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Выделяют: \n- **Поверхностную диспареунию** — боль в области клитора, больших и малых половых губ, входа во влагалище [2](https://communityclinic.ru/dispareuniya-pochemu-bolno-esli-uzi-i-mazki-v-norme/). \n- **Глубокую диспареунию** — боль внутри влагалища, в области шейки матки или внизу живота [2](https://communityclinic.ru/dispareuniya-pochemu-bolno-esli-uzi-i-mazki-v-norme/). \n\nВ некоторых случаях дискомфорт сохраняется даже после окончания полового акта [3](https://BestClinic.ru/diseases/dispareuniya/).\n\n## Причины\nДиспареуния развивается под влиянием органических и психологических факторов, в большинстве случаев эти механизмы взаимосвязаны [3](https://BestClinic.ru/diseases/dispareuniya/). **Физиологические причины**: \n* воспалительные процессы (вульвовагинит, эндометрит, цистит) [3](https://BestClinic.ru/diseases/dispareuniya/); \n* атрофические изменения слизистой влагалища (например, при недостаточной выработке смазки) [3](https://BestClinic.ru/diseases/dispareuniya/); \n* эндометриоз, спайки в малом тазу, миома матки [3](https://BestClinic.ru/diseases/dispareuniya/); \n* травмы (послеродовые разрывы, последствия хирургических вмешательств) [3](https://BestClinic.ru/diseases/dispareuniya/); \n* врождённые аномалии (гипертрофия девственной плевы, стеноз влагалища) [3](https://BestClinic.ru/diseases/dispareuniya/). \n\n**Психогенные факторы**: страх перед близостью, негативный сексуальный опыт, депрессия, тревожные расстройства, напряжённые отношения с партнёром [3](https://BestClinic.ru/diseases/dispareuniya/).\n\n## Симптомы\n**Основной симптом** — боль, возникающая во время или после полового акта [8](https://uteka.ru/articles/bolezni/dispareuniya/). Имеет различную интенсивность и характер, что зависит от причины и места её возникновения [8](https://uteka.ru/articles/bolezni/dispareuniya/). \n\n**Сопутствующие симптомы**: \n* жжение, зуд, раздражение в области вульвы [6](https://perm.fomin-clinic.ru/symptoms/bol-pri-polovom-akte/)[9](https://krasnodar.fomin-clinic.ru/symptoms/bol-pri-polovom-akte/); \n* сухость и дискомфорт во влагалище, особенно во время полового акта [9](https://krasnodar.fomin-clinic.ru/symptoms/bol-pri-polovom-akte/); \n* частые или болезненные мочеиспускания [9](https://krasnodar.fomin-clinic.ru/symptoms/bol-pri-polovom-akte/); \n* тянущие или резкие боли внизу живота вне полового акта [9](https://krasnodar.fomin-clinic.ru/symptoms/bol-pri-polovom-akte/).\n\n## Диагностика\n**При появлении болей во время полового акта нужно обратиться к гинекологу** [5](https://www.fdoctor.ru/simptom/boleznennost_polovogo_akta/). Врач проведёт обследование, чтобы найти причину диспареунии [5](https://www.fdoctor.ru/simptom/boleznennost_polovogo_akta/). Некоторые методы диагностики: \n* **Гинекологический осмотр** — позволяет оценить состояние наружных половых органов, слизистой влагалища и шейки матки [3](https://BestClinic.ru/diseases/dispareuniya/)[8](https://uteka.ru/articles/bolezni/dispareuniya/). \n* **Пальпация органов малого таза** — помогает обнаружить болезненность, напряжение мышц тазового дна или объёмные образования [3](https://BestClinic.ru/diseases/dispareuniya/). \n* **Лабораторная диагностика** — микроскопическое и бактериологическое исследование мазков из влагалища и цервикального канала для исключения инфекций, передающихся половым путём [3](https://BestClinic.ru/diseases/dispareuniya/).\n\n## Лечение\n**Лечение зависит от причины диспареунии** [5](https://www.fdoctor.ru/simptom/boleznennost_polovogo_akta/). 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