Pain during sex, or dyspareunia, is constant or recurring pain just before, during, or after sex. Painful intercourse can be felt externally on the vulva or internally in the vagina, uterus or pelvis. Factors such as underlying medical conditions or infections can cause painful sex. It is usually treated by identifying the underlying cause of the pain. It is a common condition that can have negative emotional and psychological effects. In addition to physical pain, couples may suffer a loss of intimacy or experience strain in their relationship. Pain during sex is more common in women. It can affect both men (male dyspareunia) and women (female dyspareunia) of all ages. Pain is often due to physical factors or medical conditions, but it can also be psychological. Pain during sex is one of the most common gynecological problems. It affects 10% to 20% of women in Europe at some point in their lives. The location of the pain can help determine the type of dyspareunia. It can be: Penetration pain (intraorbital or superficial dyspareunia). This pain is felt at the entrance to the vagina during initial penetration. Deep pain. This type of pain occurs with deep penetration and may feel worse in certain sexual positions. This pain is felt in the cervix or lower abdomen. A medical condition or previous surgery usually causes sexual pain that occurs deeper. Pain during intercourse can also be described as primary, secondary, complete, or situational: In some cases, painful intercourse is present in one of the following conditions: Vaginal atrophy. The vaginal mucosa can lose its normal moisture and thickness and become dry, thin and inflamed. This can be caused by medications, menopause, or other hormonal changes. Vaginismus. Fear of injury or previous trauma causes the vaginal muscles to spasm. Vaginal infections. These conditions are common and include yeast infections. Endometriosis. Ovarian cysts. Pelvic inflammatory disease. Tissue inflammation and pressure during intercourse causes deep pain. Ectopic pregnancy. Intercourse too soon after surgery or childbirth. Sexually transmitted infections. These may include genital warts, cold sores, or other sexually transmitted diseases. Injury to the vulva or vagina. These injuries can include a tear from childbirth or from an incision (episiotomy) in the perineum (the area of skin between the vagina and anus) that was made during birth. Skin disorders affecting the genitals. Psychological problems. Anxiety, depression, and low self-esteem can prevent sexual arousal. Source: my.clevelandclinic.org
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