PAINFUL INTERCOURSE—DYSPAREUNIA AND VAGINISMUS
Painful intercourse occurs in women and men. It is often caused by infection and conditions like vaginitis. It is much less common in men, who may experience painful intercourse because of a physical condition such as a tight foreskin.
Dyspareunia is painful intercourse for women that may be caused by hormonal imbalances, especially those that happen after menopause. Dyspareunia also happens in up to one out of five women because her partner tries to have intercourse with her before she is fully aroused. Some women are so sexually inhibited that they are unable to let their partners know that they are in pain. Some are in poor relationships and fear telling their partners. Others have such fears and anxieties about sex that they mistakenly suppose that sex is naturally painful.
Vaginismus occurs when a woman’s fear and anxiety about vaginal intercourse cause the muscles around her vagina to go into spasm when her partner tries to insert his penis. Vaginismus was extremely common in the nineteenth century when women were taught to fear intercourse. Today, it is much less common. It results not only from fearful attitudes toward sex but also from sexual abuse, rape, brutal early sexual experiences, or painful pelvic examinations.
Dyspareunia may be relieved by open communication with partners who are prepared to be more attentive to a woman’s need for complete arousal before intercourse begins. Physical causes may be relieved by the use of medication, lubrication, or estrogen therapy. Vaginismus may be relieved by psychosexual therapy.
Sexual dysfunctions are often a combination of physical and psychological problems. Those caused by physical conditions often develop psychological challenges. That is why psychotherapy is an important component of holistic treatment of sexual dysfunctions and inhibitions
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