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Sex is meant to be exciting and pleasurable. But what if it hurts? Pain during sex can cause fear of sex, lower your sex drive and lead to loss of intimacy. If sex is painful for you, do not brush it aside, as painful sex or dyspareunia can be a result of certain physical conditions. Let’s look at some of the causes of dyspareunia and how to treat them.

Vulvovaginal Atrophy

The estrogen produced in the ovaries reduce sharply after menopause. This low level of the beneficial estrogen severely affects vaginal health by diminishing the vagina’s capacity to secrete lubricants, to grow new cells and to expand and contract. This results in reduced blood flow which cause the vagina and vulva to atrophy or shrink. Vulvovaginal atrophy can lead to pain during intercourse, soreness and burning after intercourse and even post-sex bleeding. Here are some ways to get relief from it.

• More sex: If you are not suffering from a severe case of vulvovaginal atrophy, the best treatment is to have sex more often. Sex increases blood flow to the genital area thereby keeping it in good health.

• Estrogen: Estrogen therapy in the form of systemic estrogens (oral pills and patches) and local estrogens (tablets, creams and rings applied to the vagina) is beneficial to compensate for the lack of natural estrogen. However estrogen products can have side effects and therefore it is necessary to undertake this treatment only after proper consultation with a healthcare provider. Local estrogen therapy is much better in this respect as the side effects do not affect the entire body.

• Non-medicated lubricants: Vaginal lubricants in liquid or gel form reduce pain thereby increasing comfort. Water based or silicone based lubricants can be applied to both the vagina and penis before sexual intercourse to get relief from sexual pain.

Vestibulodynia

A severe pain which affects the entrance to the vagina or vestibule when any type of pressure or penetration is attempted can be termed as vestibulodynia. It is more common in women under the age of fifty but can even affect older women. Ways to treat vestibulodynia include estrogen creams, topical anesthetics, antidepressants, antiepileptic drugs and physical therapy.

Vulvodynia

Vulvodynia is a condition which causes pain, irritation, stinging or burning on the vulva or the tissue surrounding the vagina. The pain involved may or may not be related to touch and can be a result of certain nerve problems.Vestibulodynia and vulvodynia are treated using some of the same methods.

Vaginismus or Pelvic Floor Muscle Dysfunction

This is a condition which can make vaginal entry severely difficult and sometimes even impossible. Here, an attempt to sexual intercourse can cause the vaginal and perineal muscles to squeeze or spasm. A traumatic event like nonconsensual sex and physical problems such as musculoskeletal injuries or vestibulodynia can give rise to vaginismus. Various therapies like dilator therapy and physical therapy are used to treat vaginismus.

Other causes

There are several other factors which can lead to painful sex. Cystitis, which causes inflammation of the bladder, may result in pain during intercourse as the bladder is placed above the vagina. Endometriosis is another condition that may cause pelvic pain as the tissues in the uterus tend to grow outside the uterus. A "dropped" or prolapsed uterus can also result in painful sex. Whatever be the reason behind painful intercourse, talk to your healthcare provider to get assistance and relief.