Dyspareunia (painful sexual intercourse)

Dyspareunia are pains felt by the woman during sexual intercourse. They may have psychological and/or organic causes.

There are several types of dyspareunia:
– primary dyspareunia (the disorder exist since the first sexual intercourse);

– secondary dyspareunia (the disorder occurs after a period of painless sexual intercourse).

Dyspareunia can be selective (under certain conditions or with a particular partner). They can also be permanent or intermittent.

Finally, they are either superficial (banners) or deep. Superficial dyspareunia results in penetration pain. While remaining nuanced, they are considered to be more psychological in nature. Deep dyspareunia is pain in the abdomen triggered by sexual intercourse. They are rather organic. Organic and psychological dimensions can interfere.

When superficial dyspareunia are organic, their most frequent cause is infection (fungal infections, herpes…). They may also be due to postmenopausal physiological atrophy, congenital malformations (hymen abnormality, vaginal malformation), obstetric trauma (following childbirth), surgical trauma (for example, following surgery to treat uterine cancer), sexual trauma (lesions caused by penetration), or dermatosis (dermatological diseases).

Deep dyspareunia can be caused by fixed uterine retroversion (the uterus is reversed backwards and immobilized by adhesions, infectious lesions or endometriosis), pelvic endometriosis, high genital infections (in the uterus, ovaries and fallopian tubes), ovarian lesions (cysts), a tear in the broad ligament that participates in the suspension of the uterus (Masters and Allen syndrome), or the consequences of a hysterectomy (removal of the uterus. The cause may be more psychological than post-operative).