If an ectopic pregnancy or severe endometriosis is found, immediate surgery is needed. For the woman with severe vaginismus, or involuntary contraction of the vaginal muscles when touched, a program of gradual vaginal expansion is needed. Dilators, the woman's fingers or the partner's fingers along with psychotherapy may be helpful. Side effects depend upon the treatment used. Oral contraceptives and progestins may cause nausea, abdominal bloating, weight gain and swelling.
Antibiotics have individual side effects.
Gonadotropin agonists may cause hot flashes, headaches, lack of menstrual periods and mood swings. The healthcare provider must be patient and explain the many causes of dyspareunia. The treatment options must be made clear. If there are no physical causes, a psychological reason should be explored. Reasons may include previous sexual abuse, confusion over sexual preference and desire, dissatisfaction with the relationship and depression.