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Treatments and drugs
By Mayo Clinic staffPainful intercourse used to be viewed primarily as a psychological problem that required psychological treatment. Fortunately, that view is outdated. Researchers and doctors now understand the many causes of dyspareunia and recommend an integrated, multifaceted treatment approach. Your particular treatment depends on the underlying cause of your pain, but treatment may include:
Hygiene habits
Avoid scented bath products, such as body washes and shower gels. These products can irritate your genital area and zap your natural lubrication, particularly if you overuse them. Skip douching as well.
Sexual techniques and counseling
You and your partner may be able to minimize pain with a few changes to your sexual routine:
- Switch positions. If you experience sharp pain during thrusting, the penis may be striking your cervix or stressing the pelvic floor muscles, causing aching or cramping pain. Changing positions may help. You can try being on top of your partner during sex. Women usually have more control in this position, so you may be able to regulate penetration to a depth that feels good to you.
- Communicate. Talk about what feels good and what doesn't. If you need your partner to go slow, say so.
- Don't rush to the main event. Longer foreplay can help stimulate your natural lubrication. And you may reduce pain by delaying penetration until you feel fully aroused.
- Use lubricants. A water-based lubricant, such as K-Y jelly or Astroglide, can make sex more comfortable. If contraceptive creams cause irritation or dryness, try a different preparation or ask your doctor about switching to another type of birth control.
Medications and therapies
In some cases, medications or therapy are necessary to treat painful intercourse.
- Treating underlying conditions. If an infection or medical condition is contributing to your pain, treating the underlying cause may resolve your problem. Changing medications known to cause lubrication problems also may eliminate your symptoms.
- Estrogen therapy. For most postmenopausal women, dyspareunia is caused by inadequate lubrication resulting from low estrogen levels. Often, this can be treated with a prescription cream, tablet or flexible vaginal ring.
- Other medications. In some cases, your doctor may suggest an oral prescription pain medication or injections of pain medications into the site of the pain.
- Desensitization therapy. During this therapy, you learn vaginal relaxation exercises that can decrease pain. Your therapist may recommend pelvic floor exercises (Kegel exercises) or other techniques to decrease pain with intercourse.
- Counseling or sex therapy. If sex has been painful for a long time, you may experience a negative emotional response to sexual stimulation even after treatment. If you and your partner have avoided intimacy because of painful intercourse, you may also need help improving communication with your partner and restoring sexual intimacy. Talking to a counselor or sex therapist can help resolve these issues.
