Causes and risk factors
There can be several causes in females such as structural, pathological or psychological. vaginal causes that include vaginal dryness,vaginal infection, vaginismus. Disease like urethritis, urinary tract infections, menopause, ovarian cysts,endometriosis, hemorrhoids, herpes sores, genital warts, or other sexually transmitted diseases can cause dyspareunia. Genital irritation from soaps, detergents, douches, or feminine hygiene products, a diaphragm that does not fit properly, reaction to the latex of a diaphragm or condom, use of certain medications lead to the condition.Intercourse too soon after surgery or childbirth also predisposeto dyspareunia. Injury due to female circumcision, accident, or episiotomy can cause painful intercourse. Psychological factors such as anxiety, depression, stress, fear of intimacy, relationship problems, history of sexual abuse or rape can lead to painful sexual intercourse.
Clinical presentation
Women with dyspareunia may have following symptoms such as superficial pain at the entrance of the vagina, or deeper pain during penetration or thrusting of the penis. Pain may be described as burning or aching in character. Some women also may experience severe tightening of the vaginal muscles during penetration, a condition called vaginismus. Pain is a new pain after previously experienced pain free intercourse.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. A thorough pelvic examination is done. A pelvic ultrasound is advised. Advice from sex therapist may be recommended.
Treatment
Treatment depends upon the underlying cause. Use of water based vaginal lubricants, antibiotics, painkillers, or hormones are amongst the treatment options that may be considered. Sex therapy may be helpful, especially if no underlying medical cause is identified. Guilt, inner conflict, or unresolved feelings about past abuse may be involved which need to be worked through in therapy. It may be best for the partner to see the therapist with the patient.
Other Modes of treatment
The other modes of treatment can also be effective in treating dyspareunia. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating dyspareunia.
