Dyspareunia and Vaginismus

DSM-5 renamed the diagnosis and combined bold into what is called Genito-Pelvic Pain/ penetration Disorder with a diagnosis requiring persistent or recurrent difficulties with one or more for specific symptoms (e.g. difficulty with bachelor penetration during intercourse); symptoms have a minimum duration of about six months.

What Is Dyspareunia?

Dyspareunia, in medical terms, means ‘painful intercourse’. This term basically describes the pain a female experiences during sexual intercourse, penetration or post coitus.

There are two types of dyspareunia – primary dyspareunia is the constant pain experienced by a patient during any sort of sexual activity or penetration, while secondary dyspareunia can occur suddenly after a period of painless coitus.

Types and Causes of Dyspareunia

Dyspareunia pains can originate anywhere in the genital area, including the vagina, labia, or clitoris, and can be described as:

  • Encountering pain only at the time of sexual entry or sexual penetration
  • Feeling pain due to any kind of penetration (such as during a gynecological exam, inserting a tampon, etc.)
  • Experiencing a deep or stabbing pain during thrusts
  • Undergoing an aching or burning pain
  • Enduring a throbbing pain for hours after sexual intercourse

All types of dyspareunia, including the five listed above, can be categorized into two main categories – superficial and deep pain.

Superficial pain in dyspareunia includes vulval pain, burning, itching, and stinging. However, vaginal pain in superficial dyspareunia pain is very uncommon. It can be constant or might occur due to a particular circumstance such as:

  • Non-sexual activities
  • Inadequate lubrication
  • Topical irritants
  • Vaginal infection
  • Radiotherapy
  • Urethral problems
  • Sexual trauma

Deep pain, on the other hand, is most commonly caused by thrusting during sexual intercourse. Deep thrusting or being in a wrong position during intercourse where the thrusts are hitting the patient’s ovaries, can lead to deep pain. Other causes for deep pain might include:

  • Endometriosis
  • Pelvic inflammatory disease
  • Genital tumors
  • Pelvic tumors
  • Local surgery
  • Irritable bowel syndrome
  • Ovarian cysts
  • Urinary tract infections

Aside from the factors listed above, there are many other cases for dyspareunia including:

  • Vaginismus
  • Vulvodynia & Vestibulodynia (Vulvar Vestibulitis or Vestibulitis)
  • Childbirth trauma (postpartum)
  • Interstitial Cystitis
  • Vulvar cancer
  • Skin conditions (such as Lichen Sclerosus, Psoriasis, Lichen Planus, Eczema)
  • Side effects to medication
  • Pelvic or genital injuries
  • Menopause or other age-related problems
  • Trauma
  • Female genital mutilation
  • Bartholin’s Cyst
  • Allergic reactions

What Is Vaginismus?

Vaginismus is the involuntary spasm or contraction of the vaginal muscles, especially the ones found in the lower one-third part of the vagina, due to pubococcygeus (PC). There are two types vaginismus – primary and secondary.

Primary vaginismus occurs in females who have never experienced any sort of vaginal penetration, while secondary vaginismus occurs in females who have experienced some sort of penetration.

Secondary vaginismus is common in patients who are:

  • Victims of sexual abuse
  • Had an unfavorable sexual experience(s)
  • Underwent a traumatic or harsh medical procedure in their childhood
  • Have sexual inhabitations
  • Fear getting pregnant
  • Psychological issues
  • Have other reservations

How Are They Connected?

Dyspareunia and vaginismus are interlinked, as one may cause the other. Sometimes, the pain experienced during sexual intercourse can trigger vaginismus. While the involuntary contraction of vaginal muscles during intercourse due to vaginismus, can also result in dyspareunia.

Not only can these two conditions trigger one another, but many times, these painful conditions can co-exist, making it harder to identify which condition is plaguing the patient.

If you need help to treat Dyspareunia and Vaginismus from a AASECT Certified Sex Therapist , call (805) 308-9800, or visit our facility located at 2660 Townsgate Rd., Suite 720 Westlake Village, CA 91361