Vaginal dryness is often reported by lactating women as well. Estrogen deficiency is associated with lubrication inadequacy, which can lead to painful friction during intercourse.
Even after the original source of pain has disappeared, a woman may feel pain simply because she expects pain. Fear of being in pain can make the discomfort worse. When the vagina is dry and undilated, penetration is more painful. Both vaginal lubrication and vaginal dilation decrease. When pain occurs, the woman may be distracted from feeling pleasure and excitement. Other women begin to feel pain with intercourse after an injury or infection or cyclically with menstruation. Some women have always experienced pain with intercourse from their very first attempt. Determining whether the pain is more superficial or deep is important in understanding what may be causing a woman's pain. Some women feel pain in more than one of these places. Other women feel deeper pain in the vault of the vagina or deep within the pelvis upon deeper penetration. Some women describe superficial pain at the opening of the vagina or surface of the genitalia when penetration is initiated. The location, nature, and time course of the pain help to understand potential causes and treatments. This reflects how many different and overlapping causes there are for dyspareunia. Women who experience pain with attempted intercourse describe their pain in many ways. Globally, dyspareunia has been estimated to affect between 8–22% of women, at some point in their lives. Many women experience relief when physical causes are identified and treated. Diagnosis is typically by physical examination and medical history. Symptoms of dyspareunia may also occur after menopause. Commonly, multiple underlying causes contribute to the pain. Numerous physical, psychological, and social or relationship causes can contribute to pain during sexual encounters. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain. It can affect a small portion of the vulva or vagina or be felt all over the surface. Medically, dyspareunia is a pelvic floor dysfunction and affects up to 53% of adult women at some point in their lives, although it is frequently underdiagnosed. The pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix.
Dyspareunia ( / d ɪ s p ə r ˈ u n i ə/ dis-pər-OO-nee-ə) is painful sexual intercourse due to medical or psychological causes.