Sometimes they can become as fragile and delicate as the vaginal tissues of young girls who have not yet reached puberty and started their periods. Female genital mutilation Female genital mutilation which used to be known as female circumcision , involves varying degrees of mutilating surgery to the genitals of a girl. It may also prevent the use of tampons and any sort of gynaecological examination. This can mean that early in her sexual life a woman my feel pain from the hymen as it is forced open the first time she has intercourse. This hole becomes larger little by little as girls grow older. Vaginal or genital infection Infections of the vagina and the area around it cause inflammation of the tissues and so commonly cause pain on having sex. Endometriosis is typically found in young women, and may only become apparent when they come off the contraceptive pill if they have been taking it for a while. If there isn't enough foreplay, or you are not aroused enough, you may not produce enough secretions to make penetration comfortable. The cervix may also become tender and sensitive if you have an intrauterine contraceptive device, particularly if it is sitting a little too low or falling out.
Infection may be with thrush candida - a yeast that often lives in the bowel , with viruses such as herpes and with germs bacteria. Causes of deep dyspareunia Deep dyspareunia can be caused by the genital organs themselves but may also be caused by other structures in the tummy abdomen that can be easily knocked during sex intercourse. Dryness can also be for physical reasons - the vagina tends to be drier after the menopause see below. Lichen sclerosus carries a small risk risk of cancer of the genital skin. The causes are uncertain but may involve the nerves in the area becoming much more sensitive than normal and the way the brain communicates wtih these nerves changing in some way. It is sore and instant. In women who have passed their menopause, ovarian cysts are worrying, as they can be a sign of ovarian cancer. Causes related to womb position In some women the womb tilts backwards, rather than forwards; the ovaries then tend to fall backwards too. However, it isn't always as simple as that. Vaginal atrophy After the menopause the levels of hormones in your body fall - particularly the level of oestrogen. A wide range of bacterial infections can infect the vagina. Bowel pain During intercourse the bowel is also knocked and moved. It's also not uncommon for dyspareunia to remain after the cause has been treated, particularly if things have been left untreated for a while. Causes of superficial and deep dyspareunia Vaginal trauma The vagina is pretty flexible and strong and usually recovers well from the stretch and sometimes small tears of childbirth. Bartholinitis Bartholin's glands are a pair of glands on either side of the vagina, in the tissues of the wall. This can result in deep pain in the pelvis that is more noticeable with deep penetration and which settles slowly when penetration stops or when you change your position. If the cervix becomes inflamed then knocking it with the penis during sex may cause deep pain in the pelvis and sometimes across the fronts of the thighs. It may be caused by the immune system. It can be accompanied by severe pain on attempted penetration. Dyspareunia Pain Having Sex Dyspareunia is a term used for pain felt in the genital area or pelvis during or after having sex intercourse. However, the hymen can be quite thick and the hole not quite large enough. Many of the causes have a very simple solution and it is important to seek help if you are experiencing problems. The pain is typically felt deep in the pelvis, is worse with deep penetration and settles slowly when penetration stops. Most usually this is in the ovaries, the Fallopian tubes that link the womb to the ovaries, and the cervix. Larger cysts are more likely to leak and cause pain, and can be a sign of endometriosis, especially in younger women.
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