Advanced Care and Treatment Options for Women with Dyspareunia

Dyspareunia is the clinical term used to describe recurrent episodes of pain during or after intercourse. The pain may be felt in the vagina, clitoris, labia or deep within the pelvis and may be described as sharp, burning, throbbing, tearing, aching, dull or intense. Regardless of the type and location of the pain, the female sexual health experts at University Hospitals can help women with this condition.

What Causes Dyspareunia?

Dyspareunia can be caused by both physical and emotional/psychological conditions, most of which are treatable once identified. Some of the physical conditions that can cause or contribute to painful sex include:

• Endometriosis and uterine fibroids
• Genital skin conditions
• Genital Trauma
• Injury or trauma from childbirth
• Pelvic inflammatory disease (PID) - an infection of the reproductive organs
• Side effects of cancer treatments
• Urinary tract infections
• Vaginal dryness due to menopause, low libido, medications or inadequate arousal
• Vulvo-vaginal disorders

An Accurate Diagnosis Ensures the Appropriate Treatment

When a woman reports that she is having pain with sexual intercourse, the first step is to determine if there is an existing physical condition or conditions that could be causing the pain. This may be accomplished by:

• Taking a complete medical and sexual history
• Asking questions about the type and location of the pain and when it occurs
• Conducting a pelvic examination to look for structural abnormalities of the external genitals and vagina
• Urine and/or blood tests
• Vaginal culture test to check for bacteria or other infections
• Pelvic ultrasound to examine the internal pelvic organs including the uterus, ovaries and bladder

How is Dyspareunia Treated?

Treatment will depend on the diagnosed cause(s) of your pain.

If a physical cause is found, it will be treated as appropriate. For example, vaginal dryness may be treated with hormone therapy or an underlying infection cleared up with antibiotics, antifungals or steroid medications. Often times, pelvic floor physical therapy is used in conjunction with medical and surgical treatment in order to help you make lasting improvements.

Dyspareunia can often be distressing for women. Therefore, your provider might recommend working with a specialized psychologist or sex therapist in conjunction with other treatment.