Can all pain be related to endometriosis?

Expert answer:

No, not all pain during sexual intercourse is caused by endometriosis, although this is a common cause of dyspareunia. Feeling pain in the relationship may also be related to:

  • Lack of lubrication: It can cause pain at the time of penetration as the friction can cause microcracks in the mucosa of the vagina if it is not lubricated properly. As pain lessens excitement and pleasure, lubrication becomes even more reduced, which creates a cycle;
  • Cystitis (urinary tract infection in the bladder): It can cause burning, discomfort or pain during or after intercourse because of the proximity between the vagina and the bladder;
  • Candidiasis: It usually causes severe pain at the time of penetration. Candidiasis is an infection caused by a fungus that is usually associated with a white discharge and may also cause itching (learn more about: What are the symptoms of candidiasis?);
  • Vaginismus: Causes pain during attempted penetration. The pain is due to a muscle spasm of the pelvic floor, which closes the entrance of the vagina and prevents penetration. Vaginismus may have physiological or psychological origin (see also: What is vaginismus and what are the symptoms?).

Others causes frequent pain during intercourse include:

  • Folliculites, boils;
  • Bartolinites (inflammation of Bartholin's glands - also read: What is bartolinitis? Does it have a cure?);
  • Inflammation in the uterus;
  • Pelvic inflammatory disease;
  • Pelvic adhesions;
  • Uterine retroversion;
  • Cysts, tumors and inflammation of the ovaries.

The treatment of dyspareunia depends on the disease or condition responsible for the problem. Physical causes can be treated with medicines and surgeries. If the origin of the dyspareunia is psychological, it is indicated sexual therapy.

The gynecologist is responsible for the diagnosis and should conduct or indicate the most appropriate treatment, as appropriate.