Initial pain can lead to fear of recurring pain, making it difficult to relax, which can lead to more pain. It can be difficult to tell whether emotional factors are associated with dyspareunia. Not everyone with dyspareunia has a history of sexual abuse, but if you have been abused, it can play a role. This can contribute to pain during intercourse. Your pelvic floor muscles tend to tighten in response to stress in your life. Anxiety, depression, concerns about your physical appearance, fear of intimacy or relationship problems can contribute to a low level of arousal and a resulting discomfort or pain. Medical treatments for cancer, such as radiation and chemotherapy, can cause changes that make sex painful.Įmotions are deeply intertwined with sexual activity, so they might play a role in sexual pain. Scarring from pelvic surgery, including hysterectomy, can cause painful intercourse. The list includes endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, pelvic floor dysfunction, adenomyosis, hemorrhoids and ovarian cysts. Not having a fully formed vagina (vaginal agenesis) or the development of a membrane that blocks the vaginal opening (imperforate hymen) could cause dyspareunia.ĭeep pain usually occurs with deep penetration. These involuntary spasms of the muscles of the vaginal wall can make penetration painful. Eczema or other skin problems in your genital area also can be the problem. An infection in your genital area or urinary tract can cause painful intercourse. Inflammation, infection or skin disorder.This includes injury or irritation from an accident, pelvic surgery, female circumcision or a cut made during childbirth to enlarge the birth canal (episiotomy). These include antidepressants, high blood pressure medications, sedatives, antihistamines and certain birth control pills. A drop in estrogen levels after menopause or childbirth or during breast-feeding also can be a cause.Ĭertain medications are known to affect sexual desire or arousal, which can decrease lubrication and make sex painful. This is often the result of not enough foreplay. Pain during penetration might be associated with a range of factors, including: Emotional factors might be associated with many types of painful intercourse. Physical causes of painful intercourse differ, depending on whether the pain occurs at entry or with deep thrusting.
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