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Painful Intercourse? Why You Don't Have to Suffer in Silence

With the increasing sexualisation of western society, I have noticed that there is one area that women find particularly difficult to discuss for fear of upsetting their partner or appearing abnormal: Superficial Dyspareunia.

With the increasing sexualisation of western society, I have noticed that there is one area that women find particularly difficult to discuss for fear of upsetting their partner or appearing abnormal: Superficial Dyspareunia.

The term Dyspareunia means painful sexual intercourse and is something that, although it might seem like the end of the world when it is happening to you, can be prevented with gynecological assistance. There are 2 types of Dyspareunia: Superficial Dyspareunia and Deep Dyspareunia.

What is it?

Superficial Dyspareunia is when a woman experiences pain at the beginning of the penetration. For example, the outer part of the woman's vulva and vagina hasn't allowed their partner's penis to enter by anymore than 2cm-3cm and she is experiencing extreme discomfort. This can be a result of the pain itself or the fear of pain.

What is it caused by?

The causes of Superficial Dyspareunia are variable. They can be psychological and emotional, or pathalogical.

One psychological reason is Vaginismas. This is common in women who have been mishandled by boyfriends or raped in the past and now find it very difficult to accept sexual relationships as a result of the trauma. It is also common in women also have not been properly taught about relationships and the pleasure of sexuality as a teenager and consider it as a dirty subject to the point that, even when they are in a committed, loving relationship, they still consider sex to be embarrassing and shameful.

There are many pathological reasons why a woman may suffer from Dyspareunia. For example, their hymen to be too tough to be penetrated; they may have a very narrow vagina; or have an infection such as thrush; vaginal abscess; or genital injuries or abnormalities that may need surgical intervention to enable her to feel comfort during sex. All of these causes ARE RECTIFIABLE. For example, a woman whose Dyspareunia is caused by the pain of a very long labia pulling and tearing during sex could be advised to have a labia reduction to ease her discomfort. However, it is very important that you seek advice from an experienced gynaecologist who will be able to examine you thoroughly and diagnose the problem before deciding on any surgical intervention as, with good medical advice, surgery may be avoidable.

Who does it most affect?

Dyspareunia can happen at any age, which is why a detailed medical history, examination, investigations and studies are important to identify the causes related to each age group. Some examples include:

  • Women with psychological causes are usually in the youngest age group, with few sexual experiences.
  • Women with pathological causes are often in the reproductive age group and may have had children; or are in the early stages of their sexual life.
  • It can also be influenced by the menopause, as women in this category may lack estrogen. This may lead to vaginal narrowing as the skins elasticity may become very rigid due to the body's depleting collagen supply. This causes the vagina and its muscles to become atrophic, making penetration very difficult.
  • Radiation cancer treatments into the pelvis can cause fibrosis of the vaginal wall and muscles. Consequently, these women will need very careful gynaecological attention to enable the woman to have natural, normal sexual relationships again.
  • All of the above indicate that superficial dyspareunia can affect all women at any stage from puberty and menopause. This obviously depends on the cause of the pain.

Overall, Superficial Dyspareunia is a very big subject, but massively important. For women (and their partners!) who are affected by it, the right gynaecological advice can be life changing - improving their sex life, emotional relationship, mood and overall quality of life. Consequently, at my clinic, I place a great importance on listening to the patient's view of the situation, how it's affecting their lives and combine this information with thorough examination of the patient and their medical history before any surgery is considered. That's the difference between plastic surgeons and gynaecologists - when considering plastic surgery of the genital organs, we don't just consider the aesthetic look of the area, we also place a great importance on improving the feel, sensitivity and pleasure of the patient when they leave. If performed well, the benefits can be life changing.

My advice... visit your gynecologist prior to agreeing to any treatments so that you feel confident that any interventions are carried out with the maximum care. This is a very important area of your body - for confidence, sexual pleasure and, importantly, fertility. If you don't yet have a regular gynaecologist, there's no harm in seeking several opinions before proceeding.

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