Brief Answer:
need evaluation and provide more information

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

Dyspareunia (painful intercourse) is defined as persistent or recurrent genital pain that occurs just before, during or after intercourse. There are many causes of dyspareunia and treatment depends on underlying cause.

Please read below detail and let me know which factors are playing role in your case. Ultimately you need to be evaluated by a gynecologist also. If you have already consulted doctor please narrate me the details.

Pain during penetration may be associated with many factors, including:

- Insufficient lubrication: This is often the result of not enough foreplay. Insufficient lubrication is also commonly caused by a drop in estrogen levels.
- Medications: Certain medications are known to inhibit desire or arousal, which can decrease lubrication and make sex painful. These include antidepressants, high blood pressure medications, sedatives, antihistamines and certain birth control pills.
- Injury, trauma or irritation: This includes injury or irritation from an accident, pelvic surgery, female circumcision or a cut made during childbirth to enlarge the birth canal (episiotomy).
- Inflammation, infection or skin disorder: An infection in your genital area or urinary tract can cause painful intercourse. Eczema or other skin problems in your genital area also can be the problem.
- Vaginismus: Involuntary spasms of the muscles of the vaginal wall (vaginismus) can make attempts at penetration very painful.


Deep pain usually occurs with deep penetration and may be more pronounced with certain positions. Causes include:

- Certain illnesses and conditions: The list includes endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, hemorrhoids and ovarian cysts.
- Surgeries or medical treatments: Scarring from pelvic surgery, including hysterectomy, can sometimes cause painful intercourse. Medical treatments for cancer, such as radiation and chemotherapy, can cause changes that make sex painful.

Emotions are deeply intertwined with sexual activity and may play a role in any type of sexual pain. Emotional factors include:

- Psychological problems: Anxiety, depression, concerns about your physical appearance, fear of intimacy or relationship problems can contribute to a low level of arousal and a resulting discomfort or pain.
- Stress: Your pelvic floor muscles tend to tighten in response to stress in your life. This can contribute to pain during intercourse.
- History of sexual abuse: Most women with dyspareunia don't have a history of sexual abuse, but if you have been abused, it may play a role.

Also tell that,

- How many children do you have?

- What is your husband's opinion and attitude about this problem and how is overall married life going on?

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

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