Dyspareunia
Hello Doctor: Recently, due to a lack of sexual experience, I attempted intercourse with my boyfriend multiple times, but it was painful and difficult to achieve penetration.
Eventually, I asked my boyfriend to proceed forcefully, and during that encounter, I experienced severe pain and bleeding that felt like tearing (not the type of continuous bleeding associated with menstruation).
I thought this might mean that my hymen was torn, and that future attempts would be easier.
However, I still find it difficult to achieve penetration, and despite multiple attempts, I have not succeeded again (unless it involves a forceful approach, which seems possible).
I have a condition that causes dryness, making it hard to become lubricated.
Because of this psychological barrier, it seems even harder to become aroused, and I often push my partner away.
Each time we try, I cannot complete intercourse; even a slight attempt at penetration causes significant pain (we always use condoms and lubricant to assist).
My boyfriend believes that the lubrication issue can be addressed externally, but that the opening is too small and stretching it causes pain, which leads me to push him away.
Aside from that one instance of forceful penetration, he has only managed to insert about one-third of himself, while in other attempts, not even the tip has been able to enter without causing pain.
I would like to ask the doctor: 1.
What are the solutions for the issue of painful intercourse? 2.
Which type of specialist should I seek help from? (Gynecology, or another specialty?) 3.
Regarding the lubrication issue: I have tried to extend foreplay to help with vaginal moisture, but I find it difficult to maintain adequate lubrication; it varies between dry and wet.
4.
Concerning the small opening: Could this be due to a lack of training and elasticity? Would doing Kegel exercises help increase elasticity? (But it seems that Kegel exercises target the pelvic floor muscles and may not affect the opening itself?) I have read that gynecological infections can lead to painful intercourse, but I have never had any such infections, and there is no significant size difference with my boyfriend, so I am unsure why I am unable to succeed.
I hope the doctor can provide some guidance on possible solutions.
Thank you!
minki, 20~29 year old female. Ask Date: 2023/01/23
Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, this is not normal.
I recommend seeing a gynecologist to investigate the cause of the issue.
Wishing you good health.
Reply Date: 2023/01/23
More Info
Painful intercourse, or dyspareunia, is a common issue that many women face, and it can stem from various physical and psychological factors. Understanding the underlying causes and exploring potential solutions is crucial for improving sexual health and overall well-being.
Understanding the Causes
1. Physical Factors:
- Vaginal Dryness: This can be due to hormonal changes, medications, or even anxiety. In your case, you mentioned having a dryness condition, which can significantly contribute to discomfort during intercourse.
- Anatomical Issues: Conditions such as vaginismus (involuntary tightening of the vaginal muscles) or a narrow vaginal opening can make penetration painful or impossible.
- Infections or Medical Conditions: Although you stated you have no history of gynecological infections, it’s essential to rule out conditions like vulvodynia or pelvic inflammatory disease, which can cause pain during intercourse.
2. Psychological Factors:
- Anxiety, fear of pain, or past traumatic experiences can create a cycle of tension and discomfort. The fear of pain can lead to muscle tightening, making penetration even more difficult.
Solutions and Recommendations
1. Consult a Healthcare Professional:
- It’s essential to seek help from a gynecologist or a sexual health specialist. They can perform a thorough examination to identify any physical issues and provide tailored advice.
- If psychological factors are suspected, a referral to a therapist specializing in sexual health may be beneficial.
2. Addressing Vaginal Dryness:
- Consider using water-based or silicone-based lubricants during intercourse to reduce friction.
- Hormonal treatments, such as vaginal estrogen, may be recommended if dryness is due to hormonal imbalances.
3. Gradual Desensitization:
- Engaging in gentle, non-penetrative sexual activities can help reduce anxiety and increase comfort. This can include kissing, touching, and using fingers or toys to explore your body without the pressure of penetration.
- Gradually introducing penetration with the use of fingers or smaller objects can help your body adjust.
4. Pelvic Floor Exercises:
- Kegel exercises can strengthen the pelvic floor muscles, which may help with control and relaxation during intercourse. However, if there’s a concern about tightness, it may be beneficial to work with a physical therapist who specializes in pelvic health.
5. Communication with Your Partner:
- Open and honest communication with your partner about your feelings, fears, and comfort levels is crucial. This can help create a supportive environment where both partners feel safe and understood.
6. Professional Therapy:
- If anxiety or fear is a significant barrier, consider seeking therapy. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing fears and anxieties related to sexual activity.
7. Education and Resources:
- Educating yourself about sexual health and anatomy can empower you and reduce anxiety. There are many resources available, including books and online courses, that focus on sexual wellness.
Conclusion
Painful intercourse is a multifaceted issue that requires a comprehensive approach to treatment. By consulting with healthcare professionals, addressing physical and psychological factors, and fostering open communication with your partner, you can work towards overcoming this challenge. Remember, seeking help is a sign of strength, and there are many avenues available to improve your sexual health and overall quality of life.
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