Dyspareunia refers to painful intercourse. It is a common condition in women, and can lead to a complete loss of sexual activity. Dyspareunia may have physical causes. Inflammation of the womb or ovaries in conditions such as pelvic inflammatory disease (PID) will result in pain during deep penile penetration (i.e. during thrusting). This problem, termed deep dyspareunia, is very suggestive of an underlying physical problem. However, problems in the vagina, such as post-menopausal dryness and vaginal infections, can cause pain very early in penetration. This problem is termed superficial dyspareunia.
Superficial dyspareunia can also result from lack of lubrication and insufficient relaxation of the perineal muscles at the time of attempted penetration. This may be because penetration has been attempted before the woman is ready. The pain which results can cause a negative cycle of loss of sexual desire and increased tension. Vaginismus is the term given to a severe form of spasm which affects the perineal muscles at the time of penetration. Vaginismus will prevent penetration totally. Factors such as lack of sexual knowledge, guilt about sexuality and a childhood sexual assault may be underlying issues in a woman who suffers from these functional causes of superficial dyspareunia.
In dyspareunia any underlying physical cause should of course be treated first. Sex therapy can be effective in non-physically (functional) based dyspareunia.
