Pain during or after sexual intercourse is known as dyspareunia. Although this problem can affect men, it is more common in women. Women with dyspareunia may have pain in the vagina, clitoris or labia. 

Common causes include the following:

  • Vaginal dryness
  • Atrophic vaginitis, a common condition causing thinning of the vaginal lining in postmenopausal women
  • Side effects of drugs such as antihistamines and tamoxifen 
  • An allergic reaction to clothing, spermicides or douches
  • Endometriosis
  • Inflammation of the area surrounding the vaginal opening, called vulvar vestibulitis
  • Skin diseases, such as lichen planus and lichen sclerosus, affecting the vaginal area
  • Urinary tract infections, vaginal yeast infections, or sexually transmitted diseases
  • Psychological trauma, often stemming from a past history of sexual abuse or trauma

Dyspareunia typically is diagnosed based on your symptoms. Your medical and sexual history and your physical examination will help your doctor to determine the cause of your symptoms.

Distinguishing pain that occurs with touching the genitals or early penetration from pain that occurs with deeper penetration is a clue to the cause of your symptoms. Therefore, your therapist will ask you questions about the exact location, length and timing of your pain. He or she also will ask you: 

  • Was there ever a time you had painless intercourse, or if you have always had dyspareunia
  • Do you have enough natural lubrication, do your symptoms improve if you use lubricants
  • About your sexual history (to help assess your risk for sexually transmitted infections)
  • If you have ever been sexually abused, or had a traumatic injury involving your genital
  • If you have irregular periods, hot flashes or vaginal dryness, symptoms suggesting that can suggest you could have atrophic vaginitis

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