What are Sexual Pain Disorders?
Define. Dyspareunia, derived from the Greek dyspareunos, or “unhappily married as bedfellows”, is common amongst women, specifically refers to a current pattern of genital pain that occurs before, during or after coitus.
Female Sexual Dysfunction, Vulval Pain and Vestiblodonia, and vulvodynia can all be included under the label of dyspareunia.
The most common form of non-menopausal dyspareunia is localized pain which can be experienced as cutting, burning, tearing sensations at the vulva when there is the attempted insertion of a finger, penis, or a tampon, but the pain can also be felt with light stroking and or touch to the area between the labia minora and the opening to the vagina, known as Hart’s Line.
The symptoms of dyspareunia can vary wildly. There can be pain from lack of lubrication or pain despite lubrication. The pain can be localized or general, a dull ache or a profound burning sensation. The diagnosis may be characterised as lifelong or acquired, and as general or situational and can be due to psychological or combined factors.
Unfortunately, pain during sex marks the end of sexual arousal. Pain also reduces desire and interferes with reaching orgasm, and dyspareunia places a woman at risk for the development of vaginismus, as well as secondary desire, arousal and orgasmic dysfunctions.
Scarring post either episiotomy or of vaginal repair procedures, pelvic tumors, prolapsed ovaries PID and endometriosis must also be ruled out in diagnosis.
Dyspareunia is rare in men, the main causes being either excessive masturbation, manipulation of the penis during intercourse, or Peyronie’s Disease, but not uncommon
Many women are relatively unaware of their genital arousal state, and the idea that a woman has the right to say no, to have boundaries, can be hard to establish if she is from an abusive or neglectful background. Many women will grin and bear pain on penetration and the overwhelming feelings of inadequacy, and the lack of knowledge make these experiences commonplace, setting the the scene for breaks in the arousal circuit..
Vaginismus is classified as a type of dyspareunia. Primary Vaginismus is defined by a woman never having been penetrated, never used a tampon and never been able to tolerate an internal examination.
Secondary vaginismus can evolve as a response to dyspareunia, and the pain leads to a natural, self-protective tightening of the vaginal muscles. Vaginismus can easily be brought on by inept or painful vaginal examinations, lack of lubrication during intercourse.
I am Carolyn Cowan, a Psychosexual & Relationship Therapist who is also a sex addiction therapist and a member of COSRT & ATSAC.
You can make appointments to see me in Belgravia, central or south London. I can also work via Skype or FaceTime.
To discuss therapy options, clarify questions or to make an appointment I can be contacted by email at firstname.lastname@example.org or by phone on 0208 6513233