Painful Intercourse (Dyspareunia)

This is a very distressing both physically and psychologically for many couples sometimes putting great strains on their relationship. This is called “dyspareunia” and can be subdivided into superficial or deep.

Superficial dyspareunia causes may be simple secondary to dryness, atrophic (thin) vaginal skin, previous scaring at vaginal entrance introitus for example from an episiotomy. Sometime a more complex condition called “vaginismus” exists. This is where if a woman’s vaginal muscles involuntarily spasm /contract in anticipation of pain at penetration. This condition is harder to treat as there are can be often underlying psychological factors and requires the expertise of a psychosexual counsellor to treat and resolve.

Deep dyspareunia i.e. penetration is achieved but is very painful.This suggests that there may be underlying gynaecological conditions such as endometriosis, ovarian cysts, pelvic adhesions (internal scarring) or chronic pelvic infection. Often a Laparoscopy is required to make a diagnosis however some treatments can also be tried before embarking on surgical exploration.