Intimate physical contact between husband and wife is supposed to be a special, important part of a relationship; however, sometimes a medical issue occurs that makes it painful for the wife. When this happens, it can be a hard thing to discuss with her husband.

Dr. Daren Watts, an OB/GYN at MountainStar's St. Marks Hospital, explains this type of pain "is not only disappointing, but it can be embarrassing and significantly disruptive to relationships."

Called dyspareunia, the condition affects 10% to 20% of women, according to information from American Family Physician. "Dyspareunia can have a significant impact on a woman's mental and physical health, body image, relationships with partners, and efforts to conceive."

Overcoming the hesitancy to discuss the problem is critical to help her husband know what she is going through and to be able to get the necessary help from her doctor.

"So much of what we do in our evaluation is to try and understand the nature of the problem. We really need to know when the pain occurs," Watts says. "How long does the pain last? What is the nature of the pain (sharp, burning, or pressure)? Is there change with different sexual positions? What effect is this having on your relationship?

"We definitely feel that it is important to involve your partner and let them know that there is pain with what should otherwise be an intimate moment," Watts says.

If this is something you are dealing with, the following tips and information can be a good starting point for helping your husband understand painful intercourse and what to do about it.

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What causes dyspareunia?

Because there are so many potential causes, it is essential to talk with your doctor about the symptoms you are experiencing.

"If you have pain associated with intercourse longer than a couple of weeks, it is clearly not normal and should be addressed," Watts says. "Please do not settle in your mind to think that intercourse is meant to be painful. In fact, the opposite is true."

Possible causes of dyspareunia range from insufficient lubrication to vaginal cancer. Here is a list from WebMD.com:

• Vaginismus. This is a common condition. It involves an involuntary spasm in the vaginal muscles, sometimes caused by fear of being hurt.
• Vaginal infections. These conditions are common and include yeast infections.
• Problems with the cervix (opening to the uterus).
• Problems with the uterus. These problems may include fibroids that can cause deep intercourse pain.
• Endometriosis. This is a condition in which the tissue similar to that which lines the uterus grows outside the uterus.
• Problems with the ovaries. Problems might include cysts on the ovaries.
• Pelvic inflammatory disease. With PID, the tissues deep inside become badly inflamed and the pressure of intercourse causes deep pain.
• Ectopic pregnancy. This is a pregnancy in which a fertilized egg develops outside the uterus.
• Menopause. With menopause, the vaginal lining can lose its normal moisture and become dry.
• Intercourse too soon after surgery or childbirth.
• Sexually transmitted diseases. These may include genital warts, herpes sores, or other STDs.
• Injury to the vulva or vagina. These injuries may include a tear from childbirth or from a cut (episiotomy) made during labor.
• Vulvodynia. This refers to chronic pain that affects a woman's external sexual organs — collectively called the vulva — including the labia, clitoris, and vaginal opening. It may occur in just one spot, or affect different areas from one time to the next. Doctors don't know what causes it, and there is no known cure. But self-care combined with medical treatments can help bring relief.

When should we be concerned about painful intercourse?

No matter what is causing the pain, it is worth talking to your doctor to help you reclaim this part of your relationship.

If you suspect that you may have a serious issue, such as vaginal cancer, seeing a medical professional right away in imperative.

Signs of vaginal cancer include bleeding or discharge not related to menstruation, painful intercourse, pelvic area pain, a vaginal lump, pain while urinating, and constipation, according to the National Cancer Institute.

How can I talk to my partner about this problem?

When talking to your spouse about painful intercourse, it is important to remember that this is an important part of a marriage relationship, as well as a sensitive topic. Being respectful, both while participating in intercourse and talking about intercourse, is important.

This subject can be emotional, so discussing issues in a medically factual way may be helpful. However, if you are unsure of how to do that, taking your spouse to speak with your doctor may be helpful. Also, remember that you or your partner are not trying to permanently discourage this marital act, you are simply trying to get it to a healthy place.

What can I expect during my appointment for painful intercourse?

When in doubt, you can always ask the doctor or nurse about what to expect ahead of time. You may want to ask questions such as:

• What type of clothing should be worn for the appointment?
• Should intercourse be avoided for a certain period before or after the appointment?
• What information needs to be brought to the appointment?

What treatment options are available?

Thankfully, for most issues, there are ways to help treat or ease the pain. The treatment available will depend on your specific diagnosis. For example, your doctor may prescribe a specific type of lubricant or procedure.

"Please let us help you to discover the source of your pain and change the course of this integral part of so many relationships," Watt says.

For more information about finding a doctor or making an appointment to discuss painful intercourse with a doctor and your spouse, visit MountainStarOBGYN.com. A doctor will be able to find a personalized treatment plan for you, help you understand what your personal situation is, and help you look to the future.

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