Dyspareunia may occur prior to, during, or after sexual intercourse and may involve only slight pain, which does not interfere much with sexual activity. However, when it is ex­treme, it may make sexual intercourse difficult, if not impossible. It is estimated that close to 15% of women experience pain during sexual intercourse (Laumann et al., 1999). Contrary to popular belief, men can also experience dyspareunia, which may cause pain in the testes or penis, either during or after sexual intercourse.

Подпись:A number of things may cause such pain, from physical problems to allergies or in­fections. Psychological problems can also cause dyspareunia, and so a full diagnosis from a health professional is imperative. In Chapter 4 we discussed vulvodynia, which can be another cause of dyspareunia. Vulvar vestibulitis (vess-tib-u-LITE-is) syndrome, a type of vulvodynia, is considered one of the most common causes of dyspareunia today (Bergeron et al., 1997). In another study, almost 20% of women were found to experi­ence chronic vulvar pain, yet 40% of these women never sought treatment for the pain

Question: Every time I have sexual intercourse, the pain in my vagina is so intense, I almost feel like I should stop having sex alto­gether. Could this have anything to do with the fact that I was forced to have sex with my brother for several years while I was growing up?

Dyspareunia and VulvodyniaThe pain you experience during sexual intercourse may be due to the sexual abuse you experienced as an adolescent, as well as stress, fear, and anxiety. You should consider talking to a counselor to help clarify what is contribut­ing to this pain and also have a full medical evaluation. It is also possible that you may have a condition known as vulvodynia, which causes chronic vulval pain and soreness (see Chapter 4). In the meantime, try engaging in other sexual activities besides intercourse to relieve the anxiety that is associated with penetration through the anticipation of pain.

(National Vulvodynia Association, 2003). Women with vulvodynia report poor sexual functioning and significant pain during sexual intercourse (Masheb et al., 2004).

Dyspareunia in men is caused by the same physiological and psychological factors as in females. It can also be due to Peyronie’s disease (which we discussed in Chapter 5). Severe cases can cause curvature in the penis, which can make sexual intercourse impossible.