DYSPAREUNIA DEFINITION, PREVENTION, AND TREATMENT

DYSPAREUNIA DEFINITION, PREVENTION, AND TREATMENT

Understanding DyspareuniaDyspareunia or painful intercourse is a pain that occurs continuously or occasionally in the genital area and occurs just before, during, or after sexual intercourse. Vagina, clitoris, and labia are areas that generally feel pain when people with dyspareunia have sex.

The disorders commonly experienced more frequently in women than in men can be triggered by medical or psychological factors. Dyspareunia treatment is based on the underlying cause of the disorder. Immediately see a doctor if you feel pain during intercourse to get the right treatment.

Dyspareunia

Diagnosis of Dyspareunia

The medical evaluation of a physician to obtain a diagnosis of dyspareunia is to interview the patient (anamnesis) about symptoms, health history, and other related evaluations. The doctor will ask whether the pain is felt in all types of sex positions or not, the location of the pain, as well as the history of sexual relations, surgical procedures, and past birth experience.

Examination of the pelvic area will be performed to detect if there is a disturbance, such as infection or swelling, skin irritation or disruption of the anatomy of the body and location of pain. The mild pressure in the pubic area and pelvic floor muscles can detect the pain common to people with dyspareunia.

An examination of the vaginal area may also be performed using a device called speculum to open the vaginal wall. Patients with dyspareunia will usually feel sick even though the procedure is done slowly, it makes sense to ask the doctor to stop the procedure if it is very painful. In addition to the speculum, a pelvic examination can be performed using ultrasound.

dyspareunia reproductive system

Symptoms of Dyspareunia

The symptoms of dyspareunia vary greatly and differ from one patient to another. In women, symptoms of dyspareunia can be felt on the outer surface of the genital area, vagina, or in the deeper areas, the pelvis. Here are the signs of dyspareunia that may be felt by the patient.

  • Pain resembles heat or pain.
  • Pain that arises only when sexual penetration begins.
  • The pain that occurs every penetration occurs, even when inserting the tampon into the vagina.
  • The internal pain that arises when the movement encourages sexual intercourse.
  • Pain that arises after sexual intercourse that does not hurt.
  • A pulsating pain that lasts for hours after sexual intercourse.

Treatment of Dyspareunia

Dyspareunia is treated according to the underlying cause. If the trigger of pain during intercourse is the lack of lubricant caused by the low estrogen hormone, then the drugs to be administered is a function of increasing estrogen hormone. An estrogen ointment for the vaginal area or a portable medicine may be recommended for women with dyspareunia.
Other drugs that may be given to people with dyspareunia according to the trigger, for example, are Anti-fungal drugs if the cause of dyspareunia is a fungal infection in the vaginal area.

  • Antibiotics, if the cause of dyspareunia is a urinary tract infection or a sexually transmitted disease.
  • Steroid creams, if the cause of dyspareunia is a lichen planus or lichen sclerosis disease.

In addition to drugs, surgical procedures may be a consideration of dyspareunia treatment options in patients with endometriosis as well. The surgical procedure is performed to remove the mass in the pelvis or the infected part, scar tissue, or improve the condition of the inverted uterus that triggers dyspareunia.

The following types of therapies are also available for people with dyspareunia, namely:

  • Sex therapy or counseling to talk about certain emotional experiences that can trigger pain when the patient has sex, especially if the condition has been long-lasting. Improving the quality of communication and restoring sexual intimacy between dyspareunia and their partners is also another goal of sex counseling.
  • Cognitive behavioral therapy can help change behavior patterns and negative thoughts.
  • Desensitization therapy may include a variety of techniques that will be tailored to the patient’s condition. Basically, this therapy is done to reduce the pain by learning vaginal relaxation techniques and special exercises pelvic bone or kegel.

DYSPAREUNIA

Some therapies can also be done at home with a partner, by changing some sexual routines to reduce pain during intercourse, such as:

  • Exercise each other in talking about each other’s feelings about sexual comfort, such as what position suits your condition or whether you want a partner to slow down the rhythm of making love.
  • Not in a hurry when intercourse can stimulate the production of natural lubricants and passions that also reduce pain during penetration.
  • Choose a brand of lubricant that really fits, and you like to have sex comfortably and not painful.

Alternatively, people with dyspareunia are advised to try exchanging positions, for example with women at the top to prevent the penis touching or putting pressure on the pelvic floor and avoiding pain or cramps. The position of lovemaking with women above men also provides flexibility for dyspareunia women to control their comfortable penetration.

Cause of Dyspareunia

The cause of the perceived dyspareunia at the beginning of intercourse can be caused by something different from the one felt during sexual intercourse and can also be attributed to an emotional factor. Here is the translation:

Pain during early sexual intercourse or penetration can be attributed to several factors, namely:

  • There are inflammation or skin disorders
    The condition of atrophic vaginitis (thinning of the vaginal layer due to postmenopause) or there is eczema in the pubic area. Skin disorders called lichen planus, and lichen sclerosus that alters the environment around the vagina are also thought to cause dyspareunia.
  • The presence of infection in certain organs
    Painful sex may also indicate an infection in the genital area or urinary tract.
  • Lack of lubrication or lubricant
    Preheating before intercourse can reduce the condition of the vagina dry and useful to make sexual intercourse feel more excited and reduce pain. Some medicines used to treat the disease can reduce lubricants, such as high blood pressure medications, antidepressants, tranquilizers, antihistamines, and some types of birth control pills. In addition to painful sex, reduced lubrication may result from decreased postmenopausal estrogen, childbirth, or during breastfeeding.
  • Any injury or surgical effect
    Injury, trauma, or irritation due to accidents, female circumcision, pelvic surgery, or wounds caused by augmented birth canal during delivery (episiotomy).
  • Vaginismus
    Disorders in the form of contractions experienced by the muscles of the vaginal wall can cause painful penetration.
  • Congenital abnormalities since birth
    The presence of vaginal abnormalities that do not form completely since birth called vaginal agenesis, or the growth of membranes that block the opening of the vagina (imperforate hymen).

Pain in the body when there is deeper penetration. This condition is commonly associated with a position when having sex, can be caused by:

  • Medical procedures or specific operating effects
    Such as radiation therapy, chemotherapy, pelvic surgery, and procedures for removal of the uterus or hysterectomy that can cause pain during intercourse.
  • Disease or certain medical conditions
    For example pelvic inflammatory disease, uterine cyst, hemorrhoids, endometriosis, irritable bowel syndrome, uterine fibroids, and descent of the uterus/uterus down.

Emotional factors also have an impact on sexual intercourse and can be associated with various pain that arises when doing so. Some emotional factors that can be linked, among others:

  • The level of stress that is being experienced
    Stress can cause pelvic floor muscles to trigger pain during intercourse.
  • Psychological disorder
    Like depression, anxiety about physical appearance, anxiety prolonged, fear in relationship or intimacy can decrease the passion and lead to the emergence of discomfort or pain.
  • Ever been sexually abused
    Although not the trigger factor encountered in most women with dyspareunia, sexual harassment can be a risk factor for some women who have experienced it.

Dyspareunia can also be triggered by the trauma of repeated pain when it will have sexual intercourse that triggers pelvic floor contractions that cause the pain. Therefore, it is difficult to ascertain the psychological factors that cause this condition.
Dyspareunia can also occur in someone who never has or does not have sexual experience, especially if the spouse also does not have that experience. Other risk factors occur in someone who will or have entered menopause.
In men, dyspareunia is commonly felt in the glands around the penis and testes shortly after ejaculation. The causes of dyspareunia in men, among others:

  • Infections of the prostate gland, bladder, and seminal vesicle gland.
  • Patients with genital gonorrhea disease.
  • Anatomical deformities of the penis, for example in Peyronie’s disease.
  • Scar tissue in the foreskin of the penis due to infection or inflammation, or when interested so that it becomes too tight when having sex or masturbation.

Dyspareunia patients need to spend time specifically to identify the true cause of the symptoms experienced.

Prevention of Dyspareunia

Some ways can be done to prevent the emergence of pain when making love, for example by giving each other kisses, sensual massage, and masturbation to each other. These activities can make sex more comfortable and fun. Some other precautions, namely:

  • To prevent vaginal dryness, use lubricants, or appropriate treatment measures if the vaginal dryness is caused by atrophic vaginitis conditions.
  • To prevent urinary tract infections, get used to wipe the pubic area from front to back after urination, and urinate after sexual intercourse.
  • Avoid free sex with many sexual partners to prevent sexually transmitted diseases. For men, always use a condom every time you have sex.
  • Wear cotton clothing and do not be too tight to reduce the risk of fungal infections. Stay clean by frequently changing clothes when sweating or swimming. Also prioritize personal hygiene with bathing regularly.
  • If you have endometriosis, avoid penetration in or by having sex two weeks before menstruation (ovulation period) to relieve pain.

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