Painful sex - otherwise known as dyspareunia - can occur during or after intercourse. It can be caused by illness, infection, a physical problem or a psychological problem, which makes it quite hard to treat.
Here we look at some of the causes of dyspareunia, as well as how is best to get help for it.
What Is It?
Dyspareunia is the medical term used to describe painful sex. It can be caused by a wide range of underlying health problems such as sexually transmitted infections (STI), the menopause, endometriosis or even irritable bowel syndrome (IBS).
Recent research found that sex is more likely to be painful at the extremes of reproductive life: in menopausal women and those aged 16-24.
According to the NHS, women can experience pain either in the vagina or deeper in the pelvis - and this can be telling of what underlying condition they might have.
Pain in the vagina could be caused by:
:: an infection such as thrush, or a sexually transmitted infection (STI) like chlamydia, gonorrhoea or genital herpes
:: the menopause, as changing hormone levels can make the vagina dry and result in pain
:: lack of sexual arousal
:: vaginismus, a condition where muscles in or around the vagina shut tightly
:: genital irritation or allergy caused by spermicides, latex condoms or products such as soap and shampoo.
Pain felt inside the pelvis can be caused by conditions such as:
:: pelvic inflammatory disease (PID)
:: fibroids growing near the vagina or cervix
:: irritable bowel syndrome (IBS)
Discomfort during sex can also, in some cases, be a symptom of cervical cancer.
In the latest body of research, carried out by the London School of Hygiene & Tropical Medicine, University College London and NatCen Social Research, painful sex was strongly associated with other sexual function problems, in particular feeling anxious during sex and lack of enjoyment in sex.
It’s not the first time mental health has been associated with the problem. A previous study of Brazilian women found a strong link between co-existent nervousness and depression, and increased likelihood of pain during or after sex.
Due to there being many possible causes for dyspareunia, the general advice around it is that if you experience it, you should visit your GP or a sexual health clinic.
In some cases, if the pain is assisted by unusual discharge or soreness around the genitals, a person may be advised to have an STI test.
Women who experience vaginal dryness due to the menopause may be given a lubricating product to try.
In other cases, if the pain is a result of anxiety issues or depression, a patient may be referred to a counsellor.
Dr Kirstin Mitchell, lead author of the new study published in BJOG: An International Journal of Obstetrics and Gynaecology, said that when treating the problem, factors such as a person’s relationship with their partner should be taken into account more.
“While dyspareunia is a common problem, sexual pain disorders are often overlooked because underlying conditions are often difficult to diagnose and treat, and causes can be complex and poorly understood,” she said.
“This data demonstrates the importance of taking a holistic approach to medical care which takes into account the sexual, relationship and health context of symptoms.
“Healthcare professionals should be supported in taking a detailed history during a patient’s clinical assessment; thoroughly investigating symptoms, asking about enjoyment and satisfaction, and considering the relationship context.”
She added: “There is also a need for resources to support clinicians who feel uncomfortable broaching the topic of sexual function and pleasure with patients, including advice on language and on when to refer patients to specialists in sexual health.”