Dr Ahmed Ismail

Consultant Gynaecologist & Fertility Expert

Painful Intercourse

Painful intercourse can be either superficial or deep.

Superficial painful intercourse is called medically as Superficial Dyspareunia.

Deep painful intercourse is called medically as Deep Dyspareunia.

Painful intercourse

  1. Superficial Dyspareunia
  2. Superficial Dyspareunia can happen due to the following problems:

    • Anatomical problems
    • Pathological problems
    • Physiological problems
    • Psycho-sexual problems

    The above divisions of factors should be identified by the clinician during the history and examination. Therefore it is mandatory for the clinician to carry out a detailed history of the female’s complaints as the diagnosis is vitally important to establish the line of treatment and the management of such an important social problem.

    For us to go into details of each of the above causes of Superficial Dyspareunia will take us pages after of writing about each of these causes. I am going to summarise very briefly each of the above causes.

    1. Anatomical causes:
      • Narrow vagina
      • Congenital vaginal atresia
      • Congenital imperforate hymen
      • Swelling or tumor in the vulva-vagina region preventing penetration
      • Many other anatomical causes
    2. Pathological causes:
      • Infections (such as candida)
      • Vaginal ulcers
      • Herpes genitalia
      • Sexually transmitted diseases (such a Gonorrhoea, Trichomonas etc.)
      • Bartholin’s Abscess
      • Post-menopausal dryness of the vagina
      • Polycystic ovarian syndrome resulting of dryness of the vagina
      • Pre-mature menopause
      • Post-epideotomy scar
      • Post-operative vaginal repair scars
      • Many other pathological causes
    3. Physiological causes:
      • Hormonal changes (such as post-menopausal, polycystic ovaries, pre-mature ovarian failure, pre-mature menopause)
      • Male/female anatomical disproportion (size differences)
      • Many other physiological causes
    4. Psycho-sexual causes:
      • Vaginess
      • Loss of harmony
      • Lack of emotional response such as arranged marriages)
      • Loss of interest
      • Many other psycho-sexual causes
  3. Deep Dyspareunia
  4. Deep Dyspareunia can happen due to the following problems:

    • Anatomical problems
    • Pathological problems
    • Physiological problems
    • Psycho-sexual problems

    1. Anatomical causes:
      • Retroverted uterus
    2. Pathological causes:
      • Cervicitis
      • Pelvic inflammatory disease (PID)
      • Pelvic endometriosis
      • Pelvic adhesions
      • Ovarian cysts
      • Degenerative uterine fibroids
      • Sexually transmitted diseases such as Chlamydia and Gonorrhoea
      • Many other pathological causes
    3. Physiological causes
      • Menopausal
      • Post-menopausal
      • Pregnancy
      • Changes of positions
      • Many other physiological causes
    4. Psycho-sexual
      • Emotional
      • Lack of interest
      • Many other psycho-sexual causes
Painful Intercourse read more...

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