Painful Sex

What is Painful Sex?

Painful sex, also known as dyspareunia, is a condition characterised by pain or discomfort during sexual intercourse. The pain can be experienced in different body parts, such as the pelvic area, lower abdomen, or pelvis.

Who Does Vaginal Dryness and Painful Sex Affect?

Vaginal dryness and painful sex can become an issue for a woman at any age due to several causes. It is more prevalent in women of ages 40 and above who have gone through menopause, but other women can experience it as well.

How Does Vaginal Dryness and Painful Sex Occur?

The body produces natural lubrication to ensure that the vagina is protected from external elements. The lubrication is produced due to the circulating estrogen hormone, which plays a crucial role in women’s sexual health. When a woman reaches menopause, estrogen levels decrease, resulting in vaginal dryness. The dryness causes friction during intercourse, resulting in discomfort and pain.

Causes Of Vaginal Dryness and Painful Sex?

Vaginal dryness and painful sex can be attributed to several causes, which are listed below:

Hormonal changes: Low estrogen levels, which can occur during menopause, pregnancy, breastfeeding, or when taking certain medications, can cause thinning and dryness of the vaginal tissue, leading to discomfort or pain during intercourse.
Medical conditions: Certain medical conditions, such as Sjogren's syndrome, can cause dryness throughout the body, including the vagina. This can lead to discomfort or pain during intercourse.
Cancer treatments: Certain cancer treatments, such as radiation therapy, can damage the vaginal tissue and cause dryness and discomfort.
Vaginal surgery or injury: Surgical procedures or injuries to the pelvic area can cause dryness and discomfort in the vagina.
Medications: Some medications, such as antihistamines, antidepressants, or birth control pills, can affect lubrication and sexual response, leading to dryness and discomfort.
Lack of arousal: If a woman is not fully aroused before sexual intercourse, the vagina may not produce enough lubrication, leading to dryness and discomfort.
Psychological factors: Stress, anxiety or a history of sexual abuse can affect sexual response and lead to decreased lubrication, making intercourse uncomfortable or painful.
Dehydration: A lack of water intake or water retention can affect the moisture level of the vagina
Substance use and smoking: smoking and alcohol use or drug use can decrease the blood flow and cause dryness of the vaginal tissue.

Symptoms of Vaginal Dryness and Painful Sex

The symptoms of vaginal dryness and painful sex can vary from woman to woman, but some common symptoms include:

Vaginal itching or burning: The dryness can cause irritation and itching in the vaginal area.
Soreness or pain during intercourse: Without enough lubrication, intercourse can be uncomfortable or even painful.
Painful urination: Dryness can cause discomfort or pain during urination.
Light bleeding after intercourse: Intercourse can cause small tears or abrasions in the vaginal tissue if there is insufficient lubrication.
Vaginal irritation or discharge: dryness can lead to changes in the natural pH balance of the vagina, causing irritation or discharge.
Vaginal tightness: dryness can cause the vaginal tissue to become less elastic, resulting in tightness during intercourse.

Stages Of Vaginal Dryness and Painful Sex

The degree of vaginal dryness and painful sex varies from woman to woman. However, there is usually no progression in overall vaginal dryness with time.

How are Vaginal Dryness and Painful Sex Diagnosed?

Vaginal dryness and painful sex can be diagnosed by physical examination and discussing your symptoms. During the examination, Dr Crawford will likely:

Ask about your medical and sexual history, including any medications you currently take.
Perform a pelvic exam to check for any abnormalities or signs of infection.
Take a sample of any vaginal discharge to test for infections.
Assess the lubrication and elasticity of the vaginal tissue.

In addition to the physical examination, Dr Crawford may also recommend additional tests or procedures to help determine the cause of your symptoms. These may include:

Blood tests: Hormone levels such as estrogen may be checked through blood tests
Imaging Tests: pelvic ultrasound or MRI may be done if there's suspicion of certain medical conditions such as endometriosis, fibroids, or cysts
Colposcopy: a procedure that allows a closer look at the vaginal tissue, cervix, and the surrounding area with a microscope.

How are Vaginal Dryness and Painful Sex Treated?

After determining the cause, the main treatments prescribed for vaginal dryness and painful sex include:

Hormonal therapy: Hormone therapy, such as estrogen creams, tablets or patches, can help increase lubrication and improve the health of the vaginal tissue. This type of therapy is most commonly recommended for women experiencing symptoms related to menopause.
Lubricants and moisturisers: Over-the-counter or vaginal moisturisers can increase lubrication and make intercourse more comfortable. These can be combined with or as an alternative to hormone therapy.
Medications: If an infection is causing dryness and discomfort, antibiotics or antifungal medications can be prescribed.
Certain Medications adjustment: If a medication causes dryness and discomfort, your healthcare professional might suggest adjusting the dosage or changing the medication.
Vaginal Dilators: Physical therapy with vaginal dilators may be prescribed for women with vaginismus, a condition characterised by the involuntary contraction of the vaginal muscles.
Behavioural and Psychological therapy: if stress, anxiety, or past trauma are contributing to the dryness and discomfort, therapy sessions can help work through these issues and improve sexual response.
Lifestyle changes: Keeping the body hydrated by drinking enough water, avoiding smoking, and limiting alcohol intake may help improve the moisture level of the vagina and reduce symptoms.

What If Vaginal Dryness and Painful Sex Is Untreated

A woman going through menopause experiences a lot of changes in their body. This transformation, compounded with vaginal dryness and painful sex, can result in a loss of self-esteem and sexual confidence. Most women undergo these changes silently because discussing them with their partner or doctor can be hard. Hence, it is necessary to seek consultation as early as possible.

Your Next Step

You may require further investigation if you have any symptoms relating to your vaginal dryness.
We advise you to see your general practitioner and possibly get a referral to Dr Crawford.

Dr Crawford can offer specialised help, advice on possible diagnoses, further investigations, and suitable treatment.