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What Causes Painful Sexual Intercourse?

Medically reviewed by Regina Victoria Boyles, MD · Pediatrics


Written by Regina Victoria Boyles · Updated Nov 16, 2022

    What Causes Painful Sexual Intercourse?

    Sexual intercourse gives pleasure to couples. But sometimes, it can be more painful than pleasurable. Some things can get in the way of intimate time with your partner. There are a couple of reasons for pain during sex, and we’ll discuss them here.

    What Is Painful Intercourse?

    Painful intercourse or dyspareunia refers to the recurring pain that women feel before, during, or after sex. The pain can be felt in the vagina, clitoris, or labia.

    Dyspareunia is more common in women than men. 75% of women will experience painful intercourse at least once in their lifetime, according to the American College of Obstetricians and Gynecologists.

    Keep in mind that sex is not supposed to be painful. Experiencing pain during sex is not normal. If you feel chronic pain before, during, or after sex, immediately inform your doctor.

    Symptoms of Painful Intercourse

    Painful intercourse symptoms include:

    • Sharp pain or burning sensation during penetration.
    • All sorts of penetration are painful; even inserting a tampon gives discomfort.
    • Manageable to severe pain in the vagina during thrusting.
    • The feeling of pain lingers a few hours after the intercourse.

    The pain a woman will feel through intercourse will depend on the positions and the partners she’s going to interact with. Keep in mind that if you feel some kind of pain or discomfort during sex, immediately inform your partner and your doctor.

    Reasons Behind Pain During Sex (Dyspareunia)

    There are a lot of reasons for pain during sex. Some are physical causes and others are emotional.

    Vaginal Dryness

    Pain during sex can occur due to insufficient lubrication. Vaginal dryness is often a result of lack of foreplay, but other factors may also be a cause, such as childbirth, breastfeeding, or a drop in estrogen levels after menopause.

    Certain medications can also affect a woman’s sexual desire, which results in dryness of the vagina and pain during sex. Such medications include antidepressants, birth control pills, and antihistamines.

    Vaginismus

    One of the most common reasons for pain during sex is Vaginismus. It is a condition that refers to the involuntary spasms of the muscles in the vaginal wall.

    The tightness of the muscles in the vagina results in painful penetration or no penetration at all.

    Trauma or Injury to the Vulva or Vagina 

    Past accidents or injuries might also cause dyspareunia. Injuries obtained from past surgeries in the pelvis and episiotomy (an incision made during childbirth) are some of the reasons for pain during sex.

    Skin Disorders or Infection

    Problems in the skin of the genitalia, such as eczema, contact dermatitis, and other skin disorders, can also negatively affect your intimate moments.

    Vaginal infections such as vaginitis, sexually transmitted infections (STI’s), urinary tract infection, and yeast infection are some of the leading causes of dyspareunia.

    Congenital Anomalies of the Vagina

    Vaginal abnormalities since birth also cause pain during sex. These vaginal anomalies include:

    • Vaginal agenesis or underdeveloped vagina and uterus.
    • Imperforate hymen where the hymen is completely blocking the vaginal opening.

    Other Illnesses or Underlying Medical Conditions

    Dyspareunia can also occur due to other underlying health problems.

    • Endometriosis is a common disorder in which the endometrium (the innermost lining of the uterus) grows outside the uterus.
    • Pelvic inflammatory disease is the infection of the female reproductive organs, which results in pain during sex or during urination.
    • Uterine prolapse happens when the uterus drops down into the vaginal canal due to the weakening of pelvic muscles and tissues. Muscles and tissues weaken because of pregnancy, difficulty in labor and childbirth, menopause, or obesity.
    • Retroverted uterus or tilted or tipped uterus occurs when the uterus tilts backward towards the rectum instead of forwards facing the navel.
    • Uterine fibroids are benign tumors that abnormally grow in the wall of the uterus. Uterine fibroids can cause uncomfortable and painful intercourse in women depending on its size and the area where it grows.
    • Cystitis or the inflammation of the urinary bladder has painful intercourse as its major symptom.
    • Irritable bowel syndrome (IBS) is a common disorder of the digestive system, specifically, the large intestines. IBS causes pain during sex when penetration is deep.
    • Adenomyosis is another uterine disorder where the endometrial tissues grow in the muscle walls of the uterus instead of the uterus lining. Women with adenomyosis have a tender uterus, making sexual intercourse painful.
    • Ovarian cyst is a fluid-filled sac that forms in one of the ovaries. These cysts can cause pain during sex, especially if they’re larger.
    • Ectopic pregnancy ensues when the fertilized egg implants itself outside the uterus. This condition can cause dyspareunia and be life-threatening as well.

    Emotional Causes

    Stress, anxiety, and depression are also major reasons for pain during sex. If you had traumatic sexual experiences in the past, it might trigger fear, stress, and anxiety during sex. These emotions might urge your body to react negatively every time you’re having intercourse.

    Another factor that might contribute to the emotional causes of painful intercourse is a woman’s experience of trauma regarding sexual abuse.

    Prevention

    Some causes of dyspareunia, either physical or emotional can still be prevented. Here’s what you can do:

    • To prevent vaginal dryness, try using lubricants. Water-based lubricants are best for women who are sensitive and are prone to vaginal irritation. You can also use a silicone-based lubricant as it lasts longer and is more slippery compared to water-based lubricants.

    Consulting your doctor about discontinuing medications that cause vaginal dryness can also help. Your doctor might also prescribe pills that might help with this condition if you have low estrogen levels.

    • Infections can be prevented by wiping your genitals from front to back every after restroom break. Urinating after sex helps in cleaning your urethra from harmful bacteria that might cause UTI’s and other vaginal infections.
    • Sexually transmitted diseases can be prevented by practicing safe sex with the use of protection like condoms. Having and maintaining a relationship with one person can greatly reduce your chances of acquiring STDs.
    • When you suffer from endometriosis, inform your partner to avoid deep penetration. You can also consider having intercourse on menstrual cycle days when the condition is not that painful.
    • Only engage in sex if you are comfortable and no feeling tired and stressed.
    • Find the best position that makes you comfortable and confident about your body.
    • Talk to your partner about your condition so they can adjust to your preference.
    • If you still feel pain during sex, apply a cold compress on your vulva to relieve pain.
    • When pain becomes intolerable and gradually intensifies, immediately call for an emergency or go to the nearest hospital.

    Treatment

    There are different treatments to address different causes of dyspareunia. All you need to do is to consult your gynecologist to find the culprit that’s been causing pain during intercourse.

    Then, your doctor might prescribe medications and treatments, sometimes, surgeries to treat or cure your condition.

    Remember not to self-medicate as it can worsen your vaginal problems.

    Key Takeaways

    Sex is supposed to be intimate, fun, pleasurable, and gives you that satisfyingly good feeling. However, some women tend to not enjoy this activity due to pain.

    If you are aware of what’s been happening in your body, address it immediately. Assess yourself and talk to your partner about your condition.

    Having a supportive partner will help lessen your stress and anxiety while dealing with dyspareunia.

    Always remember, sex isn’t supposed to hurt. Instead, sex is about enjoying an intimate relationship free from pain.

    Learn more about Sexual Wellness here.

    Disclaimer

    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Regina Victoria Boyles, MD

    Pediatrics


    Written by Regina Victoria Boyles · Updated Nov 16, 2022

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