About 1 to 5% of men suffer from dyspareunia, or pain during sex. However, men sometimes feel embarrassed about discussing sexual health, which can mean that some men do not say they have painful sex when they do. When we talk about pain during sex, it can mean a variety of things: an itching or burning sensation, pain during ejaculation, general discomfort during sex and rashes or other forms of skin irritations. Men who suffer from dyspareuina may not be able to feel aroused or achieve orgasm.
Painful ejaculation, all by itself, can be caused by:
However, there are some other specific causes of pain during sex. These include:
Finally, there are two other notable types of cause:
Separately, there is anodyspareunia, which is discomfort when receiving anal sex. While this can happen due to not properly being prepared (such as not using enough lubrication (lube) or stimulation prior to penetration), or due to the bad feelings mentioned above, conditions such as anal fissures, infections or haemorrhoids can result in painful anal sex.
Treatments are specific to each cause, but can include surgery, medication, and/or therapy.
Peyronie's disease, frenulum breve, phimosis, and the squeezing of the pudendal nerve can all be treated with surgery. For frenulum breve or phimosis, this could mean circumcision.
However, Peyronie's disease and phimosis can be treated with medication: collagenase cream for the former, and steroid cream for the latter.
Yet further treatment of Peyronie's disease, and, potentially chronic (that is, long-lasting) inflammation of the prostate, can involve Extracorporeal Shockwave Therapy (ESWT). This treatment involves delivering energy pulses. For Peyronie's disease, this can relieve pain and break up the plaque, but won't change the abnormal curvature or improve sexual function. As for prostate inflammation, recent studies have shown that ESWT can lead to short-term improvements, but the long-term effects are unknown.
For STIs, the usual treatment includes antibiotics or antiviral medications, and, much like vaginal yeast infections, antifungal drugs are suitable for treating thrush in men.
When doctors aren't quite sure what the underlying cause of the disease is, they may provide drugs that help manage pain, while they look for further solutions.
Therapy may be offered to someone if it's likely that the pain has a psychological cause.
Tests for seven STIs
Urine or swab test
Urine or swab test
Blood test for four STIs
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