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Painful Sex: Symptoms, Causes, and Treatment

Sex should be a pleasurable and fun part of our lives. It provides a wonderful way to explore intimacy as a couple or by yourself. However, many women experience pain during sexual intercourse. There are several causes of painful sex, also known as dyspareunia. Read on to discover helpful tips on how to stop sex hurting.

What is painful intercourse?

Dyspareunia is the medical term used to refer to genital pain that occurs before, during, or after sexual intercourse. It’s more common in women, and it affects 3 out of every 4 females at some point in their lives.
Painful sex can affect a woman’s body image, self-esteem, relationships, and even her plans to conceive. In some cases, dyspareunia can make women avoid sex entirely. 
A doctor is usually able to determine what causes sex to be painful, but women can feel reluctant to talk about it.

Symptoms of painful intercourse

Symptoms of painful intercourse can include:

  • Sharp, shooting pain.
  • A burning sensation.
  • Cramping pain.
  • Difficulty achieving orgasm due to the pain.
  • Low libido.
  • Some conditions can have other symptoms, such as genital itching or pain during urination.

Where is the pain felt?

Painful sex can be different for each woman. Some women feel pain after penetration, while others feel discomfort upon any genital contact. Some women experience painful sex only after their menopause.  
Pain can occur:

  • Inside the vagina.
  • In the vestibule or opening of the vagina.
  • In and around the vulva.
  • In the perineum, which is the area that stretches from your genitals to your anus.
  • In the lower back.
  • In the pelvic area.
  • Inside the uterus.

In some cases, women might have painless sex but then experience pain afterward. Others might feel pain not only during sex, but also during daily activities or while urinating.

Causes of painful sex

Some of the most common causes of painful sex include:

  • Vaginal dryness: this is common after menopause since hormonal changes can decrease a woman’s ability to produce lubrication. Other causes of vaginal dryness include oral contraceptives, breastfeeding, insufficient foreplay, and stress.
  • Infections: different infections can cause pain during sexual intercourse. For example:
  1. Yeast infections are characterized by an itchy, cottage cheese-like vaginal discharge. They are not considered a sexually transmitted disease since yeast is part of our normal microbiome and isn’t usually contagious. Candidiasis can be associated with oral contraceptives or recent antibiotic use, and some women are more prone to it.
  2. Urinary tract infections (UTI) cause a burning sensation while urinating.
  3. Gonorrhea.
  4. Urethritis.
  5. Bacterial vaginosis causes foul-smelling, gray, green, or white discharge.
  6. Pelvic inflammatory disease (PID).
  7. Chlamydia.
  • Endometriosis: this condition occurs when endometrial tissue, which is usually only inside of your uterus, spreads to other parts of your body.
  • Dermatitis: the skin in your genitals can become irritated by perfumed female hygiene products, new soap or detergent, or products that contain ingredients that you’re allergic to. This condition causes itchy, dry, red skin.
  • Vulvodynia: this term refers to pain at the vulva that isn’t associated with another medical condition. Vulvodynia can also cause pain after sitting for too long, or while inserting a tampon.
  • Vaginismus: this condition causes the muscles at the entrance of your vagina to painfully and involuntarily tighten, which causes pain when penetration is attempted. It can be caused by emotional and physical conditions.
  • Hymen lacerations: each woman has a different hymen. In some women, it is very small and never causes issues; however, a large or thick hymen can cause pain in the first sexual intercourse.
    Some women might have pain after their first sexual intercourse due to a hymen that hasn’t been completely perforated. 
Other causes of pain when having sex include:
  • Hemorrhoids.
  • Postmenopausal atrophic vaginitis.
  • Cervicitis.
  • Ovarian cysts.
  • Uterine prolapse.
  • Bartholin’s abscess.
  • Depression or anxiety.
  • Past sexual or emotional trauma.

How can you stop the pain?

The treatment for painful sex will depend entirely on its cause. The good news is that after the cause of your discomfort is discovered, you’ll be able to get appropriate treatment to make sex pleasurable again.

Communication

Communication is an important factor in every relationship, and you shouldn’t feel ashamed to talk to your partner about the discomfort you’re experiencing. Repeatedly trying to have sex while you’re in pain can lead to emotional repercussions and negative associations in the future. Discuss what you’re feeling with your partner; simply talking about it can take a big weight off your shoulders.

Medications

Depending on what is causing sex to be painful for you, your doctor could prescribe different medications. The medications used to relieve painful sex include:

  • Antibiotics: for bacterial infections, such as urinary tract infections or pelvic inflammatory disease.
  • Antifungals: for mycotic infections like candidiasis. Keep in mind that these products are the best way to treat yeast infections. 
  • Non-steroidal anti-inflammatory drugs (NSAIDs): such as ibuprofen or naproxen; these can be used to relieve your symptoms.
  • Estrogen creams: these can be prescribed after menopause to relieve vaginal dryness.
  • Oral contraceptives: birth control pills are used to control some causes of painful intercourse, such as endometriosis and ovarian cysts.

Home remedies for painful sex

If your discomfort is caused by insufficient lubrication, you can ask your partner to spend more time on foreplay and use a lubricant. Many times, these steps can be enough to make intercourse stop hurting.
Keep in mind that oil-based lubricants can damage condoms, so stay clear of these products if you use condoms. Better choice is to use water-based lubricants.

If you are suffering from allergic dermatitis, you can switch to unscented products and wear cotton underwear to help your skin heal.
Women who only experience painful sex occasionally and don’t have any other symptoms can consider whether certain sexual positions or deep penetration are the cause of the issue. Gentler intercourse and a change of positions can be helpful.

When should you see a doctor?

You shouldn’t try to diagnose the cause of your dyspareunia yourself or self-medicate. Douching is also contraindicated since it can actually irritate you and predispose you to infections.

Even if you aren’t currently experiencing dyspareunia, women who are over 21 years old or sexually active are advised to get regular gynecological check-ups.

How my doctor can help me reduce pain during sex?

Your doctor is the best person to diagnose what causes pain during sex, order diagnostic procedures, and prescribe treatment.
Some conditions, such as severe endometriosis or ovarian cysts, can require surgical procedures. Pelvic floor physical therapy can also be recommended in certain cases.
If your dyspareunia is caused by past traumatic experiences or other emotional circumstances, you can ask your doctor for a referral to a certified sex therapist. Different types of approaches, especially cognitive behavioral therapy, can be helpful in managing pain during sex.
While treating painful sex can require dedication and time, it is possible to overcome it and enjoy pleasurable sex again!

https://www.obgynqueensnyc.com/dyspareunia-treatment-specialist/
https://www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999
https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet#q4
https://www.healthline.com/health/endotough/why-sex-painful
https://www.ncbi.nlm.nih.gov/pubmed/25369624

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