Dysperunia is a medical term for Recurrent or persistent genital pain associated with sexual intercourse during or after. Pain during penile, digital or any other form of vaginal penetration can be considered dyspereunia. Patients complaint of pain during initial or deep vaginal penetration may have a presentation of localized intraoital tenderness, or diffused deep soreness. It may lasts for few hours or up to days. Conditions like anxiety, depression, fibromyalgia, endometriosis, adhesion, inflammatory pathologies, vaginal atrophy, hormonal imbalance, trauma to urethral and bladder wall and other pelvic organ pathologies can lead to dyspareunia.
According to research, 57% of patients with hypertonous pelvic floor muscles and 41% of patients with urinary incontinence may have dyspereunia. It may also be due to dry stretching and/or micro trauma of tightened pelvic floor muscles or adhesions. Dyspereunia may also present with multiple triggers in pelvic floor muscles, spasms of obdurator internus, coccygeous, iliopsoas or levator ani muscle and can be found with deep penetration.
Dyspareunia can be graded into FOUR painful stages
Stage1. Some level of pain during intercourse
stage2. Penetration, thrusting and completion occurs with continuous pain
stage3. Penetration tolerable, however cannot tolerate thrusts, intercourse cannot be completed and avoid sex.
stage4. Penetration becomes intolerable and women stops having intercourse.
One study has shown how Sexual Pain among Women (Dysperunia) fits the Fear-Avoidance model (Johanna et.,al 2013)
Individuals will be subject to Clinical history taking along with a Physical Exam with the explicit concent of the patient to determine the real cause of the pain.
Rehabilitation plays an important role in relieving the pain at any stage. Treatment Plan of Action might be a combination of counselling, Relaxation techniques, addressing pain, strengthening exercises etc.,
As the problem is unique and manifests differently in differently patients, it is strongly suggested not to self-medicate or self-rehabilitate, as it might worsen the situation.
Talk to your doctor or a Pelvic Rehabilitation Therapist to know more about the options to address this issue.