What are the main reasons for pain during sex. How can lack of lubrication affect intimate experiences. Why does vaginismus cause discomfort during intercourse. What role do psychological factors play in dyspareunia. How does endometriosis contribute to painful sex. Can irritable bowel syndrome impact sexual comfort. Why might pregnancy cause discomfort during intimacy.

Understanding Dyspareunia: When Intimacy Becomes Painful

Painful intercourse, medically known as dyspareunia, is a common issue affecting many women. While occasional discomfort may not be cause for concern, chronic pain during sex can significantly impact one’s quality of life and relationships. Understanding the underlying causes is crucial for proper treatment and regaining a fulfilling intimate life.

Lack of Lubrication: A Primary Culprit in Painful Sex

One of the most frequent reasons for discomfort during intercourse is insufficient lubrication. This can occur due to various factors:

• Inadequate foreplay
• Hormonal changes
• Certain medications
• Natural variations in vaginal moisture production

How can insufficient lubrication be addressed. Using a high-quality, pH-balanced lubricant can significantly enhance comfort during intimacy. It’s essential to choose products that won’t disrupt the vagina’s natural balance. For those experiencing chronic dryness, consulting a healthcare provider may reveal underlying issues requiring treatment.

Vaginismus: When Muscles Tighten Involuntarily

Vaginismus is a condition characterized by involuntary muscle spasms in the vagina when penetration is attempted. This can make intercourse painful or even impossible. Women with vaginismus often describe the sensation as a burning feeling or as if the penis is “hitting a wall.”

What causes vaginismus and how is it treated. The exact cause isn’t always clear, but it can be related to past trauma, anxiety, or physical conditions. Treatment typically involves a combination of approaches:

• Progressive desensitization exercises
• Pelvic floor physical therapy
• Kegel exercises
• Psychological counseling

Endometriosis: When Uterine Tissue Grows Outside the Uterus

Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. This can cause severe pain during intercourse, especially if endometrial tissue is present behind the vagina or on the lower uterus.

How does endometriosis affect sexual comfort. The misplaced tissue can cause inflammation, scarring, and adhesions, leading to pain during penetration. Managing endometriosis-related pain during sex may involve:

• Trying different sexual positions
• Using plenty of lubrication
• Practicing gentle, slow penetration
• Medical treatments prescribed by a healthcare provider

Psychological Factors: The Mind-Body Connection in Sexual Pain

Physical issues aren’t always to blame for painful intercourse. Psychological factors can play a significant role in sexual discomfort. These may include:

• Anxiety
• Depression
• Fear of intimacy
• Low self-esteem
• Past trauma or abuse

How do emotional factors contribute to painful sex. Psychological stress can lead to increased muscle tension and reduced arousal, making intercourse uncomfortable. Additionally, anxiety about pain can create a cycle where the fear of discomfort actually causes pain. Addressing these issues often requires a multidisciplinary approach, including counseling and sex therapy.

Vaginal Atrophy: The Impact of Hormonal Changes

Vaginal atrophy, also known as genitourinary syndrome of menopause, is a condition where the vaginal walls become thin, dry, and inflamed. This is primarily due to a decrease in estrogen levels, often associated with menopause.

Why does vaginal atrophy cause painful intercourse. The thinning and drying of vaginal tissues can lead to irritation, burning sensations, and pain during sex. Treatment options may include:

• Topical estrogen creams or rings
• Moisturizers and lubricants
• Hormone replacement therapy (in some cases)
• Regular sexual activity to improve blood flow

Irritable Bowel Syndrome: An Unexpected Source of Sexual Discomfort

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder that can unexpectedly impact sexual function. The connection between IBS and painful intercourse is often overlooked but can significantly affect a woman’s sexual experience.

How does IBS contribute to painful sex. IBS symptoms such as bloating, abdominal pain, and constipation can make penetration uncomfortable. Additionally, the anxiety and stress associated with IBS can lead to tension in the pelvic floor muscles. Managing IBS symptoms through diet, stress reduction, and medication can often help alleviate sexual discomfort.

Pregnancy: Changes in the Body Affecting Intimacy

Pregnancy brings about numerous physical changes, some of which can make intercourse uncomfortable or painful. While sex during pregnancy is generally safe, discomfort is not uncommon, especially during the first trimester.

Why might sex be painful during pregnancy. Several factors can contribute:

• Hormonal fluctuations leading to vaginal dryness
• Increased pressure on the bladder and pelvic area
• Breast and nipple tenderness
• Changes in vaginal pH increasing susceptibility to infections

It’s crucial to communicate with your healthcare provider about any persistent pain during pregnancy to ensure both maternal and fetal health.

Addressing Painful Intercourse: Steps Towards Comfort and Intimacy

Experiencing pain during sex can be distressing, but it’s important to remember that solutions are available. Here are some steps to address dyspareunia:

1. Communicate openly with your partner about your discomfort
2. Experiment with different positions and types of sexual activity
3. Use high-quality lubricants
4. Practice relaxation techniques
5. Seek professional help from a gynecologist or sexual health specialist

Is painful intercourse always a sign of a serious condition. While chronic pain during sex should be evaluated by a healthcare provider, it’s not always indicative of a severe problem. Many causes of dyspareunia are treatable with simple interventions or lifestyle changes.

The Importance of Professional Guidance in Managing Dyspareunia

When dealing with persistent pain during intercourse, professional medical advice is invaluable. A healthcare provider can:

• Perform a thorough physical examination
• Order necessary tests to identify underlying causes
• Recommend appropriate treatments or therapies
• Provide referrals to specialists if needed

How can one prepare for a medical consultation about painful sex. Keep a detailed record of your symptoms, including when the pain occurs, its intensity, and any factors that seem to improve or worsen the discomfort. This information can help your healthcare provider make an accurate diagnosis and develop an effective treatment plan.

Exploring Alternative Forms of Intimacy

While addressing the root causes of painful intercourse, couples may need to explore alternative forms of intimacy. This can be an opportunity to deepen emotional connections and discover new ways of expressing affection.

What are some alternatives to penetrative sex that can maintain intimacy. Consider:

• Mutual masturbation
• Oral sex
• Sensual massage
• Intimate touching and caressing
• Using sex toys designed for external stimulation

These activities can help maintain physical closeness while working through issues related to painful intercourse.

The Role of Pelvic Floor Physical Therapy in Treating Dyspareunia

Pelvic floor physical therapy is an increasingly popular and effective treatment for various causes of painful intercourse. This specialized form of therapy focuses on the muscles, ligaments, and connective tissues of the pelvic region.

How does pelvic floor therapy help with painful sex. A pelvic floor therapist can:

• Assess muscle tension and weakness
• Teach relaxation techniques
• Provide exercises to strengthen or relax pelvic muscles
• Use manual therapy to release tight tissues
• Offer guidance on proper posture and body mechanics

Many women find significant relief from dyspareunia through a combination of pelvic floor therapy and other treatments tailored to their specific condition.

Hormonal Treatments: Balancing Body Chemistry for Comfort

In cases where hormonal imbalances contribute to painful intercourse, various treatments may be recommended. These can range from topical applications to systemic hormone therapies.

What types of hormonal treatments are available for dyspareunia. Options may include:

• Topical estrogen creams or tablets
• Vaginal estrogen rings
• Systemic hormone replacement therapy
• Non-hormonal vaginal moisturizers

The choice of treatment depends on the underlying cause of the pain, the woman’s overall health, and her personal preferences. It’s crucial to discuss the benefits and potential risks of hormonal treatments with a healthcare provider.

The Impact of Chronic Pain Conditions on Sexual Function

Chronic pain conditions that affect other parts of the body can also contribute to painful intercourse. Conditions such as fibromyalgia, interstitial cystitis, and pelvic inflammatory disease can all impact sexual comfort and function.

How do chronic pain conditions affect sexual experiences. These conditions can lead to:

• Increased sensitivity to touch and pressure
• Generalized muscle tension and pain
• Fatigue that reduces sexual desire and arousal
• Psychological stress that interferes with sexual function

Managing these underlying conditions through medical treatment, pain management techniques, and lifestyle adjustments can often improve sexual comfort and satisfaction.

The Importance of Self-Care in Managing Dyspareunia

While medical treatments are often necessary for addressing painful intercourse, self-care practices can play a crucial role in managing symptoms and improving overall sexual health.

What self-care strategies can help alleviate pain during sex. Consider incorporating the following into your routine:

• Regular exercise to improve circulation and reduce stress
• Stress-reduction techniques like meditation or yoga
• Maintaining a healthy diet to support overall body function
• Getting adequate sleep to promote healing and reduce pain sensitivity
• Using warm baths or compresses to relax pelvic muscles

These practices, when combined with medical treatments, can contribute to a more comfortable and enjoyable sexual experience.

Navigating Relationship Challenges Related to Painful Intercourse

Dyspareunia can put a strain on intimate relationships, leading to frustration, misunderstandings, and reduced emotional intimacy. Open communication and mutual understanding are key to navigating these challenges.

How can couples maintain a strong relationship while dealing with painful intercourse. Consider these strategies:

• Engage in honest, non-judgmental conversations about the issue
• Explore non-penetrative forms of intimacy and affection
• Attend couples counseling or sex therapy sessions together
• Support each other through medical treatments and lifestyle changes
• Focus on building emotional intimacy alongside physical intimacy

Remember that addressing dyspareunia is a journey that requires patience, understanding, and teamwork from both partners.

The Role of Sexual Education in Preventing and Addressing Painful Intercourse

Comprehensive sexual education plays a vital role in both preventing and addressing issues related to painful intercourse. Understanding normal sexual function, anatomy, and the importance of communication can help individuals recognize and seek help for problems early on.

How can improved sexual education contribute to better sexual health. It can:

• Dispel myths and misconceptions about sex and pain
• Teach the importance of proper lubrication and arousal
• Encourage open communication about sexual needs and concerns
• Provide information on when to seek medical help for sexual issues
• Reduce shame and stigma associated with sexual problems

By promoting better understanding and open dialogue about sexual health, we can create an environment where individuals feel empowered to address issues like dyspareunia proactively.

Innovative Treatments on the Horizon for Dyspareunia

As research in the field of sexual medicine advances, new treatments for painful intercourse are emerging. These innovative approaches offer hope for those who have not found relief through traditional methods.

What new treatments are being developed for dyspareunia. Some promising areas include:

• Platelet-rich plasma (PRP) therapy for vaginal rejuvenation
• Low-level laser therapy to improve vaginal tissue health
• Bioidentical hormone treatments
• Novel drug therapies targeting specific causes of sexual pain
• Advanced pelvic floor biofeedback techniques

While many of these treatments are still in research stages, they represent exciting possibilities for the future of dyspareunia management.

8 Causes Of Painful Intercourse

Has the fun and excitement of intimacy been stripped from you due to discomfort and shame? If you are experiencing painful sex, don’t worry, you’re not alone. According to ACOG, pain during intercourse is very common—nearly 3 out of 4 women have pain during intercourse at some time during their lives. Occasional minor soreness is nothing to be concerned about, but chronic painful intercourse is worth discussing with your doctor. 

Some health issues can cause painful intercourse, like endometriosis, vaginal infections, and sexually transmitted diseases. Others — like vaginal dryness and irritation — can make sex uncomfortable. Understanding what might be causing your pain can help you get the treatment you need to improve your sex life. At Kernodle OB/GYN, we prioritize sexual education and health. Here are 8 causes of painful intercourse.

#1: Lack Of Lubrication

One of the most common causes of painful intercourse is lack of lubrication. This may result from a lack of foreplay, or some women’s vaginas are naturally “under-producers.” To get things started, lube is a great option. Make sure you browse carefully and choose one that won’t disrupt your vagina’s natural pH balance.     

#2: Injury Or Irritation

Injury or irritation to the vagina or vulva can cause painful intercourse. These injuries may include a cut from shaving, a tear from childbirth, or vaginitis, an inflammation of the vagina that can cause discharge, itching, and pain. 

#3: Vaginismus

Vaginismus is the squeezing or spasming of your vagina when something enters it, such as a penis, tampon, or even when a woman is touched near the vaginal area. These contractions are involuntary, meaning women can not control them. According to WebMD, Vaginismus is often described as a burning sensation, or like the penis is “hitting a wall.” Treatment includes progressive desensitization, including kegel exercises.    

#4: Vaginal Atrophy

Most common in women during menopause, vaginal atrophy is the thinning, drying, and inflammation of the vaginal walls. This often is due to your body producing less estrogen, but it can also happen during breastfeeding or while taking certain medications. For many women, this condition causes painful intercourse and other accompanying symptoms, including burning and frequent urination.

#5: Endometriosis

Endometriosis is a disorder in which tissue similar to the lining of your uterus grows outside your uterine cavity. It can grow in the ovaries, fallopian tubes, vagina, peritoneum, or intestine. If the endometriosis is behind the vagina in your uterus, it often causes pain during sex. Try using plenty of lubrication and practicing slow and gentle penetration to mitigate this pain. 

#6: Psychological Factors

Painful intercourse isn’t always caused by physical health problems. Emotional factors 

can lead to higher levels of cortisol, impacting your sex drive. Anxiety, depression, fear of intimacy, and low self-confidence about your physical appearance can lead to discomfort, shame or pain during sex.  

#7: Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is an intestinal disorder that can cause constipation, diarrhea, stomach cramps, and bloating. An additional unpleasant symptom of IBS is painful intercourse due to these GI symptoms. According to aboutibs.org, approximately 32% of women with IBS report concerns related to sexual functioning.

#8: Pregnancy

Your belly growing is not the only thing that changes during pregnancy. A few reasons sex may be painful during pregnancy, often during the first trimester, include:

• Hormonal changes causing your vagina to be dry
• Added pressure on your bladder
• An infection
• Your breasts/ nipples are tender and sore

If you are experiencing painful intercourse during pregnancy, you should always speak with your doctor or OB/GYN.

Looking to find out more regarding painful intercourse? We provide full-scope individualized women’s health care, including gynecological care, midwifery services, and low- and high-risk maternity care for women and their families. Contact Kernodle OB/GYN for more information. You can reach us online or at (336) 538- 2367.

Women’s Healthcare of Princeton: Gynecologists

Causes and Solutions for Painful Intercourse: Women’s Healthcare of Princeton: Gynecologists

Sexual intimacy is meant to be an enjoyable experience that draws you and your partner closer together. But when sex becomes painful, you may find yourself doing anything and everything just to avoid it.

While there’s no doubt that painful intercourse can have a major impact on your life and your relationship with your partner, it’s nothing to agonize over or feel embarrassed about. This fairly common problem — three in four women experience pain during sex at some point in their lives — can usually be resolved with the right approach.  

Here at Women’s Healthcare of Princeton in Princeton, New Jersey, we’ve helped many women overcome painful intercourse and restore their sexual health, and we’re confident that we can help you, too.  

The signs and symptoms of dyspareunia

Dyspareunia, or frequent pain during intercourse, involves feeling pain at any point just before, during, or following sex. This pain may affect part of your vagina, or you may feel it in your pelvic region, lower back, uterus, or bladder.

Some women feel pain only during sexual penetration, while others feel discomfort even when using tampons. You may experience deep pain with each thrust, or your pain may slowly emerge following normal sex. Some women continue to feel throbbing or burning pain long after intercourse.  

Possible causes of painful intercourse

Pain during sex happens to women for many different reasons, including physical problems, gynecological conditions, and emotional issues.

Emotions that inhibit arousal and interfere with lubrication can make intercourse painful, especially if those emotions make it difficult to relax. Shyness, embarrassment, sexual anxiety, and a lack of body confidence are just a few causes of emotions that might get in the way of a normal physical response.  

Shifting hormones is another thing that can disrupt your body’s sexual response and make intercourse uncomfortable. Low estrogen levels mean that women are more likely to experience vaginal dryness — and painful intercourse — as they approach menopause, but menopause isn’t the only time a woman’s estrogen levels might decline.

Some women experience vaginal dryness and painful intercourse following childbirth, as their hormone levels slowly recover; breastfeeding mothers may experience similar symptoms for as long as they continue to nurse. Receiving treatment for breast or ovarian cancer also can affect estrogen levels and lead to painful sex.

Other possible causes of discomfort during intercourse include pelvic floor muscle dysfunction, nerve damage, perineum trauma, and vaginismus — or the involuntary tightening of vaginal muscles during sex.

Treatment solutions for sexual discomfort

Finding the right solution for sex-related pain depends on its underlying cause. If that cause isn’t readily apparent, a more exhaustive investigation can often reveal the reason for persistent discomfort.

In addition to performing a comprehensive physical exam, including a pelvic exam, we ask about your medical history to find out if you have any conditions or take any medications that may obstruct your normal sexual response. We also ask about your sexual history, to find out if any events in your past affect how you feel about sex.  

Effective treatment for one woman may simply mean changing a prescription medication that interferes with natural lubrication, while a woman who’s living with the aftereffects of an episiotomy or perineum tear from a recent childbirth may get the best results from physical therapy or surgery.

Hormone replacement therapy (HRT), or the supplementation of reproductive hormones that your body no longer makes, has long been the go-to treatment option for menopausal women affected by vaginal dryness and sexual pain.

Although HRT in the form of low-dose topical vaginal estrogen can be highly effective for some women, it’s a short-term solution that isn’t medically appropriate for all women.

You should avoid HRT if you have a personal or family history of heart disease and related risk factors like high cholesterol and high triglycerides; you also should avoid it if you have a personal or family history of breast cancer, blood clots, stroke, gallbladder disease, or liver disease.

Laser therapy for vaginal health

If you’re looking for a safe, non-invasive way to address painful intercourse brought on by low estrogen levels, MonaLisa Touch® laser therapy is an innovative and highly effective long-term solution.

In addition to eliminating vaginal dryness without the need for messy lubricants, hormone replacement therapy, or surgery, laser therapy also helps prevent further complications, including vaginal atrophy.

MonaLisa Touch uses fractional CO2 laser technology to revitalize the tissues that line the vaginal canal. By restoring proper trophic balance to these tissues, the treatment directly addresses the underlying conditions that cause painful sex.

In just three quick treatment sessions, MonaLisa Touch activates the production of new collagen and revitalizes the vaginal mucosa to help restore normal vaginal functional and pain-free sexual intimacy.

MonaLisa Touch is successful for nearly 90% of women affected by hormone-induced vaginal dryness and sexual pain, and it’s an excellent solution for younger women, cancer patients, and other women who can’t safely receive HRT.  

We’re proud that Women’s Healthcare of Princeton was one of the first medical practices in the United States to offer MonaLisa Touch laser therapy, and our expert team has helped countless women put an end to painful intercourse, improve sexual health, and find renewed intimacy with their partners.

You don’t have to live with sexual pain — find out what we can do for you today!

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Contents

• Causes of pain during intimacy
• Possible diseases
• How to avoid pain during intercourse

Up to 60% of women have experienced genital pain before, during or after sex. Scientifically, this disorder is called dyspareunia. Pain during intimacy leads to reduced sex drive and lack of orgasm. This negatively affects relationships in a couple: the frequency of intimate contacts decreases, the quality of life of partners decreases1. Why does pain occur during sex and how to avoid it? The answers are in the article.

Causes of pain during intimacy

Pain during sex can be associated with both bodily diseases and psychological problems. In the first case, they are most often caused by inflammatory processes or injuries of the genital organs, and in the second – by mental factors ² .

The following causes of pain during intimacy are distinguished ² :

• vaginal dryness. Insufficient sexual arousal and a small amount of lubricant (lubrication) can lead to discomfort experienced in the area of ​​\u200b\u200bthe entrance to the vagina or its walls. A small amount of lubricant may also be due to insufficient levels of estrogen;
• irritation of the vaginal mucosa. May occur in some women when using foam, contraceptive creams or jellies, and condoms or diaphragms;
• first sexual contact. Pain occurs in a girl when exposed to an intact or incompletely torn hymen;
• accumulation of secretions under the hood of the clitoris. When the hood opens during sexual stimulation, discomfort may occur. To prevent this problem, the clitoris and its hood should be washed;
• oscillation of the ovaries or sprain of the uterine ligaments. May occur during strong coital tremors and cause pain in the depths of the pelvis;
• some positions for sex. Women may only feel pain in certain positions. The first aid is to avoid positions or movements that aggravate the pain;
• certain days of the menstrual cycle. Pain during sex appears in some women only during the period of ovulation;
• congestion in the pelvic area. When excited, blood rushes to the genitals. If the sex life is insufficient or not accompanied by discharge, then the genitals may hurt.

Mental factors that cause pain during sex include ² :

• negative ideas and fears associated with sexual intercourse;
• Relationship problems that created a negative sexual experience.

Possible diseases

Pain during intercourse occurs at any age. Women may complain of burning, sharp pain, spasms that are felt in the vagina, deep in the pelvis or in the abdomen ² .

Depending on the depth of sensations, pain during sex can be superficial (at the entrance) and deep ² .

Diseases causing entry pain include ^1.2 :

• vulvodynia. This is the name of the pain at the entrance to the vagina, a burning sensation, irritation. Pain is caused not only by sex, but also by pressure on the vulva: sitting position, cycling. The skin of the vulva is not changed, sometimes there is a slight redness, almost imperceptible. The exact cause is unknown, possibly related to infections or irritants;
• vaginismus. Painful sensations are associated with involuntary contraction of the muscles of the vagina when trying to insert a penis, a finger, a tampon there. Vaginismus is associated with a reflex reaction of the muscles, psychological factors;
• vaginitis. Yeast, bacterial and trichomonas infections cause inflammation of the vaginal walls, vaginitis, which, in turn, can lead to pain during intercourse. Inflammation is often accompanied by vaginal dryness, which can irritate the walls and increase the likelihood of vaginal infections;
• urethritis. Inflammation of the urethra may be accompanied by pain during sex, burning, false urge to urinate.

The pain that occurs during deep frictions is described by women with the words “as if something is being driven inside.” Here are some diseases that can cause deep pain during intimacy ^1.2 :

• endometriosis and adhesions in the pelvis. The cause of pain in deep pelvic tissues may be endometriosis – a disease in which cells of the inner layer of the uterus (endometrium) grow outside of it. Endometriosis and adhesions in the pelvis prevent the free movement of the internal genital organs and provoke pain;
• pathology of the appendages. Due to inflammation or cysts in the appendages, they can increase, become inactive. At the same time, pain occurs on one or both sides of the pelvis during sex;
• inflammation of the bladder. Soreness with cystitis during intimacy increases as the bladder fills. In women, the lower abdomen hurts, there is a feeling of pressure over the pubis, frequent urination, including at night, and strong urges.

Often, pain during intimacy appears in women after pregnancy and childbirth. Deep pain may be due to weakening of the pelvic floor muscles or damage to the uterine ligaments during childbirth, due to which the uterus deviates backward. Superficial soreness appears in the places of suturing the vulva. Sometimes the cause of postpartum pain cannot be determined, but gradually, over the course of a year, complaints may disappear spontaneously ¹ .

How to avoid pain during intercourse?

General advice to reduce pain during sex ² :

• have sex in a relaxed psychological state, before that you can take a warm bath;
• make the foreplay longer, which contributes to the natural hydration of the vaginal mucosa;
• if dry, use water-based lubricants;
• choose with a partner those positions in which pain does not occur;
• follow the rules of personal and intimate hygiene, safe sex, to avoid infection of the urinary and genital organs;
• for washing use special products with soothing and moisturizing properties, such as Defemilema® for sensitive skin ³ ;
• get regular medical check-ups and treat diseases that make sexual life painful.

It will also help to reduce pain in a woman ² :

• empty the bladder before sex;
• on the recommendation of a doctor, you can take an anesthetic;
• after sex, you can apply an ice pack to the vulva to reduce the burning sensation.

In the complex treatment of vaginal infections, local remedies are used, for example, Depantol® vaginal suppositories. Candles Depantol® have an antiseptic effect on fungi, protozoa, pathogens of sexual infections. Depantol® also accelerates the healing of wounds and cracks in the mucous membrane, thereby alleviating burning sensation and discomfort in the vagina ⁴ .

Kegel exercises are also used to treat pain during sex. They can help relax the vaginal muscles and reduce pain levels. In some cases, surgical treatment is required. Methods of physiotherapy are widely used. To eliminate psychological causes, psychotherapeutic techniques are practiced ² .

¹ Laurie J. Heim. Dyspareunia: assessment of each case and differential diagnosis. International Medical Journal. 2002; 3. https://medi.ru/info/5668/

² Kocharyan G.S. Dyspareunia as a clinical problem. Man’s health. 2020; 3 (74): 65-74. http://gskochar. com/kocharjan_g-s-dispareunija_kak_klinicheskaja_probl.pdf

³ Instructions for use Defemilem® for sensitive skin. Reg. beats RU.77.99.29.001.R.002963.08.21.

⁴ Instructions for medical use Depantol® vaginal suppositories (dexpanthenol 100 mg + chlorhexidine 16 mg). Reg. beats No. LSR-003902/07.

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