Sunday 14 December 2014

When Sex is Painful

This is also known as dyspareunia, and is
 felt in the pelvis during or after sexual intercourse. It is more common in, but not limited to, women. But in this article we will discuss about painful sex in women. Nobody really knows exactly how common dyspareunia is, as many women  in our environment never seek medical  help. It is estimated that somewhere between 1 and 4 out of 10 women experience it. Most commonly, this is early in their sexual lives and around the menopause.
There are many causes of dyspareunia, most of which are not serious or damaging in nature, but all can be detrimental to your sex life and ultimately may lead to relationship difficulties. It can be a vicious cycle, with pain leading to nervousness about sex (intercourse), and nervousness leading to dryness and further pain.
It's also not uncommon for dyspareunia to remain after the cause has been treated, particularly if things have been left untreated for a while. For this reason, it is important to seek help early, so that treatable causes can be discovered and managed. 
In this article we will talk about the main causes of painful sex:
1. Vaginal Trauma
The vagina is pretty flexible and strong and usually recovers well from the stretch and (sometimes) small tears of childbirth. However, more significant trauma to the vagina - for example, from traumatic childbirth or mutilation - can lead to scarring, and then to pain and difficulty during sex (intercourse).

2. Vaginal or genital infection


Infections of the vagina and the area around it cause inflammation of the tissues and so commonly cause pain on having sex. Infection may be with thrush (candida - a yeast that often lives in the bowel), with viruses such as herpes, and with germs (bacteria). A wide range of bacterial infections can infect the vagina. Some (but by no means all) are sexually transmitted. The vagina is not always sore and itchy before sex, but can remain so afterwards. There is often a coloured discharge and you may notice an offensive smell.


3. Female genital mutilation

Female genital mutilation, also referred to as female circumcision, still occurs in Nigeria and involves varying degrees of mutilating surgery to the external genitalia of a woman. In the more extreme forms, the vagina is stitched shut. Following genital mutilation there is usually permanent scarring, which may lead to damaged nerves and pain. Any of these issues can cause pain on penetration and may make sex impossible.

4. Vaginal abnormalities
Very rarely, abnormalities of the vagina itself make sex painful or even impossible. These include pieces of extra tissue inside the vagina which are present at birth.
5. Intact hymen
The hymen is a membrane that lines the vaginal opening. Early in your sex life the hymen is broken down by the act of having sex. In many young women it will already have been stretched by use of tampons. The name is misleading, as the hymen does in fact have a small hole in it from birth. This hole gets larger little by little as girls grow older. However, the hymen can be quite thick and the hole not quite large enough. This can mean that early in her sexual life a woman my feel pain from the hymen as it is forced open the first time she has intercourse. The pain is superficial, felt at the entrance to the vagina as soon as penetration is attempted, and may prevent it from taking place.

6. Vaginismus
Vaginismus is a powerful and often painful contraction of the muscles around the entrance to the vagina (the pubococcygeal muscles), which makes penetration painful or impossible. It may also prevent the use of tampons and any sort of gynaecological examination. The spasm of vaginismus is not something you can cause deliberately; it's completely outside your control. It may seem to begin for no reason, but can also result from a painful or worrying experience of sex, when it becomes a kind of protective reflex. However, vaginismus is upsetting and dispiriting for both halves of a couple, as it can prevent the enjoyment of sex for many years, and can prevent sex completely. Once it has begun, fear of failure and nervousness about not being able to have sex make it worse. It's important to seek help to break the cycle of anxiety and pain.
And there you have it. The most common causes of pain during sex in women. In our next article we will discuss the treatments for painful sex in women and painful sex in men.

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