Urologenzentrum Wien - Dyspareunie bei einer Frau, sitzend auf einem Sofa, zeigt Beschwerden im Genitalbereich.

Dyspareunia

Dyspareunia refers to pain that occurs during or after sexual intercourse. This condition can affect both women and men, with women being more frequently affected. The pain can be felt superficially, in the vagina, or deep in the pelvic area. Dyspareunia can have physical, emotional, and psychological causes and can significantly impact the sexual and emotional well-being of those affected.

Causes of dyspareunia

The most common causes of dyspareunia are:

  • Infections: Sexually transmitted infections (STIs), vaginal yeast infections, or urinary tract infections can cause pain during intercourse.
  • Hormonal changes: In women, a low estrogen level after menopause or after childbirth can lead to vaginal dryness and pain.
  • Vaginismus: Involuntary muscle contractions of the pelvic floor muscles can make penetration painful or impossible.
  • Endometriosis: This condition, where uterine lining grows outside the uterus, can lead to deep pelvic pain during intercourse.
  • Scarring: Surgeries, injuries, or birth traumas can leave scar tissue that causes pain.
  • Psychological causes: Anxiety, stress, or negative sexual experiences can also contribute to dyspareunia.

Symptoms of dyspareunia

  • Pain during penetration
  • Deep pelvic pain
  • Burning or stinging
  • Long-lasting pain after intercourse

Diagnosis of dyspareunia

The diagnosis of dyspareunia is made through a combination of medical history and physical examination:

  • Gynecological examination: The doctor examines the vagina and external genitalia for signs of infections, scar tissue, or other abnormalities.
  • Ultrasound or MRI: If deeper causes such as endometriosis or cysts are suspected, an ultrasound or MRI scan may be performed.
  • Swab: To rule out infections such as sexually transmitted diseases or fungal infections, a swab is taken.

Treatment options for dyspareunia

The treatment depends on the underlying cause and may include the following:

  • Hormone therapy: For hormonally induced vaginal dryness, local estrogen therapy can help.
  • Pain therapy: Pain relievers or anti-inflammatory medications can help alleviate the pain.
  • Physiotherapy: Pelvic floor exercises and relaxation techniques can help with vaginismus.
  • Surgical procedures: Surgery may be necessary for endometriosis or scar tissue.
  • Psychological counseling: Therapy can help process fears or trauma in cases of psychologically induced pain.

Preventive measures for dyspareunia

To prevent dyspareunia, it is important to ensure adequate moisture in the vagina during intercourse. Lubricants can help avoid friction. Regular gynecological examinations for the early detection of infections or other conditions are also important. In some cases, psychological counseling can help address emotional or psychological causes.


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