pain may be present, only it is not connected with the “interesting” position in any way, rather, it is a sign of one of the above problems or the woman’s excessive suspiciousness.
Diagnosis of pain during intercourse
It is almost impossible to determine the cause of discomfort on your own. A gynecologist (for women) and a urologist (for men) can diagnose problems due to which a person experiences pain during intercourse.
In any case, the diagnosis is based on the anamnesis. Coming to the doctor, you need to be prepared to clearly answer the question of how long you experience pain during sex.
It is important for a doctor to know:
- The pain is permanent or has occurred for the first time.
- Whether there are surgical interventions and problems of a similar nature that have already bothered the patient.
If the tests and examination showed that you are healthy, then you can be referred to a psychotherapist, perhaps the problem is psychological in nature and only this specialist will help to cope with it.
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A woman, if the pain is caused by a psychological factor, needs to undergo psychotherapy (preferably with a partner).
In inflammatory and infectious processes, antibiotic therapy is prescribed, after which the vaginal microflora is restored.
- Candles Vagical - one candle 3 times a day for 10 days.
- As an anesthetic (for men and women), you can take Ibuprofen - no more than 3 tablets per day.
- Antibiotics - Tetracycline (one tablet of 0.25 mg no more than six times a day).
As a natural "folk" treatment, it is recommended to take baths with essential oils lemon balm, juniper, myrtle, rosemary, yarrow, tea tree and thyme. For a bath, they usually take 5-10 drops.
If the pain does not go away after intercourse (this applies to the external genitalia in women and the scrotum in men), you can try a cold compress - hold the ice wrapped in a soft towel (but not more than 15 minutes!)
If the doctor has established that the pain is associated with a lack of natural lubrication, then the problem is solved simply - lubricants are selected.
Be attentive to your health and let such a delicate problem as pain during intercourse never bother you!
Pain during intercourse- this is a fairly common problem with which women are forced to contact a specialist. The average age of women is completely different, it largely depends on the personal cause leading to pain.
Such a symptom can significantly disrupt the life of a girl, her attitude towards the opposite sex, as well as the performance of the reproductive function.
That is why it is so important to eliminate this condition in time, and not only a gynecologist can help with this, but also specialists from other branches of medicine, such as therapists, psychologists, etc.
Localization of pain during intercourse
It can be completely different. It depends on the main reason that causes it, it is like the area of the external genital organs, the place of entry into the vagina.
The vaginal cavity, as well as the lower abdomen, while localization can be median or predominantly in the lateral sections. Sometimes the pain radiates to the rectum and to the anterior abdominal wall.
Causes of pain
Psychosomatic
coitophobia
coitophobia- this is a condition associated with a pathological fear that occurs before sexual intercourse, as well as during it.
Currently, this is not a very common problem, it occurs in a single number of women.
Causes:
But this condition is still a state of remission, and during exacerbation it is manifested by the development of a panic attack.
A woman during the onset of sexual intercourse appears:
- dizziness,
- feeling of dry mucous membranes,
- active sweating occurs
- begins a strong trembling in the area of the knees and hands.
- a woman ceases to control her actions, she performs unmotivated actions, bites her partner, strikes, etc.
- and when penetration into the vagina occurs, severe pain occurs, which the woman describes during intercourse, in reality it does not correspond to reality.
vaginismus
vaginismus- This is a condition associated with convulsive spasm of muscle fibers in the genital area.
Features of the disease:
- As a result, there is an obstacle to sexual intercourse, as well as any gynecological manipulation.
- Such a condition is a variant of systemic neurosis, and is manifested by a variant of involuntary contraction of muscle fibers.There is spasm and contraction of the vagina, as well as raising the anus.
- Vaginismus and therefore pain during intercourse can occur at any age, but the average age group is women 25-40 years old.
- The average incidence of pathology is 1-2% of all diseases among gynecological women.
Vaginismus is usually divided into primary, i.e. occurring for the first time. As well as a secondary manifestation, which manifests itself in women after a certain sensational experience.
There are also several forms of pain during intercourse associated with vaginismus:
- This is the precoital form., which occurs only during an attempt at sexual intercourse, but no discomfort occurs during a gynecological examination and other manipulations.
- Generalized form manifested by any attempt to contact the genitals associated with penetration into the vaginal cavity. Symptoms appear with a fierce attempt to enter the vagina, for example, it may be the introduction of a speculum, tampon, medicines etc.
According to the severity of vaginismus, there are several degrees:
A predisposing factor to the development of pain during intercourse, manifested by vaginismus, is the mental or anxious state of the woman.
Vaginismus is manifested by a sharp spasm of muscle fibers. In some cases, sexual intercourse may not be possible if penetration has not occurred, since the vaginal cavity is tightly closed.
When a spasm occurs during penetration, an unpleasant sensation occurs and a rather dangerous condition for a man, like an infringement of the penis. As a result, the penis is infringed, swells and extraction from the vaginal cavity is impossible.
A woman experiences pain as the edema increases, as well as a stronger fear during intercourse and subsequent intercourse.The patient may subsequently show fear of possible pain during intercourse, conception and childbirth.
vaginismus-like disorder
pseudovaginismus- this is a pathological condition associated with the development of a spasmodic reflex in the muscles of the vagina, pelvic group, rectum and hips.
A similar condition can occur much more often and be manifested by pain during intercourse compared to true vaginismus.
The frequency of occurrence can reach about 5% of all such cases among gynecological pathologies.
A vaginismus-like condition occurs when pain appears against the background of a traumatic effect in the genital area, pathologies in the structure, as well as acquired diseases.
Very often it develops during inflammatory processes, atrophic changes, which causes discomfort at the initial stages, and later pain during intercourse.
A woman tries to exclude sexual intercourse from everyday life, and at the same time, the treatment has several other directions, and the effect of it is faster and longer.
Physiological
Spinal injury
You need to know that in some cases, the occurrence of pain during intercourse is associated with problems that arise at the level of the spinal column.
This is explained by the fact that it is from him that the skin innervation comes and it spreads to the internal organs.
The desired segment of the spinal column is responsible for the transmission of nerve impulses of a certain organ, as well as a part of the body.
The 6th thoracic vertebra is responsible for the uterus, as well as its superior and underlying intervertebral space.
While many levels are responsible for skin sensitivity, they begin at the level of the cervical vertebrae.
Often traumatic effects cause pain during intercourse:
- Incomplete or partially healed fractures of the vertebral column or its processes.
- In addition, a herniated disc can be a cause.
- The presence of a hernia in the intervertebral canal, accompanied by a pinched clinic or the phenomenon of pronounced osteochondrosis.
Pain occurs due to increased sensitivity of the skin. As a result of touching the genitals, a woman experiences severe pain. In addition, it can also occur during penetration, the pain mechanism in this case will be similar.
Uterine deformity
Uterine deformity- this is also This is one fairly common cause of pain during intercourse.It is associated with a violation of the anatomical location of the organ.
The reason for this can be both physiological conditions and pathological conditions, for example:
- Incorrect location of the uterus, its mixing, as well as bending. They occur without the development of adhesions or inflammation.In particular, the bending of the uterus can give severe pain during intercourse due to an attempt to straighten it and stretch the ligamentous apparatus.
- While pathological processes should be attributed fromsoldering process, damage to the ligamentous apparatus, as well as violation of the shape of the organ. These conditions often occur after surgical interventions and traumatic effects.
One of the common conditions is the detachment of the ligamentous apparatus during the birth process. This may be due to its lack of elasticity. A similar condition manifests itself with pain during intercourse, as well as symptoms of discomfort in everyday life. A woman may feel discomfort, aching pain in the abdomen, etc.
Adhesions in the pelvis
Adhesive process of the small pelvis This is another common problem that causes pain during intercourse. It is associated with a violation of the independent and physiological mobility of organs among themselves.
The main reason for the development of adhesions in the pelvic organs is the transferred surgical intervention:
Pain during intercourse may not occur at the time of penetration, but mainly during active movements, deep penetration. After intercourse, after a short time, the pain completely disappears.
But it can also appear in a calm state, with an exacerbation of chronic processes, as well as lifting weights, etc. Very often, pain during adhesions in the pelvic organs may increase with filling Bladder, rectum and during the act of defecation.
Pathological
endometriosis
This is one of the most common pathological problems that leads to the development of pain during intercourse.
The exact cause of the formation of this condition has not been identified.
Presumably, this is the spread of endometrioid tissue, which is the lining of the uterus, beyond the normal anatomical location.
In this case, pain during intercourse can be localized:
- In the body itself, and in the side surfaces.
- Very often there is irradiation of pain during intercourse in the anus.
This disease is also accompanied by the appearance of bloody or brown discharge before menstruation and for several days after. Pain can also be spontaneous, increasing gradually from the middle of the cycle, this is due to the growth of the endometrium in other cavities that are not characteristic of it.
According to the visual analog scale, pain can have varying degrees of severity, up to the maximum. In such cases, the woman deliberately avoids sexual intercourse due to a possible fear of pain.
Cystitis
This is an inflammatory disease that affects the bladder.The cause of this condition is most often infectious.In most cases, cystitis is combined with inflammation of the vagina.
Characterized by:
endometritis
It is an inflammatory disease of the uterus. This condition may be associated with the development of an infectious process in the organ.
The main cause is aseptic inflammation, but most often it is bacteria or viruses.
The infection can penetrate from the inflamed vaginal cavity, as well as the cervix, or hepatogenically, if there is a focus of infection in the body.
The process can be acute, subacute or chronic course:
Colpitis or inflammation of the vagina
It can develop under the influence of various reasons, most often it is the bacterial flora that inhabits the vaginal cavity and manifests its pathogenic properties.
The nature of the course of the process will largely depend on the type of flora.
Many women are currently concerned about pathological discharge in large volumes, which are accompanied by an unpleasant odor and irritation of the mucous membrane.
The latter most often causes pain in women, it appears both in a calm state and intensifies during intercourse.
At the same time, pronounced discomfort is felt and almost every friction becomes painful.
With a pronounced disease, pain during intercourse leads to the appearance of petechial hemorrhages, as well as the release of a small amount of blood that appears in smears. The partner in every possible way avoids sexual intercourse, because of possible fear, as well as swelling of the mucous membranes, lack of secretion by the glands of the vagina, etc.
Vulvitis
Causes and symptoms:
Other reasons
Partner incompatibility
Acts as one of the reasons for the development of pain during intercourse.
Often this occurs only in exceptional cases:
Defloration
Defloration - it is also one of the reasons for the development of pain during intercourse.
At the first sexual intercourse, the whole hymen is still in the vagina.
The pain is associated with ruptures of the mucous membrane, which represents the hymen.
Sometimes accompanied by bleeding.
In most cases, this pain is of a one-time nature, since later there is free access to the vagina.
Allergy
An allergic reaction can be the direct cause of pain during sex. It occurs against the background of taking medications, using drugs to protect against unwanted pregnancy, as well as lubricants and a reaction to latex.
In this case, the pain manifests itself at the time of the introduction of the penis, as well as frictions. The persistence of pain is present and for some time, which is aching and accompanied by burning.
Symptoms
May be as follows:
Pain during intercourse after pregnancy
This issue is quite relevant, since a large number of women are faced with the problem of pain during intercourse that occurs after the birth of a child.
Causes:
Diagnostics
Diagnostic steps:
Which doctor should I contact?
At the first manifestations of pain that occurs during intercourse, it is necessary to consult a gynecologist. She will conduct an examination and find out the exact causes, based on the history and diagnostic methods.
After finding out the underlying cause, it may be necessary to consult other specialists, but it is carried out in the direction of a gynecologist.
Treatment
Treatment of coitophobia
To eliminate such a problem, it is no longer necessary to consult a gynecologist, but a psychiatrist or psychotherapist:
Treatment of vaginismus-like disorder
To reduce or completely eliminate pain during intercourse, treatment is aimed at eliminating the initial pathology:
Treatment for spinal injuries
Treatment of pain during intercourse associated with traumatic injury to the spine involves the elimination of pathology from the spinal column.
If the process is acute, has arisen recently, but is accompanied by a certain clinical picture, then it requires mandatory surgical intervention.
In case of damage that occurred earlier, surgical intervention is usually futile, since changes have occurred at the morpho-functional level.
Treatment for organ deformities
Treatment in this case is a controversial issue, since in cases of physiological deformations of the organ, treatment may not be used, since there is no exact method.
There is a possibility of independent change in shape after the onset of natural childbirth. In the event of a rupture of the ligamentous apparatus, it is necessary to use an operative method aimed at restoring integrity.
Also, to reduce the severity of pain during intercourse, you need to change your lifestyle with the exclusion of physical activity, as well as lifting weights, etc.
Treatment of pain in the adhesive process
Pain management for cystitis
Eliminate the pain during intercourse associated with cystitis can be quite easy:
- For this, a large number of herbal remedies with antiseptic and anti-inflammatory effects are prescribed. Such drugs are presented in a wide range and have fewer side effects.
- Antibacterial agents can be used as etiopathogenetic therapy.
- Antispasmodics and analgesics are used to reduce pain.
Treatment for endometritis
Endometritis, regardless of the severity of the process, is subject to mandatory treatment.
It includes the use of drugs from various groups:
Treatment of pain in colpitis
Treatment of colpitis should be carried out with an exclusive definition of the causative agent of the pathological process. Only after that, funds are prescribed taking into account sensitivity to this pathogen.
It should be noted that the funds can be used in a systemic or local form:
Prevention
Measures to prevent pain during intercourse:
Based on the above problems and ways to solve them, a woman, when such a condition appears, needs to contact a specialist for qualified help as soon as possible.
If pain occurs during intimacy, there may be physiological or psychological reasons for this.
Defloration
During the first sexual intimacy, most women experience pain. Defloration occurs - rupture of the hymen. And most often the main cause of such pain becomes a woman's banal fear of sex. It is fear that leads to severe spasms of all the muscles of the body, and especially the muscles of the vagina.
Sometimes there are cases that the hymen is dense, it has a lot of nerve endings. But much more often the hymen is very thin and elastic, so at the first sexual contact it does not tear, but stretches.
vaginismus
The reason for the development of vaginismus is a sad sexual experience in which a woman experienced discomfort. These negative associations are fixed in the subconscious and make themselves felt at the most crucial moment. The pain is not due to the penetration of the penis, but due to a strong contraction of the muscles of the vagina.
The mechanism of pain is a strong muscle spasm. The way to cope with the problem in this situation will be the help of a psychologist and a sex therapist.
Inflammatory processes
If during sex a woman experiences discomfort in the vagina, such as burning, pain, itching, this may indicate an inflammatory process. Then anti-inflammatory drugs are prescribed.
At the time of treatment, sexual activity must be abandoned either in last resort use condoms. Treatment is required for both partners.
In most of all cases, the development of the inflammatory process is provoked by the microflora natural for any organism: staphylococcus aureus, Escherichia coli, fungi.
Adhesive processes
Pain in the lower abdomen may be due to adhesions. Adhesions in all cases are the result of previous inflammatory processes of the intestine or appendages. They are present in most women in the pelvic organs. Most often, the problem can be solved with the help of physiotherapy or posture selection. If adhesions are severe, surgery may be required.
endometriosis
Very often, pain in the lower abdomen during sex is a consequence of endometriosis. Endometriosis is often manifested by spotting, not associated with the menstrual cycle, and pain. Moreover, with endometriosis, pain is most severe in the middle of the menstrual cycle, and it makes sexual life impossible.
Venous congestion
Pain may appear if sex is irregular, or if a woman does not have an orgasm. Blood will constantly flow to the pelvic organs, and its proper outflow will not occur. First, a woman will have a feeling of heaviness in the lower abdomen, pulling pains after intercourse. Over time, this condition leads to swelling of the walls of the vagina, which means pain during sex itself. And the pain can be severe.
This condition is not just uncomfortable for a woman. It negatively affects the general condition of the female reproductive system. It can provoke mastopathy, uterine fibroids, endometriosis, ovarian dysfunction.
Neuralgia of the pelvic nerves
If a woman feels severe pain in the pelvic area, which intensifies during intercourse and radiates to the leg, she may have pelvic nerve neuralgia. In no case should you leave her unattended. Treatment - physiotherapeutic procedures, warming ointments, pepper patches.
Insufficient amount of lubricant
If a woman has too little lubrication during intercourse, pain may occur. You can use special lubricants that are sold in pharmacies.
Cervical erosion
Many women believe that the pain is caused by cervical erosion. But doctors say that the physiological characteristics of the female body are such that erosion simply cannot hurt. So, it is necessary to undergo an examination and identify the true cause of pain.
Anatomical incompatibility of partners
Often, women attribute pain during sexual intercourse to a mismatch in the size of their partners' genitals. This happens rarely - no more than 1% of all cases. The tissues of the vagina are so elastic that stretching the penis in a healthy woman will not cause pain.
Pain at the entrance to the vagina can be due to:
- decrease in lubrication;
- thinning of the mucous membrane;
- diseases of the bladder or urethra;
- inflammatory processes in the vagina and vulva.
Deep pelvic pain is detected in women who have:
- diseases of the cervix;
- adhesive processes in the pelvic organs;
- cysts and tumors of the ovary;
- external genital endometriosis;
- apoplexy (rupture) of the ovary;
- uterine myoma;
- varicose veins of the small pelvis;
- chronic salpingo-oophoritis.
Psychological reasons
Often the factors that provoke painful and unpleasant sensations during sexual intimacy are psychogenic. Most often, the pathological basis for the occurrence of pain is either the consequences of a negative experience of sexual activity, or problems in sexual relations partners.
Sex that does not allow a woman to reveal herself in the intimate sphere, to receive physiological relaxation and satisfaction, can cause a decrease in libido and apathy.
Violations of the emotional sphere cause changes in pain sensitivity and the formation of muscle "blocks". It is because of the spastic state of the muscles of the pelvic floor that pain occurs during intimacy.
This leads to disruption of the blood supply to the pelvic organs, as a result of which venous congestion and dystrophic processes develop in the genitals.
And they can also cause anatomical changes in the genital organs: ovarian cysts, colpitis, salpingo-oophoritis and vulvitis. Due to hormonal imbalance and impaired blood supply to organs against the background of venous stasis, hormonally dependent diseases can develop. More often it is endometriosis and uterine fibroids, which also contribute to the occurrence of pain.
Sexual relations are a normal and natural part of life, but sometimes there are various problems that hinder or even interfere with these relationships.
Dyspareunia is pain and discomfort during intercourse that occurs in the area of the external or internal genital organs. Sensations can be of varying intensity and duration, accompany the entire sexual intercourse, or be present only at the beginning. Painful sensations can be expressed cyclically or present regardless of the menstrual cycle. The causes of dyspareunia are varied and do not always lie in the bodily disease, a certain proportion of patients with such complaints have psychological causes as the basis of their condition.
Possible causes of pain during intercourse
Often the cause of pain during sexual intercourse is very simple - for example, an uncomfortable body position. If the occurrence of an attack of pain is associated only with a change in body position, do not worry. Sometimes the appearance of pain during intercourse is associated with purely mechanical causes. This is dryness of the vaginal mucosa or tension in the walls of the vagina. It is also important to consider the emotional state. If sex takes on a frankly rough form or is aimed mainly at obtaining physiological pleasure, then it can lead to the release of an insufficient amount of secretion into the vagina and pain during intercourse.
Normally, sexual intercourse should not cause any pain.
Use as a contraceptive intrauterine device(IUD) may be associated with the risk of pain during sex and prolonged painful periods. This risk is minimized with a hormonal IUD and is quite high with copper coils. The action of the IUD is based on the activation of aseptic inflammation of the inner lining of the uterus and the thickening of mucus in the cervical canal (cervical canal). Persistent inflammation and provokes pain, especially with an active sexual life.
The beginning of the use of combined oral contraceptives often associated with a decrease in libido (this depends on the progestogen component of the drug) and a decrease in the production of vaginal secretions (lubrication). Because of these factors, sex in the early stages of taking COCs may not change for the better. However, these phenomena are usually temporary and harmless.
Mismatch in the size of the genitals of partners can also cause pain and discomfort during intercourse. If the vestibule of the vagina is very narrow, and the size of the partner's penis is large, then mechanical stretching and damage to the skin and mucous membranes occurs. This cannot but create unpleasant sensations.
A hypersensitivity reaction to a contraceptive or auxiliary elements is possible. An allergic reaction is theoretically possible to anything. The latex from which the condom is made, the lubricant on the condom, the lubricants used in sex are all multicomponent matters and hypersensitivity reactions are not uncommon. But in this case, it is enough to take a short break and change the brand or type of contraception. Usually the situation is resolved quite painlessly and does not entail consequences.
Diseases accompanied by pain during intercourse
Endometriosis is a disease unique in its structure that has a tendency to invade, that is, the pathological tissue is able to invade neighboring organs and tissues and cause a specific non-inflammatory process in them.
Imagine what is normally rejected during menstruation - this is blood and particles of the mucous membrane of the inner lining of the uterus (endometrium). Normally, this mass leaves the cavity in 3 to 7 days and does not disturb the discharge until the next menstruation. With endometriosis, particles of the endometrium are introduced into the walls of the uterus (uterine endometriosis or adenomyosis), then spread to the fallopian tubes and ovaries, to the peritoneum, intestines (first to the rectum, then further) and less often to other organs. According to the cycle, the same changes occur in these foci as in the uterus, the foci swell, they can bleed (spotting brown discharge during the intermenstrual period), endometrioid cysts can form in the ovaries. All these pathological processes disrupt the quality of life in general (since pains over the womb, and sometimes throughout the abdomen, turn off a woman from her usual schedule) and the quality of sexual life in particular. Sometimes sexual intercourse is so painful that a woman deliberately refuses it. These pains are usually long time cyclical (in the middle of the cycle and a few days before menstruation), and then, when the process spreads, they become almost constant. We are now talking about the course of the disease without treatment. With specific treatment, pain is significantly reduced and may disappear altogether. It is possible to help the patient even when the process is running, as many come late, believing that painful menstruation and sexual relations are the norm, and the lot of a woman is to endure. Such women, as a rule, apply only when the pain becomes unbearable and other symptoms are present (for example, a decrease in hemoglobin due to regular heavy menstrual blood loss).
- Inflammatory diseases. Chronic or acute endometritis is an inflammation of the inner lining of the uterus of various nature, often a complication after intrauterine interventions (abortions, diagnostic curettage) and childbirth.
Candidiasis or thrush cause mucosal damage, accompanied by itching, burning and pathological discharge. The loosening and vulnerability of the mucosa make sex during an exacerbation of thrush an extremely unpleasant process throughout its entire length.
Sexually transmitted infections (chlamydia, gonorrhea, trichomoniasis, and others) also affect the mucous membrane, and combat sensations during intercourse are caused by friction.
Bartholinitis is an inflammation of the Bartholin's gland (a gland in the vestibule of the vagina) that can be caused by a variety of infectious agents. At the entrance to the vagina there is an edematous and painful rounded formation. When trying to penetrate, the woman experiences severe pain and sexual intercourse is usually impossible until cured.
- adhesive process- this, as a rule, is not an independent pathological process, but a consequence of other diseases, conditions and procedures. Adhesions are formed after the transfer of inflammatory diseases, ruptures and torsion of ovarian cysts and curettage of the uterine cavity (instrumental abortion, curettage after an unsuccessful medical abortion or missed pregnancy, separate therapeutic and diagnostic curettage for bleeding, hysteroscopy).
Adhesions are the adhesion of various anatomical structures to each other (uterine walls to each other, adhesion of intestinal loops to each other and to neighboring organs, soldering of the peritoneum to the abdominal organs).
Sexual intercourse, especially active, causes a temporary displacement of organ structures, which entails the tension of adhesions and is accompanied by pain. The pain can be localized above the bosom or in various parts of the abdomen. As a rule, partners adapt to certain positions in which pain is not so pronounced.
- Genital warts- these are outgrowths of the vaginal mucosa of an elongated shape (as a rule, they begin to form from the vestibule of the vagina, and then spread to the cervix and external genitalia), which are of a viral nature (human papillomavirus). During sex, friction is felt, warts can be damaged and even bleed. After treatment, sexual relations return to normal.
Uterine fibroids are now very common. In this case, rather large nodes are important, which can cause compression of other organs or are located in the cervical-isthmus region, or are located on a stalk and the node's nutrition process is disrupted. Constant severe pain during intercourse due to fibroids is not typical, but this does not mean that you do not need to see a gynecologist.
- Atrophic colpitis. Atrophy, that is, thinning and dryness of the mucous membranes, is a companion of ladies of elegant age. The postmenopausal period is often accompanied by the so-called genitourinary syndrome. This includes all disorders associated with age-related changes in the pelvic floor. The lack of estrogen leads to atrophic changes in the mucous membranes, while maintaining a regular sexual life, this can create discomfort (itching, burning) and pain during and after sex.
- Varicose veins of the small pelvis- a rather rare cause of both chronic pelvic pain in general and pain during sexual intercourse in particular. This shows the joint management of the patient by a gynecologist and a phlebologist.
- Somatic diseases. Some, at first glance, unrelated to sexual life, diseases can have a significant impact on sexual activity and its comfort.
Diabetes mellitus causes dry mucous membranes, reduces local immunity, and as a result, a woman suffers from endless relapses of candidiasis or nonspecific colpitis.
Diseases of the rectum and anus, such as hemorrhoids or anal fissure, and other rarer diseases (ulcerative colitis or Crohn's disease), create mediated pain. There is no pain directly in the vagina, but the close interposition of organs (bladder, uterus and rectum) contributes to the fact that sexual intercourse provokes pain.
Chronic cystitis for the same reason can be provocateurs of discomfort during sex.
Diffuse skin diseases, such as scleroderma, dermatitis, eczema, affect the skin, including the skin of the perineum. In this case, not only and not so much the sexual intercourse itself will be unpleasant, but touching and rubbing the skin.
- Condition after surgical treatment. Changes in the architectonics of the pelvic organs and pelvic floor muscles after surgical treatment (plasty of the vagina during prolapse, plastic of the perineum after complicated childbirth) can provoke pain during intercourse. Sometimes this is an initial phenomenon that disappears over time, but it happens that after the healing process comes with peculiarities and the vestibule of the vagina narrows greatly, which creates certain difficulties in sexual life with a former partner.
If we are talking about abdominal surgery (it does not matter whether it was a laparotomy or a laparoscopic intervention), then the development of an adhesive process in the small pelvis and abdominal cavity is likely. The adhesive process affects various adjacent organs, so an intense sex life can cause severe pain that persists for some time after the cessation of sexual intercourse and even require medication.
Weak pain during intercourse and bleeding after it can be with diseases of the cervix, including cervical erosion, and pain may be its only symptom.
From weak to severe pain during sex can be observed in the presence of adhesions in the small pelvis, in this case, pain occurs systematically during the same manipulations during intercourse, more often in the ovarian region.
If the pain is felt mainly after the introduction of the penis, then the most common causes of it are inflammation of the vulva or labia majora or an infectious process in them. If the pain occurs with deeper thrusting of the penis, it may be due to an infection in the vagina. Such pains, as a rule, are accompanied by leucorrhea (discharge from the vagina) with an appearance or smell that differs from the norm, itching in the external genital area. In this case, only a doctor can make a diagnosis based on the results of the analysis, taking a smear by PCR.
Pain during intercourse, radiating to the lower back (right and left) occurs with inflammation of the uterine appendages, pain in the lower abdomen, sometimes accompanied by bleeding during intercourse - with inflammation of the endometrium.
Among other causes of pain during intercourse are infectious diseases of the bladder and urinary tract.
Sometimes pain during intercourse occurs with PCOS (polycystic ovary syndrome), in which the ovaries are enlarged and slightly painful, with ovarian cysts and other neoplasms of the pelvic organs, both benign and malignant (cancer).
Sexual intercourse can provoke symptoms of an acute abdomen with appropriate disorders (rupture of an ovarian cyst, ectopic pregnancy, a myomatous node being born, torsion of the ovarian tumor, etc.), which is accompanied by severe pain and requires emergency surgical intervention. In these cases, you need to seek medical help urgently!
Hormonal disorders of the female reproductive system can provoke uterine spasm, which is also accompanied by pain in the lower abdomen.
Psychological causes of pain
- Lack of psychological readiness for sexual relations. Often, young girls follow the desires of their boyfriend, while not having their own opinion on this issue, or, even worse, there are fears and fears, but the fear of losing a relationship is stronger. Thus, sex for a young girl is initially associated with coercion and overstepping oneself. In the future, a lot depends on the partner, if the girl feels confident in the relationship, does not experience fears and is not subjected to pressure, then the first negative feelings are smoothed out and may not affect her later life. But it often happens that once having chosen a yielding position, a woman continues to build unequal and inharmonious relationships in the future. Sex is not perceived as part of a healthy adult relationship, but only as a service or a sacrifice. Over time, this role cannot but affect the body, sexual intercourse can be accompanied by pain of varying intensity, so the body tries to bring the existing problem into consideration.
Dyspareunia is in some cases one of the psychosomatic diseases (if physiological causes are excluded). Psychosomatic diseases are diseases of the body (soma in Greek means "body"), which are caused by mental and psychological causes.
- Consequences of a traumatic situation. The traumatic situation in many cases is different, everyone has a different threshold of psychological stability, but situations such as rape by acquaintances or strangers, sexual harassment from relatives or other persons whom the victim previously trusted (friends of parents, colleagues, and others) cannot but leave a trace . The trauma becomes especially severe if a pregnancy occurs as a result of rape. Few decide to save and bear in this case, and the termination of pregnancy leaves a painful mark on the soul of a woman. Subsequent potential sexual partners are perceived as hostile, and if the relationship does go to new level, then the protective reaction of the body can also manifest itself in the form of convulsive contraction of the muscles of the vagina, and then pain during penetration and the sexual intercourse itself.
- Mismatch of temperaments of partners. If a woman is naturally endowed with a gentle and calm disposition, and a partner requires a different behavior in bed and more frequent sex, then a feeling of guilt, inconsistency may arise, which leads to a defensive reaction in the form of pain during sexual intercourse. In addition to pain during sex, a woman often does not experience not only an orgasm, but in general any positive sensations.
- subconscious fears. Sometimes a woman is terribly afraid of becoming pregnant or contracting an infection. In this case, sexual intercourse is an immediate threat to her peace of mind. Such consequences are not uncommon after the termination of an unwanted pregnancy in the past, especially if the pregnancy occurred while using contraception. So a woman feels the lack of control over the situation, and the only possible way protection from undesirable consequences sees abstinence. With a long-term and unresolved fear, it takes root in the mind and can affect sexual life even when the girl decides to have sexual relations on her own.
There may also be a situation when there was a risk of contracting a serious disease (HIV infection, hepatitis B and C, gonorrhea, and others) from a partner, and the woman found out about this after sexual intercourse or during a relationship. This situation contributes to the loss of trust in the opposite sex and a decrease in sexual desire. Dyspareunia in these cases is a subconscious defense against dangerous consequences for the patient.
Consequences
The consequences of dyspareunia are usually psychological in nature. A woman avoids sex with her husband or partner, which can lead to misunderstanding and alienation. Especially if conversations about intimate problems are not accepted in the relationship. The woman becomes isolated and feels inferior.
Untreated gynecological diseases, the first symptom of which was pain during sex, progress and further lead to even greater problems (chronic pelvic pain, infertility, menstrual irregularities).
Diagnostics
Half of the diagnosis is a correct and detailed history of the disease and anamnesis of life. It matters when the pains appeared, what their nature is, whether they depend on the menstrual cycle, what diseases the patient suffered and how it was treated / treated, whether there were psycho-traumatic situations in the past. It is necessary to find out how the patient menstruates, whether the nature of menstruation has changed (duration, profusion, soreness, the appearance of clots and intermenstrual spotting). Reproductive history, number of births, abortions, miscarriages, complications. Operations and the method of contraception also play an important role.
For a full examination, the patient must be undressed, so you can assess the condition of the skin and mucous membranes, the presence of enlarged lymph nodes, and much more. When viewed on a chair, you can sometimes immediately find out the cause of pain (colpitis, bartholinitis, condylomas are visible to the naked eye). The pain of a gynecological examination already indicates any deviation from the norm. If you feel pain during the examination, be sure to tell the gynecologist and specify the localization of the pain (back wall, side, etc.), this will help in the diagnosis.
Laboratory research:
- a smear for flora and a cytological examination of a scraping from the cervical canal are mandatory routine studies that are carried out during the initial examination;
- Examination for STIs is indicated if a specific nature of inflammation in the vagina is suspected.
Instrumental research:
- Ultrasound examination of the pelvic organs is the basic level of diagnosis. Good specialist Ultrasound will see myoma, and signs of endometriosis, and varicose veins of the small pelvis, and much more, which will help the clinician in diagnosis.
- MRI and CT of the pelvis are indicated for suspected mass formation or a common pathological process.
Laparoscopy is a diagnostic and treatment procedure that is performed only in a hospital and according to strict indications.
You may need to consult a surgeon, coloproctologist, endocrinologist, dermatologist, allergist, psychologist or psychiatrist.
Treatment of pain during intercourse
The treatment of the underlying disease will be the specific treatment of dyspareunia, which is only one of the symptoms, although often the most striking and disturbing for the patient.
By removing warts or an inflamed Bartholin's gland, by carrying out a specific treatment for endometriosis or infectious colpitis, we will help a woman regain her quality of life, including sexual life.
If the cause is psychological, then competent psychotherapy and drug correction will be the best etiological (that is, affecting the cause) treatment.
Which doctor should I contact for pain during intercourse?
If pain during intercourse is not an isolated case and they are repeated from day to day or are accompanied by other unpleasant symptoms, urgently contact doctor - gynecologist for advice and treatment.
Dyspareunia is a symptom of some pathological condition, the diagnosis and treatment of which should be handled by specialists. A disease detected in time is almost always treatable with a good clinical effect.
If you notice the appearance of pain or discomfort during sexual intercourse, then see if they depend on the cycle, if there are any other complaints, cycle disorders or psychological problems. After considering the problem, be sure to consult a gynecologist. Pain during sex is not normal, at least, and then it can lead to more serious reproductive problems. Find a doctor you trust and follow his recommendations. Look after yourself and be healthy!
The content of the article:Pain during sexual intercourse is experienced by 1 out of 10 women, the causes of pain during sex are always different.
Let's try to figure out what prevents you from enjoying intimacy and is a cause for concern, provoking pain during intercourse in women.
What is the pain during sex?
Pain with vaginal dryness
The pain occurs when the penis is inserted into the vagina, continues during friction (movements) during sex.
Cause: vaginal dryness, lack of sufficient lubrication.
This problem occurs in 1 out of 4 women, factors that affect the appearance of vaginal dryness include:
Atrophy of the tissues of the vagina during menopause (this is what common cause insufficient lubrication),
hormonal disorders,
taking certain medications
psychological fear before intimacy.
You can eliminate pain during intercourse with the help of a lubricant (additional lubricant) or a special vaginal cream. Humidifiers are sold in the pharmacy chain.
Pads, various intimate hygiene products, and excessive douching of the vagina can irritate the delicate vaginal mucosa.
Urogenital candidiasis
During sex, itching is felt in the vulva of a woman, during intercourse, painful sensations (and sometimes pain) in the vagina are disturbed, a whitish discharge with a characteristic sour smell may appear.
After sex, a woman may experience burning and pain when urinating.
It must be answered that with thrush, vaginal discharge is not always, and the only sign of a candidal infection is pain in the vagina.
Cause: Thrush (candidiasis) of the vagina, infection with a fungal pathogen Candida Albicans.
What to do? Sign up for a consultation with a gynecologist, take smears, get recommendations, and be carefully treated. Your partner may need examination and treatment.
Acute vulvovaginitis
If you have a sharp pain during sex, pain after sex, discharge, the cause may be acute vulvovaginitis.
It is necessary to undergo a diagnosis for pathogens of sexual infections, pass a smear on the flora and sensitivity to antibiotics.
Ovarian cyst
Drawing pain in the right or left inguinal region, radiating to the lumbar region, down the abdomen. Increases with deep penetration of the penis into the vagina.
Cause: ovarian cyst (tumor of the ovary). Most cysts are harmless and disappear on their own in about 3 menstrual cycles. It is necessary not to postpone a visit to the gynecologist, ovarian tumors are benign (cyst) and malignant (cancer). Only after the study can a correct diagnosis be established. A large ovarian cyst can rupture, and then only emergency hospitalization with surgery can save a woman's life.
If it's the "harmless" cysts, it's best to try the "woman on top" position during sex, this will help you control the depth of penetration.
Tumor formations of the uterus
The most common is uterine fibromyoma, its clinical manifestations are characterized by pain in the lower abdomen, frequent urge to urinate, pain in the uterus during sexual intercourse, a change in the nature of menstruation (abundant, longer period).
What to do? Consultation with a gynecologist, transvaginal ultrasound; treatment is selected by the doctor in each case individually.
Tumors of the uterus are not only benign, but also malignant. In the early stages clinical manifestations both fibromyomas and cancer of the body of the uterus are very similar, a woman alone is not able to make a correct diagnosis for herself.
Erosion of the cervix (cervical tumor)
Pain syndrome during sexual intercourse is slightly expressed, but there are brownish spotting from the vagina after sex.
What to do? Urgently to the gynecologist to perform colposcopy, cauterization of erosion is possible. If a tumor pathology of the cervix is diagnosed - further treatment by an oncogynecologist, depending on the stage of cervical cancer.
urinary tract infection
After sexual contact, the urge to urinate becomes more frequent, with pains, the feeling of incomplete emptying of the bladder may disturb. Sometimes the pain radiates to the lumbar region.
What to do? Pass a general urine test, make an appointment with a urologist, gynecologist (examination for sexually transmitted diseases).
Vulvodynia
Pain in the genital area occurs not only during intercourse, but also during any contact with the genitals: when riding a bicycle, gynecological examination, inserting a tampon.
Cause: hyperactivity of the nerve endings of the vagina in response to long-term infections, taking antibacterial drugs.
What to do? Consult with a gynecologist and a psychotherapist.
Venous congestion in the pelvic area
For venous stasis, aching pains are characteristic, a feeling of "bursting" in the lower abdomen. Additionally, it is worth paying attention to the appearance of vascular networks, characteristic of varicose veins veins, edema lower extremities, episodes of exacerbation of hemorrhoids, heaviness in the legs after exercise.
What to do? It is necessary to consult a vascular surgeon, a gynecologist.
If the disease has not reached an advanced stage, it is enough to correct the lifestyle and take medications to eliminate this problem. An active sex life helps to reduce congestion in the pelvis, since during an orgasm a woman redistributes blood and improves blood circulation in the genitals.
Vaginal changes after childbirth
Especially the development of discomfort during intercourse in a woman is expected after a difficult birth. Sometimes, for obstetrics, they use surgical aids, suturing the perineum, which in some women leads to the formation of an adhesive process. Adhesions represent a connective tissue devoid of elasticity, which is why it is possible to feel pain during sex.
Early onset of sexual activity after childbirth, especially if postpartum stitches were applied, can lead to complications that accompany pain during intimacy.
Within 3-4 months, as a rule, the pain disappears, and the woman can again enjoy intimacy.
If the pain in the vagina persists for more than 6 months, then you can consult a surgeon for excision of adhesions.
The use of a lubricant will help reduce the manifestations of pain. Massage of the perineum with the use of an anesthetic drug helps well. It can also be used during intimacy.
endometriosis
Pain with endometriosis feels like menstrual pain that spreads throughout the pelvis. With deep penetration of the penis into the vagina, there is an increase in pain. The pain may continue for several hours after sex.
Such a clinic is typical for endometriosis, a disease in which the tissue lining the uterine cavity extends to other organs. Endometriosis is one of the causes of female infertility. According to statistics, about 17% of women suffer from this pathology.
What to do? Contact a gynecologist, it is possible to perform an operation, prescribe hormonal treatment, which will correct the situation.
Neuralgia of the pelvic nerves in a woman
Neuralgia of the pelvic nerves is one of the causes of pain during sexual intercourse. When the body changes in space, the pain may recede. The diagnosis is quite difficult to make, since the symptoms are similar to a number of pathological conditions that manifest as pain in the vagina. A gynecological, urological examination is carried out, with normal clinical and diagnostic indicators, they are referred for a consultation with a neuropathologist.
Taking NSAIDs (non-steroidal anti-inflammatory drugs) and physiotherapy helps to cope with pain.
In conclusion, we note that pain is the body's reaction to trouble, an attempt to attract attention, therefore, any pain sensations cannot be ignored.
The average price of a gynecologist's consultation in Moscow is 1600 rubles, neuropathologist - 1850 rubles, oncologist - 2800 rubles.
Examination by PCR method for STIs 4064 rubles.
Transvaginal ultrasound (ultrasound with a vaginal sensor) average cost in Moscow from 850 rubles.
