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Pain During and After Intercourse: Causes and Treatment

Discomfort or pain during intercourse is called dyspareunea. This symptom may be provoked by a variety of factors, from insufficiency of vaginal and cervical mucous glands and up to oncological diseases of the reproductive system. There are 10 most common causes of experiencing pain after intercourse, as well as possible methods of treatment. Among them are: atrophic changes of vaginal epithelium, candidiasis, nonmalignant vaginal diseases, uterine pathology, follicular cysts, acute adnexal affection and loss of pelvic fixation. Different etiologies of these diseases determine different approaches to their treatment.

Dryness/ atrophy of vaginal epithelium

Atrophic decline is quite a natural age-determined change of female genitalia. Due to increasing estrogen deficiency, the epithelium, which covers the vagina from inside, becomes very thin, and thus very little cervical mucus and lubrication is produced during sexual arousal.

In the setting of such degradation, the woman can experience pain during intercourse, which may be accompanied by micro traumas and precipitate bleeding. We distinguish between 2 directions among treatment and preventive methods:

  • Medically induced delay of menopause, including intake of vaginal estrogen;
  • Auxiliary (symptomatic) therapy in the form of gels and lubricants.

Discomfort or pain during intercourse is called dyspareunea. This symptom may be provoked by a variety of factors, from insufficiency of vaginal and cervical mucous glands and up to oncological diseases of the reproductive system. There are 10 most common causes of experiencing pain after intercourse, as well as possible methods of treatment. Among them are: atrophic changes of vaginal epithelium, candidiasis, nonmalignant vaginal diseases, uterine pathology, follicular cysts, acute adnexal affection and loss of pelvic fixation. Different etiologies of these diseases determine different approaches to their treatment.

Dryness/ atrophy of vaginal epithelium

Atrophic decline is quite a natural age-determined change of female genitalia. Due to increasing estrogen deficiency, the epithelium, which covers the vagina from inside, becomes very thin, and thus very little cervical mucus and lubrication is produced during sexual arousal.

In the setting of such degradation, the woman can experience pain during intercourse, which may be accompanied by micro traumas and precipitate bleeding. We distinguish between 2 directions among treatment and preventive methods:

  • Medically induced delay of menopause, including intake of vaginal estrogen;
  • Auxiliary (symptomatic) therapy in the form of gels and lubricants.

Vaginal candidiasis

Classical symptoms of vaginal candidiasis include itching, burning, disturbed urination, dyspareunea and curdyvaginal discharge with acescent or putrefactive smell.

This yeast infection, which is also known as thrush, often appears due to weakened immune system. Preventive means against candidiasis include appropriate maintenance of personal hygiene, normal acid environment and beneficial vaginal micro flora by using special care means. Apart from this, it is very important to have a permanent sexual partner and use barrier contraceptive methods (preservatives).

Nonmalignant vaginal affections

There are several varieties of nonmalignant diseases, which might settle in the vagina. Vaginal epithelium can be affected by eczema, lichen, hypertrophic changes, as well as pigmentary neoplasmas. Besides the mentioned factors, glands and canals, located in the vagina, can develop tumors and cysts. Nonmalignant tumors can grow out of the adjacent tissues: blood vessels, fat layer.

That is to say, etiology of this or that disease depends on its specific type and location. So, epithelial neoplasmas can have autoimmune nature, be formed due to regular traumas, or else depend on genetic factors. The cause of formation of cysts often has to do with chronic inflammation.

The diagnosis can be confirmed only after histopathological examination. In most cases nonmalignant epithelial affections are treated non-surgically, whereas cysts and related tumors require surgical treatment. In the first variant maintenance of proper personal hygiene is the prevailing factor. Women are not advised to wear too tight underwear, giving preference to more comfortable loose-fitting models made of natural fabric. It is also required to avoid the usage of irritating cosmetic means, aromatic oils, talc powder and others, using only neutral soap for washing. In some cases, hormonal creams can be prescribed.

The volume and methods of operative treatment depends on individual features of this or that condition.

4 factors of pain during intercourse, associated with changes in the uterus

First of all, it should be noted that dyspareunea can be caused by inherent and acquired anomalies of uterus shape. In case the deficiency provokes the appearance of any symptoms, including pain, then it should be corrected surgically.

Uterine fibroid is a nonmalignant disease, which can also cause pain during intercourse. It has hormonal background and whether to extract it or not is decided according to each unique case.

The same case is with leiomyoma. It causes painful sensations, mostly in case of lower precervical location. Its severity and intensity depend on the size of the tumor and the degree of its growth. This type of tumor is also subject to surgical extraction.

The most common and fourth in succession pathology of the uterus, which can provoke dyspareunea is endometriosis. This disease involves insular semination of endometrial cells (mucous lining of the uterus) into the pelvic organs. The pain is usually associated with profound and proliferative endometriosis of recto-uterine cavity or uterosacral ligaments, which is accompanied by significant limitation of flexibility and fixation of the uterus. Pelvic pain during intercourse in case of this disease usually occurs in a certain position.

No single and indisputable cause for the appearance of endometriosis has been established so far. There is a close interrelation between autoimmune diseases and genetic disorders. Advanced endometriosis requires exclusively surgical treatment with subsequent medicamental support.

Large follicular cysts

It is commonly known that each ovum matures in a special follicle. Disturbance of its atrophy after the emergence of female cell (often takes place at early stages of pregnancy) can lead to the formation of cysts. The bigger it is, the greater are the chances of experiencing pain after or during intercourse.

Follicular cysts constitute danger as they can twist around appendixes (ovary, tube). This is a life-threatening condition, which requires immediate hospitalization and urgent surgery. Uncomplicated cysts respond to non-surgical therapy and can even degenerate spontaneously (for example after conception).

Pelvic inflammatory disease (PID)

Acute salpingitis (inflammation of fallopian tubes) is the most common severe complication of sexually transmitted diseases. Such a disease is “attacked” by active antibiotics treatment, in complex with anti-inflammatory and disintoxication drugs.

Relaxation of pelvis

Pelvic fixation dysfunction can provoke sensations of pressure in the pelvis, disturbance of urinary bladder and strait intestine function, as well as pain during intercourse.

Causes of poor pelvic fixation can include trauma of genital tracts during child delivery, constantly increasing pressure of inner fat tissue in case of obesity, chronic coughing, regular lifting of heavy weights, inherent weakness of tissues and their atrophic changes due to estrogen deficiency.

This disease requires eventual and rather complex treatment, which can include substitutive hormonal therapy, physical exercises, usage of special supporting rings and surgical pelvic reconstruction.

Thus, chronic pain during intercourse is a considerable reason for undergoing clinical examination. Fortunately, some conditions, that might cause dyspareunea, do not present any danger and can be settled by special care, while others can constitute great danger and require immediate treatment.

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