Treatment options will vary, depending on the underlying cause of the pain.
If an infection or medical condition is contributing to your pain, treating the underlying cause may resolve your problem. Changing medications known to cause lubrication problems also may eliminate your symptoms. For most postmenopausal women, dyspareunia is caused by inadequate lubrication resulting from low estrogen levels. Often, this can be treated with a prescription cream, tablet or flexible ring that releases very small amounts of estrogen directly to your vagina.
Different types of therapy also may be helpful, including:
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- Desensitization therapy. During this therapy, you learn vaginal relaxation exercises that can decrease pain. Your therapist may recommend pelvic floor exercises (Kegel exercises) or other techniques to decrease pain with intercourse.
- Counseling or sex therapy. If sex has been painful for a long time, you may experience a negative emotional response to sexual stimulation even after treatment. If you and your partner have avoided intimacy because of painful intercourse, you may also need help improving communication with your partner and restoring sexual intimacy. Talking to a counselor or sex therapist can help resolve these issues.
- Biggs WS. Sexual pain disorders. In: Rakel RE. Textbook of Family Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191205553-4/0/1481/0.html#. Accessed Nov. 18, 2011.
- Lenz G. Emotional Aspects of Gynecology: Sexual function and dysfunction. In: Katz VL, et al. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/208746819-4/0/1524/0.html. Accessed Nov. 18, 2011.
- Kurss DI, et al. Dyspareunia. In: Ferri FF. Ferri's Clinical Advisor 2012: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05611-3..C2009-0-38601-8--TOP&isbn=978-0-323-05611-3&uniqId=291436269-101. Accessed Nov. 18, 2011.
- Moore CK. Female sexual function and dysfunction: Diagnosis. In: Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-6/0/1445/0.html. Accessed Nov. 18, 2011.
- Stewart EG. Causes and treatment of sexual pain in women. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2011.
- Stewart EG. Approach to the woman with sexual pain. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2011.
- Ask Mayo Expert. What are the treatment options for managing vaginal symptoms of urogenital atrophy in women with a history of breast cancer? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2011.
- Bachmann G, et al. Treatment of vaginal atrophy. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2011.