This is a brief overview of pain during sex. We will get a more complete article up in the futrue, but this is a starting place for women who suffer from dyspareunia - genital pain associated with intercourse.

Causes:
lack of lubrication
vaginal (yeast or bacteria) or urinary tract infection:

* Candida vaginitis (yeast infection) : Studies shows approximately 75% of all women will have a yeast infection at least once in their lifetime. Some will suffer form recurring yeast infections. Vaginal yeast infections may cause pain during urination and/or during sexual intercourse. Symptoms of yeast infection - itching, soreness and may have a white, cottage-cheese-like discharge.

* Bacterial vaginosis: For reasons unknown there may be a change in the balance of naturally occurring bacteria in the vagina that allows disease causing bacteria to dominate. It occurs commonly during reproductive years. Symptoms : Many women with this infection exhibit no symptoms, but the predominate sign of this condition is a fishy smelling gray discharge.

* Trichomonas vaginitis: (produces a refractory vaginal discharge and puritis) - causes itching and irritation of the vulva with increased vaginal discharge that may be green and frothy.

irritants (like spermicide), sexual disease, physical abnormalities

tumors

repair of episiotomy or tear - painful scar, granulation tissue, or neuroma

previous surgery

sexual trauma

vaginismus (conditioned response to pain or fear of pain). See this article.

vulvar vestibulitis
* endometriosis, a painful disease affecting the uterus and other organs
* tipped uterus
* skin thickenings that can divide the female opening or
* injury to the vulva or vagina, such as childbirth, rape or sexual abuse.
An article on vulvular pain

Chronic dyspareunia may be caused by adhesions following episiotomy or plastic repair of the vagina. Endometriosis, vaginitis, pelvic inflammatory disease and radiation therapy sometimes result in chronic painful intercourse due to adhesion formation at the round or broad ligaments, uterus or other structures.

Some women heal "too well" and form granulation tissue, which can create spotting and pain. In other cases a trigger point is formed, usually right at the 6 o'clock position at the bottom of the vagina, which can cause extreme pain with insertion of a tampon, finger, or penis. In cases where there is a bunching up of tissue, or there are knots or other abnormalities, outpatient surgical revision of the area may help. Most patients feel it's better to go through more surgery and have a 6-8 week recovery than have a lifetime of painful intercourse. In cases where trigger points are identified, injections may be helpful. In some cases a combination approach may help, such as removing the excess tissue, the doing injections later if necessary. Again, however, this is often not that hard to fix for an experienced gynecologist. If someone has not obtained relief from the basic treatments, then more intensive treatment is often indicated. Gynecologists are used to dealing with patients with painful intercourse, so you should get attention to this problem from your doctor. If not, find another.

Painful episiotomy is a known problem. The exact cause of this painful scar (and about 10% of all scars that repair injured body surfaces are painful) is often not clear. One understood problem is the formation of a neuroma (a nerve ending that is hypersensitive). Repair of an episiotomy is generally straightforward.

For more, try this article from NetDoctor

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