dyspareunia, algopareunia, cohabitation pain
Introduction
Pain during intercourse can affect both men and women. However, it is generally assumed that women suffer from pain during intercourse significantly more often than men. The pain that occurs during intercourse can be less pronounced or even so severe that the person affected suffers a high level of pain.
In addition, long-lasting pain can put increasing strain on the relationship between the patients concerned. Especially in women, the pain that occurs during traffic can be very different. Some of the affected women only feel a stabbing, pulling or burning sensation during or after sexual intercourse.
Other women, on the other hand, suffer from severe pain, which can be accompanied by pronounced itching. Because of the pain, both men and women affected usually do not reach their climax. The reasons for the development of pain during the act can be different.
If pain occurs in women, these complaints can be divided into external and internal pain. External pain usually originates from the outer area of the female sexual organ. In the case of internal pain, the cause can typically be found in the area of the uterus or the pelvis.
Especially diseases of the rectum, the bladder, the ovaries or the vagina can cause severe pain during the act. In addition, bacterial and viral infections of the reproductive organs and/or the urinary tract are among the most common causes of these pains. In addition, in the case of pain during intercourse, a distinction must be made as to whether the pain occurs during or immediately after intercourse.
The duration of the perceived discomfort can also help to narrow down the possible causes and initiate appropriate treatment. Patients who suffer from persistent pain should definitely consult a specialist as soon as possible. Only in this way can the underlying cause be determined, appropriate treatment initiated and complications avoided.
Pain during intercourse can have various causes in women. Both chronic infections of the urinary tract (so-called urinary tract infections) and bacterial, viral or fungal infections are among the most common causes of pain during intercourse. Complaints that only last for a short period of time are in most cases caused by an inflammation of the female reproductive organs (technical term: colpitis or vaginitis).
This disease occurs when the sensitive milieu, which is largely protected from pathogens, is destroyed by antibiotics, excessive hygiene measures or a pronounced estrogen deficiency. Patients suffering from pain caused by inflammation during intercourse typically notice increased discharge, which can vary depending on the pathogen present. In addition, the pain may be accompanied by severe itching and/or burning in the genital area.
Another cause of pain during intercourse is so-called pelvic inflammatory disease. Adnexitis is a disease characterized by the presence of inflammatory processes in the area of the fallopian tubes and/or ovaries, the appendages of the uterus. Patients with pelvic inflammatory disease typically suffer from bilateral pain during the act of love.
In most cases, the symptoms are caused by bacterial pathogens that ascend into the fallopian tubes through the female genital and uterus. An inflammation of the fallopian tubes can be both acute and chronic. In addition, inflammatory processes in the area of certain glands (bartholin glands) of the vestibulum of the sexual organ can cause severe pain during intercourse.
The so-called bartholinitis is usually caused by a bacterial infection and typically leads to one-sided pain during intercourse. In addition, the labia minora of a woman suffering from bartholinitis are very swollen and reddened. In some cases, these swellings are so pronounced that the ducts of the bartholin glands are completely blocked.
As a result, purulent secretions can form and promote the development of an abscess.and Bartholinitis symptoms In young women, pain may occur during intercourse if the hymen is very tight and has only a small opening. Another cause of pain during sexual intercourse is the so-called endometriosis. Endometriosis is a widespread, benign disease, which, however, remains undetected by a large number of affected women for a long period of time.
Endometriosis is characterized by the growth of endometrial cells (endometrium) outside the uterine cavity. In principle, these endometriosis foci can occur in any organ. In most cases, however, the scattered endometrial cells can be found in the area of the small pelvis or the abdominal cavity.
The tissue displaced in this disease participates in the menstrual cycle, just like the normal endometrium. This phenomenon causes the affected patients to suffer from pain during the act, especially during menstruation. In addition, women with endometriosis typically suffer from cycle disorders and low back pain.
If there are endometriosis lesions inside the bladder, blood may be washed out with the urine and urination may be difficult. Since the symptoms of endometriosis are linked to the hormonal cycle, they typically disappear as soon as menopause is reached. Regardless of this, however, endometriosis should definitely be treated early on.
The reason for this is the fact that the scattered endometrial cells of the uterus can lead to infertility. So-called myomas, i.e. uterine tumours, can also cause severe pain during sexual intercourse. A myoma is a benign tumor of the muscle layer (myometrium) of the uterus.
The actual tumor consists of a more or less strongly developed part of connective tissue and can assume dimensions of several centimeters. In most cases, a myoma causes no symptoms whatsoever and therefore remains undetected for a long period of time. In general, only particularly large tumours or myomas that grow in an unfavourable location cause a pronounced symptom.
Affected patients typically notice cycle disorders and pain during intercourse. Other causes of pain during intercourse: Sexually transmitted diseases (e.g. trichomoniasis, gonorrhea or syphilis) Genital warts Candidosis Scars after childbirth or after an episiotomy (see: Episiotomy scar) or perineal tear Congenital malformations of the reproductive organs Painful reactions to chemical contraceptives Dryness of the vagina Stress Pelvic vein syndrome Ovulation (pain during ovulation)
- Venereal diseases (for example trichomoniasis, gonorrhea or syphilis)
- Genital warts
- Candidosis
- Scars after birth, or after an episiotomy (see: episiotomy scar) or perineal tear
- Congenital malformations of the sexual organs
- Painful reactions to chemical contraceptives
- Vaginal dryness
- Stress
- Pelvic vein syndrome
- Ovulation (pain during ovulation)
In men, the pain felt by a man during intercourse can be enormously varied. Both the intensity as well as the exact timing of the onset of the pain depends on the underlying cause.
Some of these pain situations can even become an emergency and make immediate medical treatment unavoidable. A classic example of such an emergency is the so-called paraphimosis. One of the most common causes of pain in men is narrowing of the foreskin (technical term: phimosis).
In this disease, the foreskin is so tight that it can no longer be pushed back over the glans. As a result, the affected men find an erection of the penis extremely painful. In these cases, phimosis surgery should be considered.
In addition, infections and/or inflammatory processes in the area of the draining urinary tract can also cause pain during sexual intercourse in men. In this context, inflammation of the urethra (urethritis) and the bladder (cystitis) play a decisive role. In addition, pain during intercourse can be caused by inflammatory diseases of the glans (balanitis) or the foreskin (posthitis).The so-called prostatitis (inflammation of the prostate gland) is also one of the most common causes of pain during sexual intercourse.
The inflammatory processes in this disease can be of both bacterial and non-bacterial origin. In addition, the inflammation of the prostate must be divided into an acute and a chronic form. In the case of non-bacterial prostatitis, bladder voiding disorders or prostatic reflux can often be detected. As a result, urine enters the excretory ducts of the gland and attacks its sensitive tissue. Other causes of pain during sexual intercourse:
- Penis fungus – Candidosis in men
- Colon inflammation (diverticulitis)
- Genital herpes
- Soft chancre (Ulcus molle)
- Chlamydia infections
- Trichomoniasis
- Thrush/candidosis (fungal infection)
- Syphilis
- Gonorrhea
- Hardening of the penis in the area of the erectile tissue (Induratio penis plastica)
- Prostate cancer
- Torn anus
