WHAT IS IT?

Difficult or painful sexual intercourse for the female. Can affect sexually active females of all ages.

SIGNS & SYMPTOMS

Pain in the genital area during sexual activity, including foreplay, intercourse or attempted intercourse. Pain may be mild or severe and it may vary from time to time and positions.

CAUSES

Can be divided into Physical and Psychological

Physical causes include:

• Infection of the genitals, including herpes involving the vagina, cervix, fallopian tubes or ovaries.
• Pressure against the vaginal wall caused by scarring from operations or radiation treatment.
• A tight episiotomy scar from vaginal repair after childbirth.
• A fibroid or other uterine tumor.
• Endometriosis.
• A hymen that is torn or thicker than normal.
• A bruised opening to the urethra.
• Inadequate vaginal or condom lubrication.
• Allergic reactions to condoms or contraceptive foams and jellies.
• Dryness and thinness of the vaginal wall after menopause.
• Pelvic Inflammatory Disease.

Psychological / emotional causes include:

• Lack of proper sex education, sexual information and formation of wrong ideas.
• Fear of pregnancy.
• Fear of injury to the unborn child during pregnancy.
• Lack of sexual arousal and vaginal lubrication caused by inadequate or insufficient sexual foreplay, aversion to the sexual partner, fatigue or anxiety.
• Past sexual injury or psychological trauma.
• Temporary lack of desire.

RISK INCREASES WITH

• Stress.
• Recent illness.
• Fatigue or overwork.

HOW TO PREVENT

• Obtain prompt medical treatment if you have symptoms of infection of the reproductive organs.
• Discontinue use of condoms, contraceptive foams or jellies that produce allergic reactions.
• Obtain professional counseling to resolve feelings about past sexual trauma.
• Discuss the lack of sexual arousal with your partner, including ways to improve foreplay. Enlist your partner's support and patience to overcome the problem. Use a lubricant, if necessary.

EXPECTED HEALTH CARE

• Treatment of physical causes if any
• Psychotherapy or counseling (sometimes), if the cause is psychological.

DIAGNOSTIC MEASURES

• Observation of typical symptoms.
• History and physical examination by a doctor.
• Laboratory studies, such as a Pap smear and culture of any vaginal discharge.

POSSIBLE COMPLICATIONS

Damage to inter-personal relationships, permanent inability to enjoy sexual experiences and loss of self-esteem.

PROBABLE OUTCOME

Depends on the cause. Medical disorders are usually curable with treatment. Psychological problems can often be cured with therapy, and interpersonal problems can improve with communication and patience.

TREATMENT

GENERAL MEASURES

• Sitz baths frequently relieve tenderness. Sit in a tub of hot water for 10 to 15 minutes. Repeat baths as often as 3 or 4 times a day.
• Use a non-prescription lubricant, such as baby oil or a Lubricating Jelly, during sexual intercourse.
• Seek instructions, from your doctor or therapist, for exercises or techniques to dilate the vagina.
• Try different positions for sexual intercourse to discover new ones that might reduce penile penetration and be pain-free.

MEDICATION

Your doctor may prescribe antibiotic, antiviral, or antifungal medications for underlying infection.

ACTIVITY

No restrictions. Resume sexual relations as soon as possible.

DIET

No special diet.

CONTACT YOUR DOCTOR IMMEDIATELY, IF

• You notice symptoms of dyspareunia.
• Pain worsens, despite treatment.
• Symptoms don't disappear after 3 months of treatment.

| Anorgasmia | Vaginismus | Dyspareunia |