Painful intercourse has a name, and it's “dyspareunia.” It covers a lot of ground, because the reasons for the ailment range from the physical to the psychological. Still, many women will experience dyspareunia at one point in their lives.

The clinical definition of dyspareunia is a “persistent or recurrent genital pain that occurs before, during or after intercourse.” The only symptom is pain, but the pain may occur, or reoccur, at different times and in different scenarios, including:  

·         Pain only at sexual penetration, that is, entry

·         Pain with every penetration, even while putting in a tampon

·         New pain after previously pain-free intercourse

·         Deep pain during thrusting

·         Burning pain or aching pain

·         Throbbing pain, lasting hours after intercourse

The most obvious cause of pain during entry is not enough lubrication. Often this is just as a result of insufficient foreplay, but it may be caused by a drop in estrogen levels after childbirth, following menopause, or during breast-feeding. Certain medications, such as anti-depressants, sedatives, antihistamines, and high blood pressure medications have been known to decrease lubrication.

Pain during penetration may also be caused by irritation or injury resulting from pelvic surgery, female circumcision, or cuts made during childbirth. Similarly, a skin condition such as eczema or infection in the genital area or urinary tract can be the source of pain upon entry.

Deep pain, which occurs during thrusting, usually varies depending upon the position. Sources for this include endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, hemorrhoids and ovarian cysts. Painful intercourse may also be caused by scarring from pelvic surgery, or cancer treatments such as radiation and chemotherapy.

Certainly visit your doctor if you experience any pain during sexual intimacy, and do not be bashful about supplying every detail. Your doctor will likely perform a pelvic exam in preparation for a diagnosis.

If the cause of the pain is one of the many infections or other medical conditions described above, your doctor can treat those directly. She may prescribe alternate medications if one of those was the source of reduced lubrication.

The drug ospemifene (Osphena) has been approved by the Food and Drug Administration to treat moderate to severe dyspareunia in women who have problems with vaginal lubrication. The drug acts like estrogen on the vaginal lining, but doesn't seem to have estrogen's potentially harmful effects on the breasts or the lining of the uterus.