Dyspareunia is the umbrella term for painful sexual intercourse in women. The causes of dyspareunia vary widely, and include, but are not limited to, infection, an abnormally positioned uterus, muscle spasms in the vagina, preexisting disorders of the reproductive system, and emotional distress from prior sexual trauma or abuse. The pain, depending on its cause, can range from mild to intense, and women who suffer from dyspareunia regularly can find it very distressing, because of both the physical discomfort and the impact on their intimate lives.Dyspareunia may arise from a broad range of underlying problems. If dyspareunia involves the vaginal tissue and entrance of the vagina, it could be caused by vaginal dryness due to lack of arousal, side effects of medication (allergy, high blood pressure, and anti-depressant medications are most often to blame), or menopause and the friction of intercourse. Other common causes of this type of dyspareunia include allergic reactions to laundry detergents, soaps, or other topical products such as spermicides. Bacterial or fungal infections that irritate vaginal tissue can also be to blame, as can STDs such as herpes and genital warts. Another potential cause of this type of dyspareunia can be a condition called vulvodynia, in which the vulva are tender and hypersensitive to touch.
Dyspareunia that involves pain inside the vagina or abdominal pain during intercourse can be connected to a similarly wide range of causes. One common culprit is a tipped or retroverted (backwards) uterus; often, penile thrusting can come into painful contact with the uterus or cervix if the uterus is abnormally positioned. Another possible cause is an inflamed or irritated bladder or urinary tract due to urinary tract infection (UTI). A condition called endometriosis, where the tissue lining of the uterus begins to grow in locations outside of the uterus, can cause intense pain during sex, as can accumulations of scar tissue from prior pregnancy or abdominal surgery. Some women suffer from a condition called pelvic floor myalgia, or involuntary muscle spasms of the pelvic floor, which can make sexual intercourse painful or downright impossible. Ovarian cysts, uterine fibroids, and uterine or ovarian cancer may also be to blame.
If none of these problems or conditions is found to be the cause, it may be that emotional components, such as anxiety, prior sexual abuse, or prior sexual trauma, play a role in dyspareunia, causing any of a number of uncomfortable or painful symptoms, such as lack of lubrication, muscle tensing, or painful sensitivity to contact or penetration.
