Dyspareunia
Painful and unpleasant sensations in the genitals immediately before, during or immediately after sexual intercourse are called dyspareunia. This concept does not include painful sensations with the wrong technique of sexual intercourse or because of insufficient moisture in the mucous membranes( for example, when the caresses cease).Periodic pain during intimacy is experienced by up to 15% of women, and for 2% of women this is a serious problem.
■ Painful intercourse deprives a woman of pleasure and the opportunity to achieve orgasm, is able to suppress excitement and sexual desire. Fear of pain causes her to avoid intimate relationships. Frustration often leads to a decrease in sexual desire.
Two types of pain can be distinguished here:
1. Symptomatic dyspareunia is a manifestation of any other diseases not related to sexual disorders. It can be the result of anatomical changes in the genitals, inflammation and scarring, mental illness.
2. Psychogenic dyspareunia is an independent disease. Psychological foundations for the emergence of pain most often are problems in partnerships, the consequences of negative experiences of sexual life, personal characteristics of women. At its core, psychogenic dyspareunia is a manifestation of unconscious rejection of the sexual act and penis.
Psychological factors can change sensitivity, causing pain even with tactile stimulation. Emotions, anxiety, depressive states lead to increased pain sensitivity. People who are vulnerable, touchy, prone to depressive conditions, painful feelings occur faster, and they suffer more. Accompanied by a low mood, anxiety can cause, maintain and intensify pain. This is how painful sensations form during closeness as a result of disharmonious partner and sexual relations.
Pain in women. Possible causes of pain during intimacy:
1. Clitoris - pain from infectious inflammation, mucous injury in friction and rough caresses of a man.
2. Entering the vagina - scars and wounds of the first sexual experience, the consequences of violence or abortion, atrophic processes in old age.
3. Ovaries - inflammation, cysts.
4. Vagina - lack of lubrication due to low excitation or estrogen deficiency, infectious inflammation, hypersensitivity to latex.
5. Cervix - inflammation, endometriosis.
6. The body of the uterus is a painful sensation associated with inflammation, dislocations.
Pain in men. The causes of pain during sexual intercourse -
1. Seed vesicles - as a result of infection.
2. Prostate is an inflammation caused by infection, an enlargement of the prostate gland, including due to a tumor, a contraction with a spasm before ejaculation.
3. Inflammation of the bladder.
4. Eggs - prolonged excitation without ejaculation can lead to pain in the appendages of the testicles.
5. Urethra - pain during erection due to inflammation during gonorrhea.
6. Penis head - pain from squeezing the foreskin at phimosis from microbial irritation, from contact with contraceptive cream or acid medium in the vagina.
7. The body of the penis is a painful erection with Peyronie's disease( compaction and curvature of the penis), excessive bending during erection.
Dissatisfaction with partner relationships and sexuality, dissatisfaction with the behavior of a partner can cause irritation, low mood, and, as a result, develops a heightened sensitivity to pain in the sexual sphere.
The impact of negative emotions on sexuality largely depends on the woman's personality, the circumstances of her life, the choice of partner and the entire unconscious evaluation of this choice. Girls with a delay in psychosexual development can perceive proximity as an act of aggression that can inflict physical damage on them and which, therefore, associates them with a feeling of pain, or real relationships are so much different from idealized ideas that girls experience a lot of negative emotions and discomfort up topainful.
A disharmonious sex life that does not meet the needs and preferences of a woman can lead to a negative emotional background, irritation and anger, lead to chronic dissatisfaction, causing discomfort and pain during intercourse.
Once emerged, the pain is then unconsciously used as a protective mechanism to limit or completely avoid intimacy.
Primary pain associated with sexual intercourse, such as rape, gross deprivation of virginity, inflammatory diseases of the genitals and accompanied by a violent emotional reaction, can be fixed, as a result of which subsequent attempts to achieve intimacy, even in the absence of an immediate source of psychological trauma,will be accompanied by pain.
A characteristic feature of dyspareunia is the selectivity of its appearance: pain can occur only in a certain situation, with a specific partner and be absent from contacts with other partners.
It is rare that the reason for the pain sensations is a pronounced discrepancy between the sizes of the sexual organs of the partners, although they themselves often believe that this is the difficulty in making intimacy. If pain occurs only in certain positions, then this is a consequence of pressure on neighboring organs. Changing positions can solve the problem.
Therapy
The main method of treatment of dyspareunia is psychotherapy, which is aimed at removing the fear of pain, changing attitudes towards sexual intercourse as harming, optimizing partner relationships and developing sexual techniques to avoid painful sensations during sexual intercourse. Along with this, exercises similar to those used for vaginismus are used. When proximity is mandatory, the additional use of lubricants to reduce friction, and, consequently, and soreness.