Sexual Health 

Dyspareunia: A Medical Perspective

Raksha Saraf Aug 02 2019

Dyspareunia: A Medical Perspective

Do you experience pain during sex? The more often you do, the more you should be concerned - it's NOT normal!

“Dyspareunia” is the medical term for painful sex. Sex can be painful for a multitude of reasons, for any gender. It is not easy to recognize where exactly the pain is coming from, or even communicate its existence with a partner, but it is important to take action. Sex is supposed to be a stress-buster, not a stressor in itself! Here are some of the most common reasons for pain during sex:

1.       Medical Causes – If the pain is sharp, focused on a specific area, or you see unnatural growths or inflammation, the reason is likely medical, and you should consult a doctor. Some of the possible reasons common to all genders are:

  • Sexually Transmitted Infections - Blisters, warts, fungi, or any other kind of unnatural growth can be a sign. Ever since the HIV/AIDS epidemic, in most western countries, STI tests are accessible and inexpensive, so there’s no excuse for not checking!
  • Other growths – cysts, warts and lumps could exist even without the presence of an STI, due to other illnesses or environmental factors like work pressure. If you see one and your STI tests are negative, do not assume you’ll be okay. You may need medication nonetheless, so please consult a doctor.
  • Allergic reactions or skin disorders

Specific to Men:

  • Tight Foreskin/Tears in the foreskin – If you are not circumcised, and your foreskin does not roll back while masturbating or having penetrative sex, you should consult a medical professional for help. It is also possible for your foreskin to tear accidentally during poorly lubricated sex, dysfunctional zips on jeans, and other occurrences.
  • Penile Fractures – If you were in an accident during sex, or at any time when you were hard, and you heard a loud crack, (to state the obvious) go to the hospital!
  • Peyronie’s disease is a condition that generally affects older men (above the age of 55). It causes the penis to develop a curve even when erect, and can cause internal pain during penetration.
  • Pain due to IUD threads – If your partner is wearing an intrauterine contraceptive device, it is possible that the sudden sharp pain you experience during sex is due to the threads that hang lose from it. Go to a gynecologist with your partner if you think this is the issue.

"We listen to the small voice in the back of our head that says, “This medication is taking money away from your family. This medication messes with your sex drive or your weight. This medication is for people with real problems. Not just people who feel sad. No one ever died from being sad.” Except that they do." 

Jenny Lawson

Specific to Women:

  • Dryness – The duration of foreplay and the stimulation achieved through it should be a big consideration while having sex. It is not necessary that every woman will be aroused easily every time she is having sex. It's important to take the time to lubricate naturally by engaging in foreplay. However, if this does not work, it's possible for the problem to be medical. Some antidepressants, sedatives, and birth control pills can cause disruption to sexual stimulation. Even low estrogen levels can cause such problems. If you are not sure about the side effects of some drugs, or are currently breast-feeding/undergoing menopause, consult a medical professional to find solutions. Worst case scenario, use a good lubricant!
  • Injury, trauma or irritation – Injuries sustained from an accident, surgical cuts made during childbirth, or female genital mutilation (female circumcision) can cause extreme pain as well. It is important to consult a medical professional in such cases as sex can worsen the injury.
  • UTI’s and Skin Infections/Disorders – Urinary Tract Infections can often be very painful. Pain while peeing is also a common sign that you may have a UTI. These infections can generally be treated with ease by a medical professional, but riding them out without medication can be very painful, and is not advisable. Skin infections in the genital area can also cause severe pain.
  • Congenital Abnormality – Although it is rare, the vagina can sometimes have a growth defect that blocks the vaginal opening with a membrane. Sex can be very painful and a surgery may be necessary to stop the pain in such cases.
  • Illnesses and surgeries – some illnesses, such as ovarian cysts, can also cause deep pain during sex that lasts for hours even after the act. Ever surgeries like hysterectomies have been implicated in causing this kind of deep pain. It is important to ask the doctor about likely side effects on your sex life before you go through with a surgery or any other invasive medical procedure.
  • Latex Allergy – If sex with a condom, specifically, affects you, you may have a latex allergy.

Specific to Transgenders – Although the research has plenty of holes, some papers suggest:

  • Trans-men can experience pain during sex and menses due to testosterone shots that inhibit estrogen production. The excess of testosterone causes vaginal walls to dry up, akin to a post-menopausal state. If this happens, it is good to connect with a medical professional specializing in transgender treatment at the soonest.
  • If the transition has occurred, various surgical complications can also cause serious sexual dysfunction and extreme pain.

If none of these conditions seem to fit your situation, or if they're too worrisome, there is an alternative: psychologically induced pain. Stay tuned for our next segment on the Psychological Causes of Dyspareunia.


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