May 17, 2010
Dyspareunia: The “ouch!” in sex
(Warning: This article deals with the sex act and uses terms which may be unsuitable for those with sensitivities to these. If you are one of those, you are advised to refrain from reading this.)
The sexual act may put a pressure on one or both partners to achieve the ever important orgasm, or more often called “O." However, there is another “O” during sex and this is the “Ouch!” or dyspareunia.
Dyspareunia, simply stated, is painful sex. It can happen to both men and women. For this article, I will deal with dyspareunia in women. This is not too often discussed because those affected think that having dyspareunia makes them abnormal, or having female sexual dysfunction (a topic I discussed in a HerWord.com article several years ago). For those with dyspareunia, I would like to assure you that it is not “all in the mind” and many factors can cause this. Here they are:
1. Hormonal changes. This is most evident as the woman approaches her menopause, the “perimenopause.” At this time, her hormones, particularly estrogen, start to decline. Among all hormones, it is estrogen that gives the moisture or wetness to the vaginal tissues. Therefore, declining levels of estrogen also decreases the wetness of the vaginal canal, making intercourse painful due to the friction between tissues. This dryness not only causes pain but can cause injury to the vaginal canal thereby accentuating the pain.
This can also be seen in women taking contraceptives because the amount of hormones in the pill is lower than that which our bodies produce.
2. Infection. Vaginal infections can cause the tissues to become inflamed or swollen, dry, itchy or easily abraded. Due to these, sexual intercourse becomes an ordeal instead of a pleasurable experience. In addition, the infection can be transmitted to your partner.
3. Lack of adequate stimulation. The more stimulation a woman gets, either visual or physical, the more lubricated her vaginal walls become, such that upon introduction of the penis, there is less resistance and more stretchability of the vaginal walls. Consequently, she is then less likely to experience pain. It is also this sexual foreplay that makes a woman’s vagina undergo what is called a “tenting effect”—the superior vaginal wall is pulled upward producing a tent-like area which can accommodate the length of the penis.
4. Size. Yes, size does matter. In the event that the male partner is too well-endowed, even with adequate hormones, stimulation and tenting, the woman might still experience dyspareunia due to the overstretching of the vaginal walls.
5. Psychological Factors. I purposely put this at the end of the list because before we label a case as psychological, we must have eliminated all other factors possible. Almost all causes have a psychological effect, too. As an example: dryness causes dyspareunia, making a woman psychologically afraid of sex because of the pain, thereby causing more dryness—more pain—more negative mental thoughts—more pain… the cycle goes on and on.
There is no magic bullet which can eliminate dyspareunia in one click. It usually is multifactorial. For those suffering from it, you must be ready to discuss your sexual activity without qualms for the doctor to be able to get to the bottom of the problem. Then and only then can he give you the proper treatment.
If you have questions for Dr. Malu, you can email her at feedback@herword.com.
Dr. Ma. Luisa V. Torralba-Mangubat is a Fellow of the Philippine Obstetrical & Gynecological Society, Philippine College of Surgeons and International College of Surgeons. In addition to this, she is also a Fellow in Aesthetic & Medicine Surgery of the Philippine Academy of Medical Specialists and a member of the Philippine Academy of Non-Surgical Aesthetics. For personal consultations, her clinic hours are as follows:
Asian Hospital and Medical Center, Room 722
Monday, Wednesday, and Friday, 8 a.m. to 10 a.m.
Tel. (632) 771-9340
Medical Center Manila, Room 337
Monday, Wednesday, and Thursday, 1 p.m. to 6 p.m.
Saturday, 9 a.m. to 1 p.m.
Tel. (632) 528-1173
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