Dyspareunia is recurrent or persistent genital pain experienced just before, during, or after sexual intercourse. Although this condition can occur in both men and women, it is more common in women.



The cause is believed to be related to physical factors.

Some pain occurs during vaginal entry, but decreases over time. This is often caused by not having enough lubrication because of a lack of sexual arousal and stimulation. It can also be caused by dehydration , or as a side effect of some medications, such as antihistamines. Frequent douching can also cause problems.

Other causes in women include:

The cause of dyspareunia may also be related to psychological factors, although this is less common. Some examples include:

  • Previous sexual trauma, such as rape or abuse
  • Feelings of guilt
  • Negative attitudes toward sex

These factors may lead to a condition called vaginismus . This is painful and involuntary contractions of vaginal muscles. It is usually a response to past sexual trauma or other painful circumstances, but it can also be the result of chronic irritation from a physical cause.


The most common causes of pain in men are:

Pain occurs at the time of ejaculation.

Pain that occurs while obtaining an erection may be associated with:

  • Inflammation of the foreskin
  • Loss of elasticity of the foreskin
  • Trauma to the penis
  • Herpes or genital warts
  • Local allergies or irritations
  • Curvature of the penis caused by Peyronie's disease

Risk Factors

Factors that may increase your chance of dyspareunia include:

In women:

  • Being postmenopausal
  • Taking medications that produce a vaginal dryness
  • Prior vaginal surgery

In men and women, viral or bacterial infections may also increase the chance of dyspareunia.


Pain associated with dyspareunia may:

  • Occur during or after sex
  • Be itching, burning, stabbing, or aching
  • Be located in the:
    • Vagina
    • Urethra
    • Bladder
    • Pelvis
    • Penis
    • Testicles
  • Occur during all phases of sexual contact
  • May also occur with tampon use—fabric absorbs natural vaginal lubricant
Female Reproductive System
Nucleus fact sheet image
Copyright © Nucleus Medical Media, Inc.


The diagnosis is often made based on your symptoms. A medical and sexual history will be taken. A physical exam will be done.

For women:

  • Your vaginal wall will be checked for:
    • Signs of dryness
    • Inflammation
    • Infection
    • Genital warts
    • Scarring
  • An internal pelvic exam will be done to look for:
    • Abnormal pelvic masses
    • Tenderness
    • Signs of endometriosis

For men and women:

  • Your doctor may suggest more tests. They may include cultures to find infections. Imaging studies like an ultrasound may also be used.
  • You may be referred to a counselor. This will help to determine whether psychological issues may be a cause.



  • Your doctor may recommend that you use water-soluble lubricants or creams that contain estrogen. Other medications may be prescribed, as well.
  • Infections may be treated with antibiotics or antifungal medication.
  • Inflammation and dermatitis may be treated with topical or injectable corticosteroids.
  • Viral infections like herpes and genital warts will need to be treated.
  • Endometriosis may be treated with medications. In some cases, surgery may be necessary.


To treat prostatitis and urethritis, the doctor may recommend:

  • Antibiotic treatment
  • Sitz baths—soaking the hip and buttocks area in warm water
  • Avoiding alcohol and caffeine, which may be helpful for prostatitis

Sometimes, surgery may be done to treat foreskin and other erectile problems.

Men and Women

When no physical cause of the pain can be found, sex therapy may be helpful. Some concerns need to be worked through in counseling. These may include:

  • Guilt
  • Inner conflict
  • Unresolved feelings about past abuse
  • Need for self-punishment


  • Wait at least 6 weeks before having sexual relations after childbirth. It may be necessary to use a lubricant because of hormonal changes causing vaginal dryness.
  • Use proper hygiene and get routine medical care.
  • Practice safe sex to prevent sexually transmitted diseases .
  • Adequate foreplay and stimulation will help to ensure proper lubrication of the vagina.
  • Use a water-soluble lubricant. Vaseline should not be used as a lubricant. It is not water-soluble, and it may encourage vaginal infections.


Please note, not all procedures included in this resource library are available at Henry Ford Allegiance Health or performed by Henry Ford Allegiance Health physicians.

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at HLEditorialTeam@ebscohost.com.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Editorial Policy | Privacy Policy | Terms and Conditions | Support
Copyright © 2008 EBSCO Publishing. All rights reserved.

Here’s a tip for including more healthy foods in your diet. As you put your groceries away, chop some fruits and vegetables. Keep them in snack size bags in the refrigerator so they will be ready to grab on the go.