Dyspareunia: when sex does not cause pleasure

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It affects both sexes, but more women.

Dyspareunia is defined as pain during intercourse, in both women and men. It can occur at the onset (superficial dyspareunia), during (intracoital or deep), or after intercourse. The discomfort usually manifests with sensations of stinging, stinging and burning.

“In women the pain can appear as soon as the penis presses to enter the vagina (vulvodynia). In these cases it is usually a consequence of having suffered from vaginismus, which is the involuntary contraction of the muscles of the vagina that prevents all types of penetration, or having suffered from vulvar and / or vaginal infections. Painful discomfort can also occur once the penis penetrates the vagina. In men, on the other hand, pain can arise during erotic play, with high sensitivity in the glans and increase during penetration. It can also extend to pain in the testicles, the prostate, and during ejaculation “, he explains to Clarion The psychiatrist and sexologist Walter Ghedin.

Dyspareunia is due to organic, psychological and mixed causes. The most common organic causes in women are: vaginal infections, atrophy or loss of elasticity and lubrication of the vaginal mucosa (menopause).

On the other hand, in men the most frequent organic cause is persistent difficulty retracting the skin covering the glans (foreskin), a problem called phimosis that is resolved with surgery.

Within the psychological causes there are sexual traumas, modesty, repression, religious beliefs, misinformation, little sexual exploration and self-knowledge, fears (sexual phobias), fear of pregnancy or catching diseases.

In addition, the relationship problems such as relationship crises, power games, violence, little foreplay, poor communication, monotony, anxiety that hurries the relationship, poor intimacy, etc.

“This disorder was only reserved for painful sexual intercourse in women, but currently male dyspareunia is also known and is defined as recurrent or persistent genital or pelvic pain with sexual activity, or sexual dysfunction that is present for three months or more. In most cases it is related to the presence of pain in ejaculation; likewise, it may be associated, during the arousal phase, with erection, or during intercourse with penetration “, Ghedin points out.

To avoid this ailment it is essential to use water-based lubricants (for example those that come with condoms) and it is very important to give yourself a lot of time for sexual games before moving on to penetration.

“Let’s demystify that all encounters have to end in intercourse. Penetration is not mandatory, we can avoid it when we don’t feel like it. Let’s remember that there are many erogenous zones in our body “, affirms Cecilia Borghetti, psychologist and specialist in Clinical Sexology and Sexual Education.

Dyspareunia has a higher prevalence in the female population. The World Health Organization reported a worldwide prevalence among 8 and 22% in the female sex. The prevalence of male dyspareunia is still unknown. However, some studies show that approximately between 1% and 5% of males suffer pain during sexual intercourse.

“This situation can lead to the avoidance of sexual encounters, but it is a problem when there is no communication in couples since many times there is difficulty in telling what happens to them, what they feel and the couple can experience it as rejection, not knowing that there is pain. Another consequence could be that following the please the other personTo continue sexual encounters with pain, but out of bed this situation can translate into anger and reproaches. And it is clear that in all cases they are people who cannot enjoy and live their sexuality pleasantly, “Borghetti responds.

Before considering a treatment, the first thing to do is rule out physiological problems in the gynecological consultation. “Once we make sure that from the organic, from the functional, there is no difficulty, sexological therapy with a sexologist or clinical sexologist is recommended where through interviews and exercises that are carried out in privacy, the dyspareunia, either individually or as a couple. On many occasions it is the woman who asks us if she can go with her partner, since this dysfunction has resulted in some conflicts, “says Borghetti.

Ghedin offers a series of recommendations so that couples can work on the problem and, in this way, begin to enjoy sexual encounters.

✔The sexological information helps to debunk myths that are naturalized.

✔Find moments to be together.

✔Learn to communicate, especially when sexual dissatisfaction appears. Don’t be afraid to speak up. What is not spoken becomes guesses, assumptions, or symptoms.

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