Dyspareunia: understanding and acting when you suffer during sexual intercourse

Sexual intercourse is widely considered a moment of pleasure and intimate sharing for couples. It's a moment of complicity, gentle or, on the contrary, more lively, between two or more people! But all this 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, constraint, or 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 area (internal and external). Contrary to popular belief, 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 are suffering from male dyspareunia, we recommend that you read this particularly interesting article 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, secondary dyspareunia, permanent dyspareunia and intermittent dyspareunia ). We will take the time to describe all of these types of pain in the rest of this article.

The main cause of dyspareunia is vaginal dryness , but this condition can also be the result of a wide variety of factors. To treat dyspareunia, it is necessary to determine the cause(s). Many medical and natural treatments are available!

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.

Regardless of your age, sexuality, or culture, sexuality shouldn't be a source of suffering. If you're in pain, you need to talk about it: with your partner and with your healthcare professionals. The former will be able to adapt, and the latter can help you find medical and natural solutions to relieve your pain.

Natural Treatments for Dyspareunia >

Occasional pain or chronic dyspareunia: know the difference

Before we delve any further into this article on dyspareunia, it's essential to understand one important point. There's an important difference between occasional pain and chronic dyspareunia.

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

Chronic dyspareunia refers to recurring pain. If you experience pain every time you have sex, whether during or after intercourse, this isn't normal. Especially if the pain always stems from the same causes and is similar, you may be suffering from a medical condition that's preventing you from enjoying your sexuality.

The different forms of dyspareunia

As we discussed earlier in this article, dyspareunia is often classified based on the types of pain experienced. Understanding what type of dyspareunia you have can help you better identify its causes and better discuss it with your healthcare professional.

Primary dyspareunia

Primary dyspareunia refers to dyspareunia that manifests itself from the beginning of a person's sexual life. In other words, the person has always experienced pain during sexual intercourse, particularly during penetration. This is called primary pain. This form of the condition can be caused by initial trauma, stress, or physiological issues.

Secondary dyspareunia

Secondary dyspareunia, on the other hand, occurs after a period of pain-free intercourse – this is called secondary pain. This form of dyspareunia can be triggered by factors such as surgery, infection, trauma, or hormonal changes.

Superficial dyspareunia

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

Deep 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 for several minutes after the end of sexual intercourse. It can be linked to conditions such as endometriosis, ovarian cysts, or other internal medical conditions.

Permanent dyspareunia

In permanent dyspareunia , the pain is constant. It occurs every time sexual intercourse occurs in the same way (for example, with 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 is not systematic: for example, if you have the same pain one time out of three 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 looking at the forms the pathology can take, let's discover together the different symptoms and types of pain you may experience and which may point you to 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 useful tool.

Pain on penetration

As the name suggests and describes it well, it is a pain that occurs during penetration. It can occur from the beginning of the penetration attempt, in your vulva or the entrance to your vagina, or later, during penetration.

Deep pain during intercourse

It's possible that penetration doesn't cause you any particular pain, but that it manifests itself later, deeper in your lower abdomen, with each movement or thrust. You may even feel as if your partner's penis is pushing against you, causing you pain.

Prolonged pain after intercourse

Pain may be persistent and continue after intercourse, whether or not you have asked your partner to stop.

Burning or stabbing pain

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

Muscle spasms, vaginismus

During foreplay or penetration, you may experience painful muscle spasms. The pelvic floor muscles contract suddenly and involuntarily—you have no control over them, and they cause significant pain. This is called vaginismus. This type of pain can be caused by both physiological and 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, whether it's yours, your partner's, or the practitioner's.

Pain when inserting a tampon

This type of pain also refers to pain that is present outside of sexual intercourse. Your vulva, labia, vaginal opening, or vagina are so sensitive 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 particularly pelvic examinations (touching, vaginal penetration, etc.). These latter 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 or in pain. There are different examinations to understand the causes of your dyspareunia and not all of them involve penetration.

What are the causes of dyspareunia?

The pains that fall under the umbrella of dyspareunia are numerous, so it's only 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 and non-sexually transmitted infections (such as yeast infections or urinary tract infections) can disrupt the balance of your vaginal flora and make you particularly sensitive. In addition to pain during intercourse, they are often accompanied by a specific white discharge ;
• Diseases and conditions: various diseases can cause superficial or deep pain during penetration, including vaginal dryness , endometriosis and interstitial cystitis;
• Vaginismus: As vaginal penetration approaches or occurs, your pelvic muscles contract, creating significant pain and preventing penetration. Vaginismus can be linked to both physiological and psychological causes;
• Vulvodynia: Vulvodynia is persistent vulvar pain with no identifiable cause. It can result from a malfunction of the pain modulation system and is particularly disabling during sexual intercourse and in everyday life;
• Trauma or injury: Irritation or injury at the entrance or inside your vagina, resulting from repeated intercourse, a scratch or a shock, can cause recurring pain during intercourse – especially if intercourse contributes to reopening the wound and preventing it from healing;
• Vaginal atrophy: This condition is linked to a decrease in estrogen production. The vagina loses its flexibility and its walls thin. This is often accompanied by severe vaginal dryness. Vaginal atrophy generally occurs during menopause, but it can occur at other times in a menstruating person's life, such as during breastfeeding.
• Allergic reactions: An allergy to sanitary towels , condoms (latex allergy), massage oils, or lubricants can cause pain during sexual intercourse. This can be caused either by weakening your private parts or by contact with the allergen during intercourse. Signs of an allergy include burning, redness, and itching.

Psychological causes

• Past trauma: For some people, their sex life is a magnifying glass 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 sex and for your body to defend itself as best it can;
• Fear of pain and sexual anxiety: the fear of pain or violence (in the case of past trauma) can lead to strong sexual anxiety which generates pain that begins during foreplay;
• Stress and anxiety: While not necessarily related to abuse or your current partner, chronic stress can have an impact on your sexuality. You feel tense, unable to let go, unable to concentrate on what's happening: your body isn't reacting the way you'd like it to… These elements are likely to create pain that can grow until you develop sexual anxiety;
• Relationship or confidence issues: Lack of self-confidence and body image can also impact how you experience your sexuality and cause pain.

Can penis size cause intimate pain?

Many women attribute their pain during intercourse to the size of their partner's penis (width and/or length). This isn't untrue, but it's not entirely true either.

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

Physiologically, except in the case of the specific condition of vaginal atrophy 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 can adapt to the size of a baby. Every woman can learn to use her vagina, relax the vaginal muscles, contract them during intercourse…

Diagnosis of the causes of dyspareunia

We've already told you this in this article, but we'll take the liberty of repeating it in the introduction to this new section: if you experience pain during sexual intercourse regularly and repeatedly, we can only recommend that you contact your trusted healthcare professionals.

Competent health 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 comprehensive view of your health and is trained to treat all kinds of conditions. Since dyspareunia has several causes, both medical and psychological, the general practitioner's broad approach is beneficial. They will suggest additional tests and/or consult specialists, if necessary.
• Gynecologist: since dyspareunia is linked to the female genital organs, your gynecologist is the preferred specialist to support 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 consult a psychologist once physiological causes have been ruled out with your doctor or gynecologist;
• Sexologist: In recent years, several health professionals have specialized in sexology. It may be worth consulting one of these professionals to support you in the event of dyspareunia. Just pay attention to the second role your sexologist plays when choosing one: sexologists are generally gynecologists or psychologists specializing in sexology.

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

Tests to diagnose the causes of dyspareunia

We recommend that you meet with a general practitioner or gynecologist to first conduct tests to ensure that your dyspareunia is not physiological in origin, before then turning to approaches related to your mental health. The following is a list of medical tests to diagnose the causes of your dyspareunia.

Gynecological examination

The first test that can help detect an abnormality and a cause of your pain is a gynecological exam. This generally involves external examination of your genitals, a vaginal examination, or even a penetrative pelvic ultrasound.

If you are particularly sensitive and afraid of being in pain, you have the right to ask for explanations (why are these tests being performed?) and to refuse the various tests offered to you. As you will see, there are other tools for diagnosing the physiological causes of dyspareunia.

Crops

The second test involves taking a vaginal swab and performing a bacteriological test on your vaginal flora, in particular to check that you do not have any genital infections. This test can be performed at your gynecologist's office or in a testing laboratory, and you will receive the results within a few days.

Abdominal ultrasound

The third test involves an abdominal ultrasound. This doesn't involve penetration and will therefore be less apprehensive on your part if this practice is terrifying for you. It will allow us to observe your genitals and look for abnormalities, such as vaginal atrophy or the presence of cysts or endometriosis, which could explain the deep pain you're experiencing.

Laparoscopy

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

Psychological assessment

The final test that may be worthwhile if you suffer from dyspareunia is a psychological assessment. Each psychologist has their own methods. In one or more sessions, the professional will be able to identify whether you are suffering from a disorder that may be causing stress and apprehension, which could explain your pain during sexual intercourse.

What are the solutions and treatments?

Do you experience pain just before, during, and after sex? Whatever the cause of your pain, there are solutions and treatments to relieve it and reduce it, whether temporarily or permanently. We recommend following your healthcare professionals' recommendations based on your condition, and below we offer a list of approaches and treatments, both medical and non-medical.

Medical approaches

These approaches will be particularly interesting and effective if physiological diagnostics produce 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 restore balance and certainly provide relief;
• Surgery: If medical imaging reveals a problem with your endometrium (severe endometriosis) or a cyst, surgery may help you feel better.

Non-medical therapies

These approaches will be useful 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 a useful solution, especially in cases of vaginismus. Learn more about Kegel exercises here ; For those who are more self-taught, you can choose to do Kegel exercises with perineal beads .

  You can also opt for aconnected perineal probe , which allows you, thanks to its application, to establish a map of your perineum and to suggest adapted exercise programs. You will be able to follow the evolution of your progress.

• Biofeedback: Biofeedback, composed of the terms “bio” for “biology” and “feedback” for “return,” is an application of psychophysiology, which links 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 of your pelvic floor contractions (especially in cases of vaginismus);
• Pelvic physiotherapy: This discipline consists of performing exercises to educate or re-educate the pelvis and perineum, always with the idea of ​​better controlling the muscles of the genital area. The Kegel exercises, mentioned above, can be part of pelvic physiotherapy;
• Ericksonian hypnosis: If your sexual anxiety is very (too) strong, hypnosis, which involves reprogramming your reactions and sensations, can be a solution if you are receptive to it. Don't hesitate to ask for advice from those around you to find a practitioner you trust.

Solutions to relieve perineal pain >

Psychological therapies

The psychological approach will be particularly interesting if the diagnoses do not show any physiological reason for your pain and if the psychological assessment identifies stress and fears linked to the sexual act.

Before discussing the various therapies available, let's remember that there are several psychological approaches in France, including psychoanalytic approaches and cognitive and behavioral therapies. Because the latter have proven themselves internationally, we can only recommend them. Furthermore, each practitioner is different: don't hesitate to change psychologists several times to find the one whose method suits you.

The different types of therapies are:

• Individual therapy: Therapy involves working with you individually. This will include understanding your blockages, doubts, and traumas, if you have any.
• Couples therapy: Couples therapy will allow you to communicate with your partner in a protected environment, 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 can even weaken the relationship, this can be an interesting solution to facilitate your daily exchanges;
• Support groups: Women's sexuality is gradually becoming more open to discussion, and discussion groups are beginning to exist around dyspareunia and vaginismus. Sharing experiences, opening up the conversation, and breaking down taboos: this type of support can help overcome many barriers.

Living with dyspareunia: practical advice for daily life

Despite diagnosis and treatment to relieve your dyspareunia, you may still experience pain during intercourse—often because it will take time for it to return to normal. While you can choose to abstain, you have the right to continue your sex life regardless. Here are some tips and practical advice for your daily life.

Protect your vulva

If your dyspareunia is superficial and the pain is more in your vulva and labia, we can offer you several options:

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

I want it >

Use of lubricants

We've said it several times in this article: vaginal dryness is one of the main causes of dyspareunia. It can affect all women, from adolescence to menopause. To increase your natural lubrication and facilitate penetration, don't hesitate to look into intimate lubricating oils .

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

I want her >

Use of condoms

Are you experiencing irritation at the entrance to your vagina from penetration? Do you have a vaginal infection? Wearing condoms is essential to protect your partner and yourself. Just check beforehand that you're not allergic to latex, in which case you'll need to find alternative products.

🌈 In store, we offer super -thin male condoms from the My Lubie brand. Vegan, odorless, and made of natural latex, they are particularly strong, allowing you to focus on your pleasure.

Using organic towels and menstrual panties

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

🌈 If you prefer the practicality of menstrual panties, we have found 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 related to your perineum? Consult a gynecologist, sexologist, or physiotherapist specializing in the perineum to establish an assessment and receive personalized medical support.

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

I want these vaginal dilators >

If penetration is possible, you can re-educate your perineum from home with aconnected perineal probe . Its application allows you to map your perineum and suggest suitable 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

Sex isn't just about missionary and penetration. While you're allowed to enjoy this position and practice, there are thousands of other practices and positions out there... don't stop at the ones that hurt you.

Blowjob, cunnilingus, anal sex, missionary, doggy style, sex toys ...

If penetration hurts, there are many other ways to have sex. Don't hesitate to take the time to also discover non-penetrative sex, alone or with a partner. Here are some informative readings that will help you better understand 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 sister Ona , the soft vibrating pebble Dune or even the Mini Coco !

There's no shortage of practices and positions, and it's possible that some of them won't cause any pain for you while fully satisfying your partner... so why deprive yourself?

Communicating with your partner

And finally, this may seem obvious to you, but we have to tell you about it: it is essential to communicate with your partner, before and during sex. This will help them better understand you and adapt their practices and gestures to your needs, desires, and pain.

🌈 Need a little help opening the dialogue? We're offering the card game "Discultons" by Play Gender Games in our store. This game, perfect for couples, builds momentum and helps you explore your relationship and sexuality.

I want it >