Heather Jeffcoat, DPT
Here's What You Need to Know if Your Partner Has Dyspareunia
Author: Alex Denny
Reviewer: Vita Eizans, D.O.
Support goes a long way when your significant other suffers from painful intercourse.
Many people experience painful intercourse at some point in their lives. Whether you needed more lubricant or you just weren't in the mood—the reason doesn't matter—it's not unusual to occasionally feel pain during sex.
When that pain is chronic, however, it might be a condition called dyspareunia. Dyspareunia is the medical term for genital pain that occurs consistently before, during or after sex. This recurrent pain can make having sex nearly impossible for some sufferers.
Dyspareunia affects approximately 10 percent to 20 percent of all women in the United States. You may have a female partner with the condition, now or in the future, so understanding what it means to have dyspareunia and how you can best support your partner is important.
What is dyspareunia?
There are two different types of dyspareunia, according to Heather Jeffcoat, D.P.T., a physical therapist at Femina Physical Therapy in Los Angeles and author of "Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve."
"Dyspareunia is categorized as deep or superficial," Jeffcoat explained. "Deep dyspareunia is pain near the cervix. Superficial—sometimes referred to as introital dyspareunia—is pain with initial penetration. Pain with initial penetration may be determined to be vestibulodynia or vaginismus. Pain with deeper thrusting located closer to the cervix may be due to endometriosis, for example."
Being examined by a qualified doctor is a crucial first step in healing from dyspareunia. The causes are many, and only a doctor can determine the best treatment plan.
While your partner seeks treatment, you can take the emphasis off penetrative sex, which can go a long way toward strengthening your relationship.
Educating yourself about the condition can also indicate your willingness to be supportive. We talked to experts about the facts you should understand about dyspareunia in order to be a supportive and understanding partner.
Fact #1 - Dyspareunia has several root causes
Many medical conditions are a direct result of a specific factor, but dyspareunia is different. There are many reasons a woman may be suffering from chronic painful sex. The good news is that determining the cause means a doctor can prescribe the correct treatment.
Dyspareunia is not a lifetime disorder in the vast majority of cases. Once the root cause is determined, a treatment plan can be put in place to help support your partner," Jeffcoat said.
The potential causes vary by type of dyspareunia, deep or superficial. The causes of superficial dyspareunia may include the following:
- Genital infections, such as urinary tract infections (UTIs) or sexually transmitted infections (STIs)
- Skin conditions, such as eczema
- A lack of lubricant
- A physiological difference, such as a vagina that never fully formed or an imperforate hymen
Causes of deep pain can come from medical conditions such as endometriosis, pelvic inflammatory disease (PID), ovarian cysts, uterine issues and more. Scarring from past surgeries, such as hysterectomy, can cause painful intercourse. Certain medical treatments, such as radiation therapy and chemotherapy, can also cause dyspareunia.
Emotional factors can also contribute to painful sex, and these may fluctuate depending on your partner's emotional state at that time. Anxiety, stress, self-esteem issues and other psychological distress may cause dyspareunia.
Fact #2 - Dyspareunia is often a side effect of endometriosis
Endometriosis is a common uterine disorder that affects more than 200,000 women in the United States and occurs when endometrium-like tissue—similar to the tissue that lines the uterus—grows outside of the uterus, typically on the ovaries, fallopian tubes or intestines.
If deep dyspareunia is due to endometriosis, the gold standard to determine if this is present is laparoscopic surgery, as there is no single test, nor any combination of tests, that will rule out all types of endometriosis," Jeffcoat said.
Even after laparoscopic surgery, however, it's important to know that endometriosis can return, and with it your partner's dyspareunia.
Fact #3 - Dyspareunia may not happen every time the woman has sex
As discussed above, dyspareunia can be the result of many different root factors, and because of this, the condition tends to flare up depending on those factors.
Fact #4 - The condition is usually treatable
Depending on the cause of your partner's dyspareunia, the symptoms are often treatable. It can take time to find the best course of treatment, and those treatments may fluctuate in effectiveness. These treatments include the following:
- Water-based lubricants, because dryness can occur when there is anxiety about intercourse, causing deep pain and, therefore, less natural lubrication
- Medications for dryness due to menopause
- Sexual therapy
- Pelvic floor therapy
Treatments for suppressing the endometriosis implants, such as progesterone, birth control pills, certain intrauterine devices (IUDs) or medications that can alter or suppress ovulation. If your partner is open to it, go to appointments with them and continue to educate yourself about the condition and the various treatments. This level of support can make them feel less pressured to constantly explain the pain they are experiencing.
This treatment plan should include a great deal of ongoing education regarding why specific treatments are chosen to be a part of recovery or why certain providers are recommended to be a part of [the] care team," Jeffcoat said.