What is dyspareunia? What is the connection between dyspareunia and vaginismus?

Any type of dyspareunia (general sex pain) may trigger vaginismus (ongoing sex pain or penetration problem from involuntary vaginal tightness).

Dyspareunia

Dyspareunia is a medical term that simply means ‘painful intercourse’. It is a general term used to describe all types of sexual pain. Sexual pain may occur upon penetration, during intercourse, and/or following intercourse. It can exist anywhere in the genital area - the clitoris, labia, or vagina, etc. The pain may be described as sharp, stinging, burning, bumping, cramping or may be described in other ways.

The connection between dyspareunia and vaginismus

There are many causes of sexual pain (dyspareunia) and vaginismus is one of these. Vaginismus is uniquely characterized by involuntary tightness of the vagina due to the pubococcygeus (PC) muscles. With attempts at intercourse, vaginal tightness may cause sexual discomfort, sensations of burning, tightness, pain or inability to penetrate.

I can't seem to have orgasms. Could this be related to vaginismus?

Vaginismus is also closely related to any of the other forms of dyspareunia in that any type of general sex pain may trigger vaginismus. In these cases, vaginismus becomes a complicating discomfort or pain condition in addition to the original pain problem and typically remains even after the original problem is resolved or managed. A woman may, in fact, confuse the ongoing problems of vaginismus with the original pain problem, believing that the original problem is still unresolved.

“With any kind of sexual pain that is ongoing and seems to have no physical cause, vaginismus should be considered as a possible contributor or perhaps the primary cause.”

Diagnosing and treating sexual pain can become quite difficult when there are overlapping complications from vaginismus. It can be frustrating for both physicians and patients. Take for example, a woman who experienced a temporary infection (one form of dyspareunia) that triggered vaginismus. Perhaps by the time a visit is made to a physician the infection had resolved itself but the vaginismus remains. When the physician attempts to discover the source of the pain, there may seem to be no physical cause evident, since the patient continues to experience pain from vaginismus and no longer from the original infection. Moreover, the woman’s description of the pain may seem confusing since there was really two separate pain-causing issues at different times.

Where there are two forms of sexual pain present at the same time, and the second one is vaginismus, most specialists recommend treating the original medical condition first, and then taking the steps necessary to treat the vaginismus.

Caution: Surgeries and medical procedures have been thought necessary by physicians and their patients when in fact a simple case of vaginismus was present which could have been resolved without any invasive procedures. Patients should be careful to seek second opinions with physicians who are experienced in treating female sexual pain disorders, especially if they are contemplating invasive surgical treatment options. Vaginismus treatment does not normally involve surgery.

Possible causes of painful sex (dyspareunia)

There are many causes of sex pain:

• Vulvodynia / Vestibulodynia (Vulvar Vestibulitis or Vestibulitis)
• Pelvic Inflammatory Disease (PID)
• Genital or Pelvic Tumors
• Ovarian Cysts
• Urethritis
• Urinary Tract Infection
• Interstitial Cystitis
• Vaginal Atrophy (atrophic vaginitis)
• Vaginal Dryness
• Insufficient vaginal lubrication
• Childbirth Trauma (postpartum)
• Vulvar Cancer
• Radiation Therapy
• Vaginal Infections / Irritants - Yeast or bacterial, some STDs, etc.
• Skin Conditions - Lichen Sclerosus, Lichen Planus, Eczema, Psoriasis
• Side-effects to certain medications
• Injury to the pelvic/genital area
• Age-related symptoms associated with menopause and/or aging
• Allergic reactions to clothing, condoms, contraceptive foams, and/or spermicides
• Painful pelvic examination
• Trauma due to sexual assault
• Female Genital Mutilation (FGM)
• Bartholin’s Cyst
• Endometriosis

It is important to note that vaginismus can co-exist with the above conditions or continue to be present even after they have been resolved or managed.