Dyspareunia, or pain during or after sexual intercourse, is a condition that can affect both women and men, but is more common in women. Women with dyspareunia may have pain in the vagina, clitoris or labia. There are numerous causes of dyspareunia - many of which are easily treatable. It occurs most frequently in individuals who are sexually inexperienced (particularly if their partners are also inexperienced).
To sum it up, this is a form of erectile dysfunction, as such the problem should be approached by the couple rather than just the individual. General measures to be taken include the following:
• Treatment should be directed at the underlying cause.
• If psychological causes are involved, then appropriately directed counselling is essential.
• Vaginal lubricants, local anesthetics or pelvic relaxation exercises may also be helpful to break the cycle of spasms in women with vaginismus (the physical or psychological condition that affects a woman's ability to engage in any form of vaginal penetration, presumed to be the result of an involuntary vaginal muscle spasm).
• Vaginismus is most effectively managed via a combination of behavioral modification, vaginal dilatation, and emotional counselling. Vaginal dilatation is not a mechanical procedure, but a process of learning that something can be inserted into the vagina without causing pain.
• Modification of sexual technique may help to reduce pain with intercourse. Increasing the amount of foreplay and delaying penetration until maximal arousal will increase vaginal lubrication and decrease pain with insertion.
• Women may be frightened that their vagina is too small to allow entry of a penis. In response to sexual arousal, the vagina increases in length by about 35-40% and expands in width at the upper end by about 6 cm. Also women should be reminded that the vagina can be tight enough to hold a pencil or wide enough to accommodate a baby's head during childbirth.
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