Painful Sexual Intercourse-Dyspareunia

As well as desires, desires and pleasure in our sexual life, the feeling of pain, which can vary from person to person and the form of sexual activity, has a place and is natural. The reason is that there is a very close similarity between sexual pleasure and pain. Even in couples who have lost themselves with sexual enthusiasm, the facial expression of a person in pain can be seen at some moments. However, it is common for a "fear of pain" to become ingrained in sexual intercourse because of ignorance or lack of sex education. It is necessary to distinguish this situation from the pain experienced due to a real physical illness. Because over time, instead of enjoying sexual intercourse, it becomes painful. This is because of the fear of pain.

The majority of sexually active people may experience pain during intercourse at some point in their lives. However, the problem arises if this pain is recurrent and increases with each passing day. This problem can lead to disappointment, sexual reluctance and lack of self-confidence between couples. Many women may experience pain and soreness during or after intercourse (especially during penetration) involving penile-vagina intercourse. This condition is called “dyspareunia”. Women often describe the pain as "pressure and pain in the genital area", "tearing" or "burning sensation". Women who experience dyspareunia often experience pain in the vagina, clitoris, inner and outer lips. Some women may experience a superficial pain at the entrance of the vagina, while they may feel a deeper pain at the further entrance of the penis. Generally, with the fear of this pain, a clinical picture called "secondary vaginismus", which is characterized by the contraction of the vaginal muscles to prevent the entrance of the penis, may occur during intercourse.

Types of Dyspareunia

• Primary Dyspareunia

A condition in which complaints of pain during or before and after penetration have been present since the first sexual experience.

• Secondary Dyspareunia

It is the condition that the complaints of a woman who has experienced the sexual intercourse process appear later.

• Superficial Dyspareunia

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There is a pain at the entrance to the vagina. Reasons and the following are:

• Structural problems of the hymen; The hardness of the hymen causes a painful and painful intercourse during the union. >

• Pain and burning sensation may occur due to irritation caused by the loss of elasticity of tissues during and after menopause.

• As a result of insufficient stimulation caused by genital infections A painful intercourse may be experienced.

• As a result of not keeping the foreplay long enough and the vagina not fully wet, a painful and painful intercourse can be experienced.

• Deep Dyspareunia

The pain that occurs in the depths of the vagina and is felt in the lower abdomen during penis-vagina coexistence is called deep dyspareunia. The reason is as follows:

• Vaginal infections can cause pain.

• Mass in the vagina, tumor, etc. Factors can cause pain and bleeding.

• Coexistence experienced before the woman is ready for intercourse can cause pain and suffering.

• Sagging of the vaginal walls As a result, pain may be experienced due to stretching.

• Allergic conditions to synthetic underwear, suppositories, condoms, gels and vaginal washing materials can cause pain.

• Changes in the vaginal area due to surgery or radiotherapy may cause pain.

• Abnormalities arising from birth may cause pain.

Causes

Dyspareunia can develop due to many factors ranging from a simple anatomical problem to complex psychosocial causes. Therefore, dyspareunia is a specific form of chronic pelvic pain. The reason may be only from the reproductive organ, but also from sources such as digestive system diseases, kidney and urinary tract diseases, musculoskeletal system diseases and mental diseases. In general, the causes are as follows:

• Surgeries on reproductive organs,

• Genital herpes, vaginitis, pelvic e infections, etc.

• Involuntary contractions seen in women who are concerned about sexual activity,

• Fear, anxiety, conversion reactions,

• Incompatibility with partner,

• Psychological trauma from first relationship,

• Attempts of sexual intercourse without foreplay and adequate vaginal wetness,

• Mass or tumors in the genital organs,

• Vagina anterior or posterior wall sagging,

• Allergic response to foreign bodies in the vagina,

• Congenital anomalies in the vagina,

• Endometriosis

• Previous pelvic fractures,

• Lesions related to the urethra or bladder,

• Digestive system diseases,

• Anus and rectal region diseases such as hemorrhoids, fistula and fissure,

• Constipation,

• Inflammatory bowel diseases,

• Antihistamine etc. side effects of drugs

Prevention Ways

• Using cotton underwear,

• Wearing comfortable and loose clothing,

• Wiping the genitals from front to back when cleaning the toilet,

• Preferring a monogamous sexual life,

• Keeping the genital area away from sweat and moisture,

• Changing underwear frequently ,

• Swimming etc. Changing wet swimwear immediately after activities,

• Using vaginal lubricants,

• Using condoms.

Treatment

If dyspareunia is not treated, it also affects a woman's daily life, harms the relationships she has with the opposite sex, causes vaginismus over time, and prevents pleasure from sexual intercourse. and ultimately damages the self-respect and trust of women. The purpose of sexual therapy, which should be done after the diagnosis of dyspareunia made as a result of the gynecological examination; The aim is to eliminate these factors by revealing the psychological or physical causes underlying dyspareunia. Therapeutic efforts in treatment have 3 important goals:

• Pain reduction and control

• Overcoming the negative consequences of pain on life

• Restoring a satisfactory sex life creation

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