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Dyspareunia

Learn more about dyspareunia and how it is treated. 

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Overview

Dyspareunia is the medical term that describes persistent pelvic pain during sexual activity.  

Dyspareunia refers to pain during or after sexual activity that can be felt in many ways.

Pain might be felt on the outside of your vulva or at the opening of the vagina. Pain might also be felt internally with deep penetration.

Some people have had dyspareunia since becoming sexually active, while others may develop it after having had pain-free sex. Some may experience pain during sex in certain situations.  

Dyspareunia can put a strain on your relationship or cause stress and social isolation. It has also been linked to depression and anxiety. 

Our care

Learn more about the specialized care provided at Mount Sinai Hospital for Gynaecology.

This content is intended for informational purposes only and is not intended to be used or relied upon for any diagnostic or treatment purposes. It does not replace the need for consultation with a health-care professional. Please speak with your health-care professional for questions about your health.

Symptoms

Symptoms

The causes of dyspareunia can be physical, psychological, relational or sociocultural. Often, more than one cause contributes to the pain.  

Causes of dyspareunia may include any of the following:

  • Gynaecological conditions such as vaginitis or endometriosis
  • Infections such as yeast infections or pelvic inflammatory disease
  • Dermatologic conditions such as lichen sclerosis
  • Vaginal dryness in menopause
  • Medication side effects
  • Anxiety or depression
  • A past history of abuse
  • Inadequate stimulation
  • Inadequate lubrication
  • The quality of your relationship
  • Personal values
  • Religious influences
  • Cultural expectations 
Diagnosis

Diagnosis

If you have symptoms of dyspareunia, a gynaecologist can perform a thorough assessment of your health to help discover the causes. 

This may include asking you questions about your symptoms or about any past physical or emotional trauma. It may also include a physical exam that includes a pelvic exam. 

Please communicate any pain or discomfort you feel during the exam so your physician can adjust or stop the exam. 

Treatment

Treatment

Your treatment choices will depend on the specific causes of your pain and may include several different approaches. A gynaecologist will work with you to develop a care plan that is specific to your needs. You care plan may include any of the following.

Anesthetics

If you have pain upon entry, a special numbing cream might be prescribed to use around the opening of the vagina.

Lubricants

Water- or silicone-based lubricants or products like coconut oil can help reduce friction and ease pain in some cases.

Moisturizers

Moisturizers work to reduce friction in the same way as lubricants. They may even work better and last longer in some cases.  

Medication

Topical estrogen medication are creams that can be applied locally to the vagina. These can help with vaginal dryness and ease pain.

Other medication such as steroids, antibiotics and antifungals may be prescribed to treat other conditions that may contribute to dyspareunia.  

Pelvic floor physiotherapy

Physiotherapy done over several weeks can help by strengthening and relaxing your pelvic floor muscles. This can help ease pain during intercourse in some cases.

Psychotherapy

Psychotherapy that may include cognitive-behavioural therapy can help you learn strategies to change thought patterns associated with any pain and fear related to sexual experiences.