Dyspareunia is the medical term for painful sex.  It usually does not go away by ignoring it, and it can be very isolating during intimacy and outside the bedroom .   There can be many components to dyspareunia.  Sometimes it is a cutaneous/superficial irritation (see vulvadynia and vulvar vestibulitis above). 

When it is due to spasm at the opening of the vagina causing a small opening, it is referred to as vaginismus.  When the deeper muscles in the vagina or the pelvic floor are tight and painful, it may be referred to as levator ani syndrome.

Patients may report they have had pain since a vaginal birth injury or an episiotomy.  Many patients also report pain after a pelvic floor repair or hysterectomy.  Similarly, patients who are cancer survivors also have vaginal pain after radiation or hormone therapy.

• Common patient descriptors are as follows: “It feels like a too tight fit with my partner”, “ It feels like my partner is hitting something”, “I have cramping when I have sex”, I have a tearing sensation when I try to have sex”, “I have burning with sex”, “it feels like period cramps during and after sex,” among many others.

• Regardless of the cause,  it is not your fault or something you did wrong.  There are many reasons for dyspareunia, and there are now many therapy options to heal it.