What Causes Dyspareunia? The 101 on Painful Sex

Dyspareunia is the term for painful sex, so it is quite a broad term really. It refers to pain before, during or after sexual intercourse, which is obviously very distressing. Women struggling to have satisfying intercourse are often left wondering what causes dyspareunia, as the reasons can be varied and are often tied to other physical conditions or psychological problems.

A healthy sex life is part of a healthy relationship for most couples, and one thing that can really block intimacy (and therefore relationship progress) is painful sex. It’s little wonder then that dyspareunia is seen as a serious problem. In order to recover from it, you will need to get to the bottom of what is behind it.

This article looks into the different causes of dyspareunia and the impact it can have on a woman’s life:

What causes dyspareunia?

During normal sexual intercourse, the Bartholin glands in the vagina secrete lubricating fluids that prevent friction upon penetration. This will only happen when a woman is sufficiently relaxed, so if she is not, penetration will become difficult and perhaps even painful. She is likely to feel burning, stinging, throbbing or even tearing sensations during penetration. 

The causes of dyspareunia can be either physical and psychological. Here are some of the most common ones:  

Physical dyspareunia causes

• Inflammation or soreness around the vaginal opening
• Lack of vaginal lubrication (vaginal dryness)
• Infections (dermatological infections, yeast infections or sexually transmitted diseases)
• The condition of vaginismus (vaginal spasms and tightness)
• Pudendal neuralgia (nerve damage around the pelvic area)
• Surgery in the pelvic area
• Menopause (including post menopausal vaginal atrophy)

Psychological dyspareunia causes

• Loss of libido
• Performance anxiety
• Past psychological trauma
• Relationship problems (resulting in loss of libido)
• Mood disorders and emotional problems

There are two types of dyspareunia

The type of dyspareunia you have depends on where you feel the pain during intercourse. It will be either superficial dyspareunia or deep dyspareunia.

Superficial dyspareunia

This type of dyspareunia refers to initial penetration and the pain felt at this stage of intercourse. The causes of this dyspareunia type can be:

• The penis being too large for the vaginal opening
• An unbroken or unusually thick hymen membrane
• Vaginismus
• Libido issues
• Medications that interfere with estrogen production
• Infections

Deep dyspareunia

This type of dyspareunia occurs in the top part of the vagina, near the cervix, womb or ovaries, for example. Pain is usually experienced during or after thrusting and can feel like an aching, burning or tearing sensation. The following conditions can be causes of deep dyspareunia:

• Pelvic Inflammatory Disease (PID)
• Endometriosis
• Ovarian cysts

Who suffers from dyspareunia?

Women of all ages and backgrounds can experience painful sex for all of the above reasons and more. However, it is statistically more likely to affect younger women and those who have gone (or are going through) the menopause. Women who have had a hysterectomy or surgical menopause (ovaries removed) may also have this problem.

Once you have understood what causes dyspareunia, you will be in a better position to manage it. That may mean seeking psychological therapy, communicating about sexual problems, or addressing an underlying physical condition. It could mean getting medication for hormonal or mood imbalances, using vaginal dilators for painful sex, or simply investing in a product to aid sexual intercourse, like a water-based lubricant.

Whatever the reason, there is likely to be a solution, so it is better to look at dyspareunia as a temporary problem. Anxiety (although sometimes difficult to manage) is likely to make it worse. VuvaGirl offers a wealth of information on the site aimed at helping women to overcome sexual problems and maintain good sexual health, so take a look around and get in touch if we can help in any way.