Dyspareunia: Why Do You Find Sex Really Painful?

Sex isn’t always smooth-sailing, but when it’s downright painful your wellbeing may be at risk of dyspareunia. This is the clinical term for painful sex, which can cause a burning, sharp, searing or cramping pain in your abdomen, pelvic region or vagina. The pain can also affect you externally, but why does dyspareunia have such an impact on your wellness?


The exact number of women whose sexual health is affected by dyspareunia is unknown, but, back in 1986, Masters, Johnson, and Kolodny discovered that roughly 15% of adult women have painful intercourse on at least a few occasions in a given year, but 1-2% suffer more often than that. Then, in 1990, Spector and Carey reviewed the literature on dyspareunia and reported incidence ranging between 8% and 23% percent across studies. The cause of each case may be due to any number of given factors, or the precise cause may not be identifiable at all. As with most cases of sexual dysfunction, the causes of dyspareunia can be classified as either organic (physical or medical factors such as illness, injury or drug effects) or psychosocial (including psychological, interpersonal, environmental and cultural factors).


As a woman, your dyspareunia may be caused by dozens of underlying physical conditions – basically anything that leads to poor vaginal lubrication. Commonly, drugs that have a drying effect – such as antihistamines, certain tranquilizers, marijuana – and disorders such as diabetes, vaginal infections, and oestrogen deficiencies can cause discomfort during intercourse. Still, the buck doesn’t stop there. Other causes of dyspareunia include:


  • Blisters, rashes and inflammation around your vaginal opening or vulva
  • Clitoral irritation or infection
  • Disorders of the vaginal opening, such as scarring from an episiotomy, intact hymen or remnants of the hymen that are stretched during intercourse, or infection of the Bartholin’s glands
  • Disorders of the urethra or anus
  • Disorders of the vagina, such as surgical scarring, thinning of vaginal walls (be it due to ageing or oestrogen deficiency), and irritation due to chemicals found in contraceptive materials or douches
  • Pelvic disorders such as infection, tumours, abnormalities of the cervix or uterus, and torn ligaments around your uterus


There are also psychosocial causes of dyspareunia. These may be as frequent and varied as organic ones, but it’s harder to see the clear link between such factors and the condition itself. According to many authorities, developmental factors – such as a troubled parent-child relationship, a negative family attitude towards sex, a traumatic childhood, a traumatic adolescent sexual experience and a gender identity conflict – may all predispose you towards developing a sexual dysfunction. When it comes to dyspareunia, if you’ve been brought up to believe that sex is wrong or will cause you pain, you’re more likely to feel pain with intercourse as an adult. Similarly, a one-off painful sexual experience may make you expect painful intercourse in the future.


Then you have personal factors at play in dyspareunia, such as anxiety or fears or pregnancy, intimacy and rejection. These feelings, and others, may block your brains’ pathways of sexual response, and instead cause you to feel pain. Dyspareunia can also result as a consequence of relationship problems or interpersonal conflicts, including power struggles, hostility towards your partner, preference for another partner, distrust, poor communication and lack of attraction to your partner. Other personal factors involved in painful sex include feelings of guilt, depression and poor self-esteem. That said, it is not always clear which came first, the feelings or the dysfunction. If you suffer from dyspareunia, this can cause you to feel depressed or unconfident, and so identifying a problematic feeling does not always mean it caused the dysfunction.

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