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PAIN DURING SEXUAL RELATIONSHIP: WHAT IS DYSPAREUNIA?

  • On 24/08/2020
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PAIN DURING SEXUAL RELATIONSHIP: WHAT IS DYSPAREUNIA?

 

The medical term used to define pain in women during intercourse is dyspareunia. This pain can have many causes: a yeast infection, an ovarian cyst, the onset of menopause, a recent childbirth ... or a psychological blockage?

Definition
Dyspareunia is defined by "the appearance of pain during intercourse in women", explains Brigitte Letombe, medical and obstetric gynecologist in Lille. This pain is frequently defined as burning or cramping. "It can be localized in the vagina, at the start of intercourse and penetration, or in the abdomen, so a deeper pain." The pain may stop at the end of intercourse, but it may also continue afterwards.

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Types of dyspareunia
There are two types of dyspareunia: "Primary dyspareunia, in which the pain appears from the first sexual intercourse, explains the doctor, and secondary dyspareunia, that is to say that the woman has had a normal sex life, then then the pains appeared. " An infection is often the cause of these dyspareunias.

Causes
The causes of dyspareunia are numerous.
In case of superficial dyspareunia (from the start of penetration): there may be problems of infection, irritation, itching, dryness at the vulvar or even vaginal level. There are also flora imbalances, which can lead to yeast infection and vaginosis. These last give abundant, irritating losses, with bad odors.

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Then we have all the vulvovaginitis: "Sometimes there are bacterial infections, but this is not the most common, which requires antibiotics," she says. It can also be chlamydiae: "It is a bacterium which is transmitted sexually, which can give signs or not. Sometimes the signs are just small losses, and in this case the infection is not seen and can go away. infect organs higher up. " This leads, in the worst case, to fertility problems. In infections, we can also mention herpes which causes severe pain.

A yeast infection
  Yeast infections are very common ailments. "They cause irritation problems, vulvar edema, cracks, very thick discharge and redness." They can be due to taking antibiotics or corticosteroids, which unbalance the flora and facilitate the development of fungi. "In these cases, we often have women who do not consult and who go directly to the pharmacy to buy an egg for mycosis," notes the gynecologist. If we do it once, it is not serious, especially if the treatment works, "but if it is repeated, we must consult. There are many women who put eggs for yeast infection regularly and who do not have any. never did, it was something else, ”she insists.

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Genital herpes
 Genital herpes is one of the sexually transmitted diseases, extremely contagious. Indeed after the first infection, the virus settles in the body and "falls asleep" there, so it never really disappears. It manifests itself during flare-ups by small white blisters filled with liquid that develop into sores, and located on or near the sexual organs. Treatments can reduce the frequency of relapses. Be careful, only 20% of people carrying the virus know it: either because they have no symptoms or because they confuse them with other diseases.

Burn
Burns during penetration are a symptom of many diseases: vaginitis, inflammation caused by the presence of bacteria or a fungus (vaginal yeast infection), or simply a sign of vaginal dryness. In this case, the use of a lubricant may be necessary. If the burns persist although the examination is normal, it is called vulvodynia. In this case, it is important to be followed by a trusted doctor who will recognize the pain, and who will find solutions on a case by case basis.

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Condoms in question
As for condoms, you should know that there may be an intolerance or an allergy to latex. In this case, it is recommended to take it without latex, or even to find another means of protection if possible (as a reminder, condoms are the only contraception that protects against STDs and STIs). It is important to find contraception suited to your lifestyle.


Endometriosis:
 Endometriosis is a special case because the main symptom is "dysmenorrhea (pain during menstruation) which only gets worse". Nevertheless, pain during intercourse is another recognized symptom of endometriosis. This happens when the lesions have affected the uterosacral ligaments, the Douglas pouch or the rectovaginal septum. The only way to make this pain go away is usually surgery to remove the lesions.

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Retroverted uterus:
Having a retroverted uterus is not a disease or a defect, it is actually minor and more common than you might think. It is simply an anatomical variant: in the majority of cases, the uterus is "anteverted", that is to say, tilted forward, above the bladder. But in the case where it is "retroverted", it is tilted backwards, towards the rectum. According to Dr. Letombe, having a retroverted uterus does not necessarily cause pain: "In my clinical practice, I have never encountered this case", she confirms.

Ovarian Cyst
It is a small abnormal lump in an ovary, affecting less than 10% of women. The ovarian cyst and is benign in most cases and most of the time has no symptoms. However, if they are numerous and large, they can cause pain. But in general, these are localized in the lower abdomen, and not specifically during intercourse.

Pain after childbirth
Childbirth, especially if it has been complicated (requiring an episiotomy or forceps) can cause pain that lasts. Naturally in these conditions, it is necessary to wait for the healing and the re-conditioning before considering sexual intercourse. "However, having pain for several months is not normal, recalls the gynecologist. Do not hesitate to consult for that and do not get stuck."

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Pain during menopause
Menopause can lead to sexual problems, including vaginal dryness. This is a common case: as the hydration of the vagina is strongly influenced by hormones, when the estrogen level drops during menopause, the lubrication weakens and can cause vaginal dryness in some women. Solutions exist, such as creams or eggs, but also lubricants to use before the report.

Vaginismus: a case apart
Vaginismus is a special case, because "it comes from a muscle contraction. By an unconscious reflex, the lower third muscles of the vagina close as soon as an attempt is made to penetrate, making it impossible". This contraction is done involuntarily, often the woman is not aware of it and believes she has another problem. The pain caused by vaginismus evolves according to women, from a simple discomfort to a feeling of burning, even tearing. "To overcome vaginismus, you need psychological treatment: from a sexologist for example or a psychologist if it has to do with a particular story, a painful past." Above all, do not allow the pain caused by vaginismus to settle without consulting, or the anxiety of being penetrated will not result in an avoidance of intercourse and will settle permanently.

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