Dyspareunia Causes

Dyspareunia is a term that denotes a recurrent genital pain present just before, during or after sexual intercourse. This is a complex entity linked to multiple medical, biological, psychological, interpersonal and socio-cultural dimensions. Generally the condition is almost unique to women, albeit men can also be affected in rare instances.

Organic Causes of Dyspareunia

A specific type of dyspareunia that refers to spasms of perineal muscles and musculus levator ani (making in turn sexual intercourse painful, difficult and undesirable) is known as superficial dyspareunia or vaginismus. Although often linked to anxiety and grouped with psychological conditions, organic disorders of external genitalia and introital parts may result in such grave discomfort that any penetration attempt usually leads to spasms.

Among the most common causes of dyspareunia are interstitial cystitis and pelvic inflammatory disease. Interstitial cystitis can be defined as recurring pain or discomfort in the bladder and surrounding region, whereas pelvic inflammatory disease represents an infection of the uterus, cervix, Fallopian tubes and adjacent structures in the pelvis (with potential further progression into the peritoneal cavity).

Causes of dyspareunia that presents with deep pain include endometriosis, uterine retroversion, uterine myomas or fibroids, ovarian diseases (like ovarian remnant syndrome), adenomyosis, pelvic congestion syndrome, bladder leiomyoma, as well as irritable bowel syndrome.

Neuronal sensitization in the spinal cord and certain parts of the brain has been proposed as the most likely cause of deep dyspareunia. This theory hypothesizes that intense stimulation of peripheral tissue, as a result of repetitive abrasive stimulation or a physical trauma, may sensitize the neurons that are responsible for conveying painful information to the brain.

As a consequence, the sensitized neurons necessitate less stimulation for their activation, or may even be activated without any stimulation at all. Therefore the individual may experience pain after only a slight touch, or even no touch. Women with this type of dyspareunia may also report genital pain during non-sexual situations.

Psychological Causes of Dyspareunia

Anxiety that is associated with sexual activity and (often irrational) fear of pain has been proposed as a cause of dyspareunia, although it can also be considered a symptom of the condition (thus forming a vicious circle). In any case, various research studies have shown a strong correlation between pain during sexual intercourse and high trait anxiety.

Even though anxiety can be linked to dyspareunia, not all women with sexual anxiety present with the symptoms of sexual pain. It is known that women with dyspareunia often fear sexual interactions and harbor increased phobic anxiety of sexual activity when compared to women without sexual pain. The explanation is that after initial experience of sexual pain, anxiety about sexual activity (and dyspareunia) remains present, since the awareness for sexual pain is increased.

In addition to anxiety, negative attitudes towards sexuality have been found to be correlated with dyspareunia. Several studies have found that women presenting with dyspareunia generally have more negative attitudes towards sexual intercourses than sexually functional women.

When it comes to depression, longitudinal studies have failed to show its direct relationship with this condition. However, from a relational point of view, women with dyspareunia tend to report more painful incidents when their relational distress increases – an indication that pain during sex may partially be associated with negative sentiments between partners.

Sources

  1. http://www.aafp.org/afp/2014/1001/p465.html
  2. http://www.aafp.org/afp/2001/0415/p1535.html
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4956781/
  4. http://www.tjog-online.com/article/S1028-4559(11)00123-9/fulltext
  5. jeanhailes.org.au/.../Vulvovaginal_pain_part2.pdf
  6. Dor K. Dyspareunia. In: O’Connell TX, Dor K. Instant Work-Ups: A Clinical Guide to Obstetric and Gynecologic Care. Elsevier Health Sciences, 2009; pp. 66-70.
  7. Meston CM, Pulverman CS. Sexual Dysfunction. In: Craighead WE, Miklowitz DJ, Craighead LW, editors. Psychopathology: History, Diagnosis, and Empirical Foundations, Second Edition. John Wiley & Sons Inc., New Jersey, 2013; pp. 616-648.

Further Reading

Last Updated: Feb 26, 2019

Dr. Tomislav Meštrović

Written by

Dr. Tomislav Meštrović

Dr. Tomislav Meštrović is a medical doctor (MD) with a Ph.D. in biomedical and health sciences, specialist in the field of clinical microbiology, and an Assistant Professor at Croatia's youngest university - University North. In addition to his interest in clinical, research and lecturing activities, his immense passion for medical writing and scientific communication goes back to his student days. He enjoys contributing back to the community. In his spare time, Tomislav is a movie buff and an avid traveler.

Citations

Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Meštrović, Tomislav. (2019, February 26). Dyspareunia Causes. News-Medical. Retrieved on October 15, 2024 from https://www.news-medical.net/health/Dyspareunia-Causes.aspx.

  • MLA

    Meštrović, Tomislav. "Dyspareunia Causes". News-Medical. 15 October 2024. <https://www.news-medical.net/health/Dyspareunia-Causes.aspx>.

  • Chicago

    Meštrović, Tomislav. "Dyspareunia Causes". News-Medical. https://www.news-medical.net/health/Dyspareunia-Causes.aspx. (accessed October 15, 2024).

  • Harvard

    Meštrović, Tomislav. 2019. Dyspareunia Causes. News-Medical, viewed 15 October 2024, https://www.news-medical.net/health/Dyspareunia-Causes.aspx.

Comments

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment
Post

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.