Dyspareunia: understanding and acting when you suffer during sexual intercourse

The sexual act is widely considered as a moment of pleasure and intimate sharing for couples. It's a companionable moment, sweet or on the contrary more lively, between two or more people! But this whole balance becomes more difficult when one of the people involved experiences regular or even recurring pain during sexual intercourse : the moment of sharing can turn into torture, into constraint, into a problem. Together, let's discover dyspareunia and what can be done to address it and relieve your pain.

What is dyspareunia?

Dyspareunia refers to pain felt just before, during and after sexual intercourse , in the genital region (internal and external). Contrary to what one might think, dyspareunia affects both women and men. This article will not deal with male dyspareunia because our expertise concerns women: if you are a man and think you suffer from male dyspareunia, we recommend that you read this article , which is particularly interesting, and consult your doctor.

Dyspareunia in women

In women, there are different types of dyspareunia depending on the location of the pain ( superficial dyspareunia and deep dyspareunia ) but also depending on when the pain is felt in the person's life ( primary dyspareunia, dyspareunia secondary, permanent dyspareunia and intermittent dyspareunia ). We take the time to describe all of these pains in the rest of this article.

The main cause of dyspareunia is vaginal dryness , but this pathology can also be the consequence of a wide number of factors. To treat dyspareunia, it is necessary to determine the cause(s). Many medical and natural treatments then exist!

Dyspareunia should not be taboo

Don't stay in pain and say no to pain during sex ❤️

Female sexuality sometimes remains taboo and we can only deplore this.

Whatever your age, your sexuality, your culture, sexuality should not be painful. If you are in pain, you need to talk about it: with your partner and with your healthcare professionals. The first will know how to adapt and the second will be able to help you find medical and natural solutions to relieve you.

Occasional pain or chronic dyspareunia: know the difference

Before going any further in this article on dyspareunia, it is essential to focus on an important point of understanding. There is an important difference between occasional pain and chronic dyspareunia.

If you experience occasional pain during sexual intercourse, there may be no reason to worry. This pain can be induced by the sexual position, by the fact that penetration was done with too much enthusiasm or that you were a little irritated by several sexual encounters... It is not serious to suffer occasionally during intercourse: talk Ask your partner and take a break/change position/practice.

Chronic dyspareunia involves recurring pain. If you suffer every time you have sex, at the time of penetration or during, or after every sex, this is not normal. Especially if the pain always comes from the same causes and is similar: it is possible that you suffer from a pathology that prevents you from enjoying your sexuality.

The different forms of dyspareunia

We talked about it a little earlier in this article: dyspareunia is often qualified based on the types of pain felt. Understanding what type of dyspareunia you suffer from can help you better identify the causes and discuss it with your healthcare professional.

Primary dyspareunia

Primary dyspareunia involves dyspareunia that occurs early in a person's sexual life. In other words, the person has always felt pain during sexual intercourse, especially during penetration. We then speak of primary pain. This form of the pathology can be caused by initial trauma, stress or even physiological problems.

Secondary dyspareunia

Secondary dyspareunia occurs after a period of pain-free sexual intercourse – we speak of a type of secondary pain. This form of dyspareunia can be triggered by factors such as surgery, infection, trauma or hormonal changes.

Superficial dyspareunia

Superficial dyspareunia concerns forms of the pathology where pain is felt in the vulva and labia or at the entrance to the vagina. The term “superficial” refers to the location of the pain (on the surface) and not the intensity of the pain which can be significant and bothersome. It is often associated with local causes, such as infection or irritation.

Profound dyspareunia

Deep dyspareunia refers to forms of the disease where pain is felt deeper in the lower abdomen, in the pelvis, particularly during penetration. This pain resonates and sometimes lasts several minutes after the end of the sexual act. It can be linked to conditions like endometriosis, ovarian cysts, or other internal medical conditions.

Permanent dyspareunia

In the case of permanent dyspareunia , the pain is permanent. They take place each time sexual intercourse takes place in the same way (for example at each penetration). This form of dyspareunia can be caused and/or triggered by factors such as surgery, infection, trauma or hormonal changes.

Intermittent dyspareunia

Intermittent dyspareunia , finally, refers to pain that occurs regularly, in the same context, but which is not systematic: for example, if you have the same pain one in three times during vaginal penetration. This form of the pathology can be linked to an infection or hormonal changes.

What are the symptoms and different types of pain?

After having seen the forms that the pathology can take, let's discover together the different symptoms and the different types of pain that you can feel and which can put you on the trail of dyspareunia. If you choose to consult a practitioner about your pain (we recommend it), it will be important to describe the pain you are experiencing and this list can be a tool.

Pain on penetration

As its name suggests and describes it well, it is a pain that occurs during penetration. It can appear from the start of the penetration attempt, at the level of your vulva or the entrance to your vagina or afterwards, during penetration.

Deep pain during intercourse

It is possible that penetration does not particularly cause you pain but that it manifests itself later, deeper in your lower abdomen, with each movement or each thrust. Perhaps you even have the impression that your partner's penis is pressing against you, causing you pain.

Prolonged pain after intercourse

The pain may be persistent and continue after sex, whether or not you have asked your partner to stop.

Burning or shooting pain

This pain refers to the way you feel pain, right before, during or after sex. Some describe the pain as a burning or tingling sensation, while others call it stabbing and stabbing pain that lingers even after intercourse.

Muscle spasms, vaginismus

During foreplay or during penetration, it is possible to experience painful muscle spasms. The pelvic floor muscles contract suddenly and involuntarily – you have no control over them, and they cause significant pain. We are talking about vaginismus. This type of pain can be caused by physiological or psychological reasons (stress, trauma, etc.).

Pain on palpation

This type of pain refers to pain that is present outside of sexual intercourse. The genital areas are sensitive to touch, yours, that of your partner, or even that of the practitioner.

Pain when inserting a tampon

This type of pain also refers to pain that is present outside of sexual intercourse. Your vulva, labia, entrance to your vagina, or vagina are so sensitized that inserting a tampon can be painful.

Pain during gynecological examinations

This last type of pain refers to pain that is present outside of sexual intercourse, during medical examinations and in particular pelvic examinations (touch, vaginal penetration, etc.). These cause or exacerbate your pain: talk to your gynecologist and remember that you always have the right to refuse an examination if you are uncomfortable/in pain. There are different tests to understand the causes of your dyspareunia and not all of them involve penetration.

What are the causes of dyspareunia?

The pains that are part of dyspareunia are numerous and it is therefore quite logical that the causes are varied. Let's discover together the physiological and psychological causes that can lead to pain before, during and after sexual intercourse.

Physiological causes

• Infections: certain sexually transmitted or non-sexually transmitted infections (such as yeast infections or urinary infections) can destabilize the balance of your vaginal flora and make you particularly sensitive. In addition to pain during sexual intercourse, it is often accompanied by peculiar white discharge ;
• Diseases and conditions: different diseases can cause superficial or deep pain during penetration, this is particularly the case for intimate dryness , endometriosis or even interstitial cystitis;
• Vaginismus: as you approach or during vaginal penetration, your pelvic muscles contract, creating significant pain and preventing penetration. Vaginismus can be linked to physiological and psychological causes;
• Vulvodynia: Vulvodynia is persistent vulvar pain with no identifiable cause. It can result from a dysfunction of the pain modulation system and is particularly disabling in the context of sexual relations but also in daily life;
• Trauma or lesions: an irritation or wound at the entrance or inside your vagina, resulting from repeated intercourse, a scratch or a shock, can generate recurring pain during intercourse – especially if intercourse help to revive the wound and prevent it from healing;
• Vaginal atrophy: this pathology is linked to a reduction in estrogen production. The vagina loses its flexibility and its walls become thinner. This is often accompanied by severe intimate dryness. Generally, vaginal atrophy occurs at menopause but it can occur at other times in a menstruating person's life, including during breastfeeding;
• Allergic reactions: an allergy to sanitary napkins , condoms (latex allergy), massage oils or even lubricants can cause pain during sexual intercourse. Either because your private parts are weakened, or because your private parts come into contact with the allergen during intercourse. Markers of an allergy include burning, redness and itching.

Psychological causes

• Past trauma: sex life is, for some people, a magnifying mirror of the trauma they have experienced. If you have been a victim of abuse, violence or even sexual violence, it is not abnormal for you to feel vulnerable during intercourse and for your body to defend itself as best it can;
• Fears of pain and sexual anxiety: the apprehension of pain or violence (in the case of past trauma) can lead to strong sexual anxiety which generates pain which begins during foreplay;
• Stress and anxiety: without necessarily being linked to abuse or your current partner, chronic stress can have an impact on your sexuality. You are tense, unable to let go, to concentrate on what is happening: your body does not react as you would like... These elements are likely to create pain which can increase until you develop a sexual anxiety;
• Relationship or confidence problems: lack of self-confidence and body image can also have an impact on the way you experience your sexuality and cause pain.

Can penis size cause intimate pain?

Many women associate their pain during intercourse with the size of their partner's penis (width and/or length). This is not false but it is not completely true either.

The size of the partner's penis can indeed play a role in the intimate pain you feel, but mainly in a psychological context: you tense, you anticipate, you contract and you suffer.

Physiologically, other than in the case of the particular condition of vaginal atrophy we discussed above, there is no reason why the size of your partner's penis should be the cause of physical pain. Indeed, the vagina can adapt to any size – the ultimate proof being that it is able to adapt to the size of a baby. Every woman can learn to use her vagina, relax the vaginal muscles, contract them during sexual intercourse…

Diagnosis of the causes of dyspareunia

We have already told you in this article but we would like to repeat it in the introduction to this new part: if you feel pain during sexual intercourse on a regular and repeated basis, we can only recommend that you turn to your trusted healthcare professionals.

Competent healthcare professionals

Because dyspareunia can be linked to both physiological and psychological reasons, there are four health professionals you can contact for information:

• General practitioner: the general practitioner has a global view of your state of health and is trained to treat all kinds of conditions. As dyspareunia has several causes, both medical and psychological, the broad approach of the general practitioner is interesting. He will suggest that you carry out additional examinations and/or consult specialists, if necessary;
• Gynecologist: as dyspareunia is linked to the female genital organs, your gynecologist is the preferred specialist to assist you with this pathology;
• Psychologist: because dyspareunia can be 100% psychological in origin, the intervention of a psychologist may be required. We recommend that you contact a psychologist once the physiological causes have been ruled out with your GP or gynecologist;
• Sexologist: in recent years, several health professionals have specialized in sexology. It may be interesting to consult one of these professionals to support you in the event of dyspareunia. Just pay attention to the second hat of your sexologist when choosing him: generally, sexologists are gynecologists or psychologists specializing in sexology.

We have recently developed a directory of healthcare professionals recommended by our community (and by you) for their kindness and professionalism: consult them and let us know your comments and feedback on their support.

Examinations allowing the diagnosis of the causes of dyspareunia

We advise you to meet a general practitioner or a gynecologist to first carry out examinations to ensure that your dyspareunia is not of physiological origin, before subsequently turning to approaches linked to your Mental Health. The following is a list of medical examinations to diagnose the causes of your dyspareunia.

Gynecological examination

The first examination that can help detect an anomaly and a cause of your pain is a gynecological examination. Generally, this involves external auscultation of your penis, a vaginal examination or even a pelvic ultrasound with penetration.

If you are particularly sensitive and are afraid of having pain, you have the right to ask for explanations (why are these examinations carried out?) and to refuse the various examinations offered to you. As you will see, there are other tools to diagnose the physiological causes of dyspareunia.

Crops

The second examination consists of taking a vaginal sample and carrying out bacteriological research on your vaginal flora, in particular to check that you do not have any genital infections. This examination can take place at your gynecologist or in an analysis laboratory and you will receive the results within a few days.

Abdominal ultrasound

The third examination consists of doing an abdominal ultrasound. The latter does not involve penetration and will therefore be subject to less apprehension on your part if this practice is terrorizing for you. It will allow you to observe your genitals and look for abnormalities, such as vaginal atrophy or the presence of cysts or endometriosis that could explain the deep pain you feel.

Laparoscopy

The fourth medical test that may be prescribed to diagnose the causes of your dyspareunia is laparoscopy. Another name for laparoscopy, this surgical procedure consists of observing the walls of your various genital organs in search of abnormalities that could create pain. The abdomen is incised under local or general anesthesia and the surgeon views the inside of your body through small cameras. This examination makes it possible to identify a very thin vaginal wall (consequence of vaginal atrophy) or the presence of cysts or endometriosis.

Psychological assessment

Last test that may be interesting to do if you suffer from dyspareunia: the psychological assessment. Each psychologist has his own methods. In one, or several, session(s), the professional will be able to identify if you suffer from a disorder which can induce stress and apprehensions which could explain your pain during sexual intercourse.

What are the solutions and treatments?

Do you suffer just before, during and after sex? Whatever the causes of your suffering, there are solutions and treatments to relieve you and reduce your pain, either temporarily or permanently. We advise you to follow the recommendations of your health professionals depending on your pathology and we offer below a list of approaches and treatments, medical or not.

Medical approaches

These approaches will be particularly interesting and effective if physiological diagnostics obtain results.

• Medication: if your condition and pain require it (particularly in the case of an infection), your doctor will prescribe medication to treat you;
• Hormonal therapies: vaginal atrophy and imbalances in vaginal flora can be caused by hormonal imbalances. Hormonal therapies will help you restore balance and certainly provide relief;
• Surgery: if medical imaging highlights a problem with your endometrium (severe endometriosis) or a cyst, surgery may help you feel better.

Non-medical therapies

These approaches will be interesting if physiological diagnoses show that your reaction is primarily psychological. It will then be interesting to combine non-medical and psychological therapies.

• Kegel exercises: these exercises help educate or re-educate your pelvis and perineum. This is an interesting response, especially in cases of vaginismus. Learn more about Kegel exercises here ; For the more self-taught you can choose to do Kegel exercises with perineal beads .

  You can also opt for a connected perineal probe , which allows you, through its application, to map your perineum and offer you suitable exercise programs. You will be able to monitor your progress.

• Biofeedback: biofeedback, composed of the terms “bio” for “biology” and “feedback” for “return”, is an application of psychophysiology, which makes the link between the body and the mind. This method consists of using visual or auditory feedback to control bodily functions long thought to be involuntary. The goal here? Better control the contractions of your pelvic floor (especially in cases of vaginismus);
• Pelvic physiotherapy: this discipline consists of carrying out exercises to educate or re-educate your pelvis and perineum, always with the idea of ​​better controlling the muscles of your genital area. Kegel exercises, discussed above, can be part of pelvic physiotherapy;
• Ericksonian hypnosis: if your sexual anxiety is very (too) strong, hypnosis, which consists of reprogramming your reactions and sensations, can be a solution if you are receptive to it. Don't hesitate to ask around for advice to find a practitioner you trust.

Psychological therapies

The psychological approach will be particularly interesting if the diagnoses show no physiological reason for your pain and if the psychological assessment identifies stress and fears linked to the sexual act.

Before talking about the different existing therapies, let us remember that there are several psychological approaches in France, in particular psychoanalytic approaches and cognitive and behavioral therapies. Because the latter have proven themselves internationally, we can only recommend them to you. Even more, each practitioner is different: do not hesitate to change psychologists several times to find the one whose method suits you.

The different types of therapies are:

• Individual therapy: therapy consists of following you individually. This will include understanding your blockages, your doubts, your traumas, too, if you have any;
• Couples therapy: couples therapy will allow you to communicate with your partner in a protected setting, surrounded by the aura of a professional who will know how to ask the right questions, reformulate, and support. In the case of chronic dyspareunia, which goes so far as to weaken the couple, this can be an interesting response to facilitate your daily exchanges;
• Support groups: the word is gradually opening up about women's sexuality and there are beginning to exist support groups around dyspareunia and vaginismus. Sharing experience, freedom of speech, end of taboos: this type of support can help remove many obstacles.

Living with dyspareunia: practical advice for daily life

Despite the diagnosis and the implementation of treatment to relieve your dyspareunia, it is possible that you continue to feel pain during sexual intercourse – often because it will take time for the regulation to take place. If you can choose to practice abstinence, you have the right to want to continue a sex life regardless. Here are some keys and practical advice for your daily life.

Protecting your vulva

If your dyspareunia is superficial and the pain concerns your vulva and labia, we can offer you several actions:

• Wear loose, non-tight underwear and clothing: avoid thongs that rub the vulva, panties that have poorly placed seams and tight pants that compress and irritate your private area;
• Dare to use fatty balm to protect your vulva: once the allergic cause has been ruled out and with the agreement of your doctor, you can apply fatty substances to your private area to soften the burning sensations. 🌈 On our e-shop, we particularly like the vulva care balm from the Baûbo brand. Organic and 100% natural, it will soothe your daily vulvar discomfort.

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Use of lubricants

We have said it several times in this article: vaginal dryness is one of the main causes of dyspareunia. The latter can affect all women, from adolescence to menopause. To increase your natural lubrication and facilitate the act of penetration, do not hesitate to look at lubricants.

🌈 In store, we selected the water-based lubricant from the My Lubie brand. Its advantage? It is odorless, edible and composed of very few ingredients to limit allergies and reactions. If you are not using a condom, we recommend using a lubricating oil instead, as this provides a protective layer and lasts longer. My Lubie CBD intimate oil also nourishes and relieves pain linked to penetration or periods. You will be able to concentrate on your pleasure and that of your partner!

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Use of condoms

Are you irritated at the entrance to your vagina due to penetration? Do you have a vaginal infection? Wearing condoms is essential to protect your partner and yourself. Simply check in advance that you are not allergic to latex in which case you will need to find alternative references.

🌈 In store, we offer you super ultra-thin male condoms from the My Lubie brand. Vegan, odorless and made of natural latex, they are particularly resistant to allow you to devote yourself to your pleasure.

Use of organic pads and menstrual panties

Could your dyspareunia be linked to an allergy to menstrual pads? Do you suffer when you insert a tampon? Make your periods easier by using organic disposable pads, reusable pads or even menstrual panties.

🌈 In store, we like the organic menstrual pads from the Jhô brand, natural, organic and very thin for maximum comfort and safety during your period. And if you prefer the practicality of menstrual panties, we have identified for you the absorbent panties from the Smoon brand which have the particularity of being so thin that they are invisible!

Re-educate your perineum

Does your pain seem to be linked to your perineum? Consult a gynecologist, sexologist or physiotherapist specializing in the perineum in order to establish an assessment and personalized medical support.

In the case of vaginismus, that is to say when an involuntary and prolonged contraction of the muscles of the perineum, which surround the vagina, makes penetration (tampon, penis, finger, speculum, etc.) impossible or very painful, we recommend that you work on the gradual opening of your vagina thanks either to massaging your perineum using your fingers and a suitable perineal oil or using vaginal dilators (of different sizes, start with the smallest) and a lubricant to facilitate penetration.

If penetration is possible you can re-educate your perineum from home with aconnected perineal probe . It allows you, thanks to its application, to establish a map of your perineum and to offer you adapted exercise programs. You can also track your progress.

For the more self-taught you can also choose to do Kegel exercises with perineal beads .

Try different practices and positions to reduce pain

The sexual act is not only missionary and penetration. If you're allowed to love this position and practice, there are thousands of other practices and positions...don't stop at the ones that hurt you.

Blowjob, cunnilingus, sodomy, missionary, doggy style, sex toys …

If penetration hurts you there are many other ways to have sex. Don't hesitate to take the time to also discover sex without penetration alone or in pairs. Here are some instructive readings that will help you better decipher your body, your desires and your pleasure: Jouissance club or the guide to female masturbation .

And why not try a clitoral sex toy? Take a look at the incredible SILA , its sidekick Ona , the soft vibrating pebble Dune or even the Mini Coco !

There is no shortage of practices and positions and it is possible that some of them will not cause you any pain while fully satisfying your partner... so why deprive yourself of them?

Communicate with your partner

And to conclude, this will seem obvious to you but we have to tell you about it: it is essential to communicate with your partner, before and during the sexual act. He will thus be more able to understand you and adapt his practice and his actions to your needs, desires and pains.

🌈 Do you need a helping hand to open the dialogue? We offer the Let's Talk card game from Play Gender Games on our store. This game to discover as a couple goes from strength to strength and helps you question your relationship and your sexuality.

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