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Dyspareunia in Women

Medically reviewed by Last updated on Aug 31, 2022.

What is dyspareunia?

Dyspareunia is pain during intercourse (sex). You may have pain before, during, or after sex. You may have pain every time you have sex, or only certain times. You may have had pain since the first time you had sex, or the pain might start suddenly. Dyspareunia may cause you to feel embarrassed or cause problems in your relationship with your partner. Many causes of dyspareunia can be treated. It is important for you to talk with your healthcare provider about your symptoms.

What causes or increases my risk for dyspareunia?

  • Hormone changes that happen just before or during menopause, or because of breastfeeding
  • Stress, anxiety, or emotional problems
  • An episiotomy scar after childbirth, irritation in or around your vagina, or an abnormal vaginal structure
  • Irritation from a lack of lubrication during sex
  • An infection, trauma, or tumor
  • Endometriosis, or surgery in your lower abdomen
  • Pregnancy, or a recent vaginal delivery
  • Constipation, or irritable bowel syndrome
  • Use of drugs, alcohol, or medicines such as antihistamines

What are the signs and symptoms of dyspareunia?

Signs and symptoms will depend on the cause. You may have any of the following:

  • Pain anywhere from the opening of your vagina to your abdomen
  • Pain with penetration, including when you insert a sex toy
  • A feeling of pressure or burning anywhere in your vagina
  • Less interest in having sex, trouble becoming aroused, or trouble having an orgasm
  • A watery discharge from your vagina

How is dyspareunia diagnosed?

Your healthcare provider will examine your vagina for possible causes of your pain. Your bladder, rectum, or other parts of your lower abdomen may also need to be examined.

  • Blood or urine tests may be used to check for an infection.
  • A vaginal exam will help check for problems at the opening or inside your vagina that can cause dyspareunia. Your healthcare provider may insert a finger into your vagina. A cotton swab may be used to check for pain or other symptoms. Talk to your healthcare provider if you have any anxiety or concerns about an exam.
  • A colposcopy is a procedure used to check your vagina and cervix (opening to your uterus). Your healthcare provider will insert a scope into your vagina for the exam. A sample of tissue may be taken during the colposcopy.
  • Laparoscopy is surgery used to check the uterus, fallopian tubes, and ovaries. Your healthcare provider will make an incision in your lower abdomen. A thin tube with a light on the end is put through the incision. Laparoscopy is used to check for a tumor, fibroid, or other problem causing your pain. Your healthcare provider may also take a tissue sample.

How is dyspareunia treated?

  • Medicine may be given to treat an infection or to relieve pain. Pain medicine may be given as a pill or as a cream you can apply to your vagina.
  • Estrogen may be given as a cream, a pill, or a ring that fits in your vagina. Estrogen may help relieve your symptoms if they are caused by low estrogen levels.
  • Lubricant can help make sex more comfortable. Lubricants are available without a prescription. Talk to your healthcare provider about which kind to use if you are using condoms for birth control. Oil-based lubricants can damage condoms. Choose a silicone-based or water-based lubricant.
  • Surgery may be needed to remove a tumor or fibroid. Surgery can also be used to remove extra tissue from your vagina, or to widen your vagina. You may need surgery to fix a problem with a structure in your lower abdomen.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

View more treatment options

What can I do to manage dyspareunia?

  • A sitz bath may help reduce inflammation. To make a sitz bath, fill the bathtub with warm water until it is at about the level of your belly button. Stay in the bath for about 15 to 20 minutes. A sitz bath is also available as a small tub that will fit under your toilet seat. You will fill the tub with water as directed once it is under the toilet seat. Your healthcare provider can tell you how often to use a sitz bath.
  • Kegel exercises may be recommended to help strengthen your pelvic muscles. Pelvic muscles hold your pelvic organs, such as your bladder and uterus, in place. To do Kegel exercises, tighten your pelvic muscles slowly. It should feel like you are trying to hold back urine. Hold these muscles and count to 3. Relax, tighten them quickly, and release. Repeat the cycle 10 times.
  • A change of position can help make sex more comfortable. You might also want to try having sex at different times of the month if you have monthly periods. This will help you find a time of the month that is most comfortable for you.
  • Therapy with a mental health counselor may help you feel less anxious about sex. You can talk to a counselor by yourself or with your partner.

When should I contact my healthcare provider?

  • You have new or worsening symptoms.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Treatment options

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Further information

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