One of the most pleasurable activities is sex, but when this gratifying activity turns painful it can make you abstain from it. Painful sex is known as dyspareunia-about 75% of women experience sometimes in their life. If you experience a one-off pain, then it’s quite fine but if it’s chronic and, sharp pain, then it’s better you consult a doctor or a sex therapist depending on the underlying cause. You might experience this pain before, during or following sexual activity Dyspareunia symptoms: · Penetration pain · Even non-sexual penetration like tampon insertion causes pain and discomfort · Deep pain due to thrusting · Burning or throbbing sensation · Pain in the lower back and abdomen that lasts even after intercourse is over Dyspareunia Causes Dyspareunia maybe caused due to both physical and psychological reasons. Many women feel extremely shy to discuss problems with the doctor and sometimes even with their partners. The causes of painful sex can be one of the following: Pain during penetration · Lack of lubrication: it may be due to insufficient arousal or foreplay or due to the onset of menopause which can lead to vaginal dryness. Childbirth and breastfeeding can also reduce the level of estrogen which leads to dryness. Certain medications like birth control pills, antihistamines, and antidepressants can also lead to loss of vaginal lubrication. · Injury in the vaginal area: most women experience painful sex after childbirth. An injury might also be caused due to pelvic surgery or even female genital mutilation. · Inflammation or infection: Urinary Tract Infection (UTI) can make sex extremely painful. Apart from these STIs, vaginal yeast infection or infection near the vaginal opening known as vulvar vestibulitis can lead to dyspareunia. · Vaginismus: The involuntary spasm of the pelvic muscle can make both sexual and non-sexual insertion extremely excruciating. · Vulvodynia: pain in the vulva area-labia, clitoris, and vaginal opening. The pain can be chronic or one-off. · Birth aberration: vaginal agenesis-absence of the fully formed vagina and an imperforate hymen, which are birth anomalies than can disrupt adult life. Deep pain Such pain is exhibited when your partner deeply penetrates you or in certain positions. · Cystitis and interstitial cystitis · Endometriosis · Fibroid · Ovarian cysts · Pelvic inflammatory disorder · Uterine prolapsed · Irritable bowel syndrome and hemorrhoids · Trauma from pelvic surgery or hysterectomy. Cancer treatments can cause physical changes and make sex painful. Emotions can affect intercourse · If you are suffering from stress, anxiety, depression or any such psychological issues it can lead to an uncomfortable sexual experience. · Body image issues or performance pressure with a new partner can also contribute to further sexual problems. · Often women, who have a history of sexual abuse or bad sexual experience, can subconsciously make you want to avoid sex and lead to sexual dissatisfaction. What to expect when visiting a doctor You should visit a gynaecologist if you are having trouble copulating. The doctor would ask for a detailed medical history-the time since you are experiencing the pain, intensity of the pain, what were you doing when you experienced the pain and the place where the pain is felt. Don’t be shy to discuss your issues in detail. The doctor might also suggest a pelvic exam to check for any physical abnormalities. Women who suffer from dyspareunia can also experience discomfort during a pelvic exam with an instrument called a speculum. The doctor might also suggest an ultrasound for a better understanding of the underlying issue. If an emotional trauma is involved or if there is an issue with your sexual partner you might have to visit a sex therapist. Dyspareunia treatment Medication can help treat certain physical causes like UTI and infections. Also by changing the existing medication that you might be partaking can also help. In menopausal women, the doctor might prescribe topical creams. You can opt to use water-based lubricants as not only will it make penetration easier but unlike gel-based lubricants, it won’t lead to perforation of the condom. You should discuss your concern with your partner and engage in longer foreplay sessions as well as trying different positions for a much more pleasurable experience. Maintain proper sexual and genital hygiene to avoid any sort of infection and STIs. Kegel exercise helps to strengthen the pelvic muscle which can be beneficial for women suffering from vaginismus. Undergo counseling can help deal with emotional trauma. Also, you can visit a sex therapist. If the pain is too much or you are undergoing treatment for the same, then you can avoid sex for a while. There are many other ways to get intimate like cuddling and kissing, sensual massages and mutual masturbation. Sex isn’t just a physical act but it is a deeply emotional act that makes couples intimate and helps in strengthening the relationship. But with dyspareunia, sex can become a huge turnoff and lead to relationship issues as well as a loss of self-esteem.