DYSPAREUNIA.

Dyspareunia.

Dyspareunia (from Greek meaning "badly mated") is 'painful sexual intercourse', due to medical or psychological causes.

The symptom is significantly more common in women than in men, affecting up to one-fifth of women at some point in their lives. 

The causes are often reversible, even when long-standing, but self-perpetuating pain is a factor after the original cause has been removed.

Symptoms in women:
When pain occurs, the woman experiencing dyspareunia may be distracted from feeling pleasure and excitement.

Both vaginal lubrication and vaginal dilation decrease.

When the vagina is dry and undilated, thrusting of the penis is painful.

Even after the original source of pain (a healing episiotomy, for example) has disappeared, a woman may feel pain simply because she expects pain.

In brief, dyspareunia can be classified by the time elapsed since the woman first felt it:

• During the first two weeks or so of symptoms, dyspareunia caused by penis insertion or movement of the penis in the vagina or by deep penetration is often due to disease or injury deep within the pelvis.
• After the first two weeks or so of symptoms, the original cause of dyspareunia may still exist with the woman still experiencing the resultant pain or, it may have disappeared, but the woman has anticipatory pain associated with a dry, tight vagina.

Physical causes in men:

In men, as in women, there are a number of physical factors that may cause sexual discomfort.

 

Pain is sometimes experienced in the testicular or glans area of the penis immediately after ejaculation.

 

Infections of the prostate, bladder, or seminal vesicles can lead to intense burning or itching sensations following ejaculation.

 

Men suffering from interstitial cystitis may experience intense pain at the moment of ejaculation.

 

Gonorrheal infections are sometimes associated with burning or sharp penile pains during ejaculation.

 

Urethritis or prostatitis can make genital stimulation painful or uncomfortable.

 

Anatomic deformities of the penis, such as exist in Peyronie's disease, may also result in pain during coitus.

 

One cause of painful intercourse is due to the painful retraction of a too-tight foreskin, occurring either during the first attempt at intercourse or subsequent to tightening or scarring following inflammation or local infection. 

 

Another cause of painful intercourse is due tension in a short and slender frenulum, frenulum breve, as the foreskin retracts on entry to the vagina irrespective of lubrication.

 

In one study frenulum breve was found in 50% of patients who presented with dyspareunia.

 

During vigorous or deep or tight intercourse or masturbation, small tears may occur in the frenum of the foreskin and can bleed and be very painful and induce anxiety which can become chronic if left unresolved.

 

If stretching fails to ease the condition, and uncomfortable levels of tension remain, a frenuloplasty procedure may be recommended.

 

Frenuloplasty is an effective procedure, with a high chance of avoiding circumcision, giving good functional results and patient satisfaction.

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http://en.wikipedia.org/wiki/Dyspareunia 

 

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