All You Need To Know About Dyspareunia in Women ?

WikipediaBy Dr Swapan Ghosh 
Pain in the genital region during sexual intercourse is also termed as dyspareunia, and this occurs in women due to many psychological as well as medical reasons. This can affect men too, but the overall number of instances in which men have been affected is significantly less. Doctors generally rule out all physical causes for dyspareunia first before starting on the emotional causes.

Any form of persistent or recurrent genital pain can be classified under dyspareunia, and women might experience rare cases in which their pelvic floor may contract in an involuntary manner (vaginasmus). Dyspareunia can either caused due to vaginasmus or improper lubrication in the genital region.

Symptoms and Causes of Dyspareunia

Although a small level of pain is expected during sexual intercourse, the pain can get quite unbearable in the case of dyspareunia. Women will hardly experience any pleasure in such a situation, and their vaginal dilation and vaginal lubrication will decrease significantly.

Sometimes an episiotomy can cause pain and dyspareunia, but even after this problem heals, the individual might experience pain purely because the brain starts expecting pain during sexual intercourse. The vaginal orifice can also shrink and narrow down due to some issues, and this can cause dyspareunia.

When cases of dyspareunia are reported, doctors often conduct a careful study of the genital region in order to point out where the problem lies. Genital mutilation, practiced in some cultures on females, can cause dyspareunia. The clitoris is removed in some cases, and this can cause excessive pain. Herpes, hymenal remnants and other infections and anatomic conditions can also cause dyspareunia and discomfort during sex.

Sjogren’s syndrome, which is an autoimmune disease that causes vaginal dryness, can cause dyspareunia. This can be easily identified, as this syndrome affects the glands that produce tears and saliva. A low level of estrogen in the body can cause dyspareunia, and infections in the fallopian tubes, cervix, urinary tract (lower) and vagina are the common causes. Endometriosis and Chlamydia are major causes of this problem too.

In some cases, dyspareunia can be a symptom too, and Interstitial Cystitis is a disorder of which dyspareunia is often a symptom. Discomfort during, before or after sex and bladder pain, are also symptoms that come along with IC.

Diagnosis of Dyspareunia

Dyspareunia is quite hard to detect because pain is the only symptom, so people with dyspareunia will normally consult a series of doctors before they actually identify their problem.

Symptoms of dyspareunia start surfacing when women turn sexually active; so many women try and avoid consulting a doctor during the initial stages of the problem.

Doctors will try and identify dyspareunia by focusing on three key regions in the female genital region – vaginal pain (that occurs in the vagina), vulvar pain (that occurs in the opening portion of their genitalia) and deep pain (that occurs in the inner reaches).

Categories of Dyspareunia

Pain during sexual intercourse can be broadly classified under three categories, which are external vulvar pain, deep pain or vaginal pain. The most common categories are the major subtypes – vaginal atrophy and Vulvar Vestibular Syndrome. These can be easily diagnosed, due to their prevalent nature.

1. Vulvar Vestibular Syndrome

A burning sensation in the genital region can point towards Vulvar Vestibular Syndrome (VVS) and this syndrome affects premenopausal women. This syndrome can also cause depression and such pain lasts for a long time after intercourse (even days). More than 10-15% of women who consult gynecologists with vulvar pain normally suffer from this condition. The vaginal region is carefully examined to diagnose this condition successfully, and atrophies are (if any) are identified.

All potential bacterial and viral causes are ruled out first during these tests. The cotton swab test is a very effective test that can help in identifying dyspareunia and in this test; doctors apply pressure on the genital region and note any complaints of pain that the patient makes. Pressure is applied in a circular fashion so that the entire region is covered. Under this condition, the affected person might experience sores (erythematous ones) in the vulval vestibule, which can result due to infections that are bacterial in nature, HPV infections or even cases of candidiasis. Conditions like vestibular neural hyperplasia can also cause this problem, and this is an entirely neurological cause. The cause can also be psychological, as expecting pain can bring on nonexistent sensations of severe pain.

2. Vaginal Atrophy

Vaginal atrophy mainly results due to low levels of estrogen in women, and this is characterized by inadequacy in lubrication, and friction during copulation. Such friction can cause extreme pain, based on the region where the problem is centered. Doctors normally split the pain involved in dyspareunia into primary, tertiary and secondary varieties.

Treatment Options

The problem can be easily treated once it is identified, and doctors will prescribe measures that can help in eliminating the infection and negating the friction. Lubricants and other such substances can be used during intercourse if dyspareunia is mainly due to lack of vaginal lubrication.

You should watch out for the key symptoms given above and contact your doctor pronto to avoid further complications.

Source:: http://www.lifemojo.com

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