Patient education: Dyspareunia (painful sex) (The Basics)

What is dyspareunia? — Dyspareunia is pain that happens just before, during, or after sex. It can happen in males and females, but is more common in females.

In females, pain can affect the vulva, which is the area around the opening of the vagina. Or the pain can be inside the vagina or in the lower belly (figure 1).

Males can have pain in the penis, testicles, belly, and sometimes the rectum.

What causes dyspareunia? — There are many possible causes.

In females, common causes include:

●Childbirth – Sex can be painful for several weeks or months after giving birth.

●Endometriosis – In this condition, tissue that normally grows inside of the uterus grows outside of it. This can cause pain in the belly during sex.

●Vaginal dryness – This can be caused by:

•Menopause – This is the time in life when you stop having monthly periods. At menopause, the vagina and tissues around it can get dry and thin. This can make sex hurt.

•Not being aroused or "excited" before sex

●Conditions that cause long-lasting pain in the vulva, bladder, or pelvis – These can include:

•"Vulvodynia" – This is pain in the vulva.

•"Interstitial cystitis/bladder pain syndrome" – This causes bladder pain and other symptoms.

•"Chronic pelvic pain" – This is pain in the area below the belly button that lasts 6 months or longer.

●An infection in the vagina or bladder

●Skin problems around the vagina

●Bad feelings about a partner or relationship – Feeling bad about your partner or about yourself can make sex painful.

●A painful experience in the past – This could be a past experience of sex or a medical exam that hurt. It could even be pain from using a tampon.

●Birth control pills – Some people who take birth control pills start having pain during sex.

In males, common causes include:

●Infections – These can include:

•An infection in the prostate – The prostate is a gland that makes some of the fluid that is released during sex. Infections in other parts of the body can also make sex hurt.

•An infection spread through sex, such as gonorrhea

●Skin problems

●Bad feelings about a partner or relationship – Feeling bad about a partner or about yourself can make sex painful.

Should I see a doctor or nurse? — Yes. If sex is painful, see your doctor or nurse. Some people feel embarrassed talking about it, but your doctor or nurse can help you.

Will I need tests? — Your doctor or nurse will decide which tests you should have based on your age, other symptoms, and individual situation. They will do an exam and ask you about your symptoms.

Some common tests doctors use to find the cause of dyspareunia:

●Urine tests – These can look for a bladder infection.

●Tests on a sample of fluid from the vagina – These can look for an infection in the vagina or cervix.

How is dyspareunia treated? — Treatments for females include:

●Antibiotics or antifungal medicines – These can help if the pain is caused by an infection in the vagina or bladder.

●Creams or gels to keep the vagina moist – These include:

•Vaginal lubricants, which are used during sex

•Vaginal moisturizers, which are used several times a week

•A prescription cream to treat vaginal dryness or a skin condition

●Gels or ointments to numb the vagina before and after sex.

●Physical therapy to loosen the muscles around the vagina.

●Counseling – This can help if pain is caused by bad feelings about sex, a relationship, or yourself.

●Surgery – In a few cases, pain is caused by a growth inside of the body. Doctors might do surgery to take out the growth.

Treatments for males include:

●Medicines to treat infection or other conditions that cause pain – These can include antibiotics and other medicines.

●Treatment for skin problems

●Counseling – This can help if pain could be caused by feeling bad about sex, a relationship, or yourself.

More on this topic

Patient education: Sex problems in females (The Basics)
Patient education: Sex problems in males (The Basics)
Patient education: Endometriosis (The Basics)
Patient education: Vaginal dryness (The Basics)
Patient education: Menopause (The Basics)
Patient education: Vulvar pain (The Basics)
Patient education: Bladder pain syndrome (interstitial cystitis) (The Basics)
Patient education: Chronic pelvic pain in females (The Basics)
Patient education: Bartholin gland cyst (The Basics)
Patient education: Bacterial prostatitis (The Basics)
Patient education: Sex as you get older (The Basics)

Patient education: Sexual problems in females (Beyond the Basics)
Patient education: Sexual problems in males (Beyond the Basics)
Patient education: Endometriosis (Beyond the Basics)
Patient education: Vaginal dryness (Beyond the Basics)
Patient education: Menopause (Beyond the Basics)
Patient education: Diagnosis of interstitial cystitis/bladder pain syndrome (Beyond the Basics)
Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics)
Patient education: Chronic pelvic pain in females (Beyond the Basics)