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Description:Soft tissue and vaginal massage Medications to reduce pain signals Relaxation skills Counselling Emotional causes Feeling stressed, self-conscious, depressed or afraid of intimacy can affect your libido and make sex painful Sometimes dyspareunia begins as a physical problem but also affects your mental wellbeing and relationships, causing stress and anxiety The stress and anxiety can then make the physical problem worse Some women with dyspareunia may have a history of trauma including sexual or emotional abuse How is dyspareunia diagnosed? Your doctor may ask questions such as: Your sexual history, surgical history and childbirth experiences may also be relevant. Pelvic examination This is a physical examination where your doctor will check for signs of infection, irritation or anatomical problems. This may involve gently touching the genital and pelvic area to locate the site of the pain and inserting a speculum a plastic instrument that allows the doctor to see into the vagina.