Genito-Pelvic Pain / Penetration Disorder

Dyspareunia

Dyspareunia is painful sexual intercourse due to medical or psychological causes. The symptoms are significantly more common in women than in men. The pain can primarily be on the external surface of the genitalia or deeper in the pelvis upon deep pressure against the cervix. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain. 

Symptoms:

  • Pain Only at Sexual Penetration (Entry)
  • Pain with Every Penetration, Even While Putting in a Tampon
  • New Pain after Previously Pain-Free Intercourse
  • Deep Pain During Thrusting
  • Burning Pain or Aching Pain
  • Throbbing Pain, Lasting Hours after Intercourse 

Causes

Any part of the genitals can cause pain during sex. Some conditions affect the skin around the vagina. The pain from these conditions is usually felt when a tampon or penis is inserted into the vagina, but pain can also occur even when sitting or wearing pants. Inflammation or infection may be the cause (such as a yeast infection, urinary tract infection or inflammation of the vagina). Injury to the vagina and the surrounding area can also cause pain. If a diaphragm or cervical cap (which is a type of birth control) does not fit correctly, sex may also be painful. 

Pain during intercourse may feel like it is coming from deep in the pelvis. Women often report the feeling that “something is being bumped into.” The uterus may hurt if there are fibroid growths; the uterus is tilted or if the uterus prolapses (falls) into the vagina. Certain conditions or infections of the ovaries may also cause pain, especially in certain sexual positions. Past surgeries may leave scar tissue that can cause pain. Because the bladder and intestines are close to the vagina, they may also cause pain during sex. Endometriosis and pelvic inflammatory disease may also cause pain. 

We know that the mind and the body work together. This is also seen with sexual problems. Often the problem that first caused the pain may go away, but you have learned to expect the pain. This can lead to further problems because you may be tense during sex or you may be unable to become aroused. The problem can then become a cycle and you are caught in the middle. 

Negative attitudes about sex, misinformation about sex and misinformation about the functions of the woman’s body are often associated with some types of pain. Is painful sex all in your head? No! But it is important to discuss feelings and difficulties with your partner and if necessary a qualified expert.

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