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Search the Health A-Z Search. If dyspareunia is not managed, it may result in a loss of sexual interest, mood changes and other psychological symptoms. A visual exam of your vagina, using an instrument called a speculum to separate the vaginal walls, may be performed as well. Is it supposed to hurt? Kissing, cuddling, massage, mutual masturbation and oral sex are all good alternatives and can expand your views on what makes a fulfilling sex life. Pelvic floor physiotherapy Soft tissue and vaginal massage Medications to reduce pain signals Relaxation skills Counselling. Penetration may be painful for some women because the muscles in the vagina spasm. Drawbacks are that the drug might cause hot flashes, and it carries a risk of stroke, blood clots and cancer of the lining of the uterus endometrium. It is not intended to provide specific medical advice or replace advice from your health practitioner.