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The medical term for painful intercourse is Dyspareunia. Pain causes a woman to fear lovemaking, which can cause her vaginal muscles to contract when they should be relaxing to cause an even more painful condition called vaginismus.

Dyspareunia is classified into two types: superficial and deep. Superficial dyspareunia means that the pain come from the opening of or inside the vagina and is usually caused by vaginal infection; a dry vagina; a thin old vagina that needs estrogen to thicken it; skin conditions, such as lichen sclerosis, that can only be diagnosed by a biopsy; or old scars from childbirth or previous surgery. Vaginal infections are associated with itching, burning, a foul-smelling discharge, discomfort much of the time and urinary symptoms such as burning on urination, having to urinate frequently, urgency to urinate and having to get up in the middle of the night to urinate. Women who have an infection need to be treated as soon as possible because allowing a mycoplasma infection to go untreated can result in permanent pain when the bladder is full and arthritis; and untreated vaginal warts can lead to cancer.

The most common cause of superficial dyspareunia is an ignorant partner. Most women need time to lubricate. Inserting a penis into a dry vagina can tear the vaginal linings as well as the skin on the penis. No caring individual would ever insert his penis into a vagina until it is lubricated. Most women prefer to use oral sex as foreplay. She often will lubricate while she is performing oral sex and he can lubricate her by depositing saliva, the most effective lubricant known to man. If taking your time doesn't lubricate the vagina, you may need to treat an infection or lack of estrogen. If oral sex turns you off, you may need to use a non-greasy lubricant such as KY jelly that you can buy at any drug store. Greasy lubricants can damage condoms and can be aesthetically unpleasant.

Deep dyspareunia, or pain with deep thrusting of the penis, almost always occurs when the penis hits something tender in a specific spot. It can often be avoided by changing position so that the penis does not hit that spot. You can expect the ovaries to hurt when they are hit by the penis. If you have this problem, just ask your partner try another position such as rear entry or moving to one side. If he refuses to cooperate, punch him in the testicles and he will understand immediately how much it hurts to be banged on the ovary. If changing position doesn't stop the pain, check with your gynecologist. A very common cause of superficial dyspareunia is psychological trauma from previous abuse or an ignorant partner. Deep thrusting dyspareunia can also be caused by chronic infections, tumors, endometriosis, uterine fibroids, cysts on your ovaries or a pelvic infection.

MG Marin, R King, GJ Dennerstein, S Sfameni. Dyspareunia and vulvar disease. Journal of Reproductive Medicine 43: 11 (NOV 1998):952-958.

Checked 9/3/05

May 16th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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