Overview

Dyspareunia is the term used for recurring pain in the genital area or the pain within the pelvis during sexual intercourse. The pain can be sharp or intense in nature. This pain can occur before, during, or after sexual intercourse.

Causes

• Vaginal dryness- hormone deficiency

• Infections-sexually transmitted diseases

• Skin disorders -affecting the vulva

• Pelvic conditions

• Injury or trauma

• Vaginismus: Involuntary tightening of vaginal muscles.

• Emotional and Psychological Causes

• Stress or anxiety

• Hormonal and Lifestyle                                                   

• Endocrine disorders  

• Hypothalamic-Pituitary Axis Disorders

• Hypopituitarism: Leads to reduced secretion of gonadotropins (LH, FSH), causing low estrogen levels and vaginal atrophy.

• Hyperprolactinemia: Elevated prolactin suppresses GnRH, reducing estrogen and libido, contributing to vaginal dryness and discomfort.

• Thyroid Disorders-Hypothyroidism, Hyperthyroidism

• Diabetes Mellitus

• Peripheral neuropathy can reduce genital sensation

• Vascular complications: Impair genital blood flow, increased risk of infections, Like candidiasis, which can cause pain during intercourse

• Polycystic Ovary Syndrome (PCOS)

• Hormonal imbalance: Elevated androgens and insulin resistance can lead to anovulation and estrogen deficiency

• Menopause & Premature Ovarian Insufficiency

• Estrogen deficiency: Leads to vulvovaginal atrophy (thinning, dryness, loss of elasticity)

• Adrenal Disorders-Addison’s disease: Low cortisol and androgen levels can reduce libido and vaginal lubrication

• Cushing’s syndrome: May cause menstrual irregularities and mood changes

Symptoms

• Pain during or after intercourse, which can be sharp, burning, aching, or cramping in nature, either in the deep pelvic region, the superficial vaginal region or the lower abdomen and back.

• Muscle spasms or tightness

• Emotional distress is due to the above symptoms.

Ayurvedic View

Kruchra vyavaya - antar mukhi yoni vyapad-its a symptom occuring in many disease related to reproductive system.In female,due to  aggravated vata dosha in yoni (vagina)praesha(area-female reproductive organ),its marga(path)is blocked by food,crooks or narrows the mukha(opening)of yoni(uterus-cervix),resulting in ati ruk(severe pain)and kruchra vyavaya or maithuna ashnuta(pain during performing coitus).Ayurveda way of approach is to treat symptom by bringing vata dosha to prakruta awastha(balance state ), by ayurvedic panchakarma treatment and local treatment for yoni pradesha (female reproductive system)