Painful Intercourse – Symptoms and Causes
Overview
Painful intercourse, medically known as dyspareunia, affects many people at some point in their lives. This condition involves genital pain that occurs before, during, or after sexual activity on a recurring basis.
The causes can be diverse, ranging from physical issues to psychological factors.
If you experience pain during intercourse, it’s important to consult with a healthcare professional. They can help identify the underlying cause and recommend appropriate treatments to address your specific situation.
Various effective treatments exist depending on what’s causing the discomfort. With proper medical guidance, this common problem can often be managed successfully.
Pain During Sex
Pain during sex can feel different for each person. You might have pain when something enters your vagina, like during sex or when using a tampon.
Some people feel deep pain during thrusting or a burning sensation. Others experience aching or throbbing that continues for hours after sex has ended.
When You Should Talk to a Doctor
If you regularly feel pain during sex, it’s important to speak with a healthcare provider.
Getting proper treatment can improve your sexual experiences, strengthen your relationship with your partner, and boost your self-confidence.
Don’t hesitate to discuss these symptoms, as they’re common and often treatable.
Why Sex Can Hurt
Pain when starting sex often comes from not having enough wetness. This happens when there isn’t enough foreplay.
Lower estrogen levels after menopause, childbirth or while breastfeeding can also cause dryness. Some medicines like antidepressants, blood pressure drugs, and certain birth control pills may reduce sexual desire and natural lubrication.
Injuries to the genital area can make sex painful. These might come from accidents, surgery, or cuts made during childbirth to help the baby come out.
Common causes of entry pain include:
- Infections in the genital area
- Skin problems like eczema
- Muscle spasms in the vaginal wall (vaginismus)
- Birth defects affecting the vagina
Pain Deep Inside
When pain happens with deep thrusting, it may be worse in some positions than others. Several health conditions can cause this type of pain:
| Condition | How it causes pain |
|---|---|
| Endometriosis | Tissue grows outside the uterus |
| Pelvic inflammatory disease | Infection in reproductive organs |
| Uterine fibroids | Non-cancerous growths in the uterus |
| Ovarian cysts | Fluid-filled sacs on the ovaries |
| Irritable bowel syndrome | Digestive condition affecting the colon |
Surgery scars, especially from hysterectomy (removal of the uterus), can lead to painful sex. Cancer treatments like radiation and chemotherapy can change tissues and cause pain.
Feelings That Affect Pain
Our emotions play a big role in sex and can contribute to pain. When you feel anxious or depressed, you might not become aroused enough, leading to discomfort.
Stress causes pelvic floor muscles to tighten, which makes sex hurt.
People with past sexual abuse may experience more painful sex, though not everyone with pain has this history.
The mind-body connection creates a cycle that’s hard to break:
- Pain during sex
- Fear of more pain
- Inability to relax
- More pain
This cycle often leads people to avoid sex altogether.
Risk Factors
Several conditions and circumstances can increase your chances of experiencing painful intercourse.
Medical Conditions
- Infections (vaginal, urinary tract, or pelvic)
- Endometriosis
- Ovarian cysts
- Pelvic inflammatory disease
- Vaginismus (involuntary tightening of vaginal muscles)
- Vulvodynia (chronic vulvar pain)
Physical Changes
- Vaginal dryness due to hormonal changes
- Tissue changes after childbirth
- Scarring from surgeries or injuries
- Skin conditions affecting genital area
Hormonal Factors
- Menopause and perimenopause
- Breastfeeding
- Certain hormonal medications
- Low estrogen levels
Psychological Factors
- Stress and anxiety
- History of sexual trauma
- Relationship problems
- Depression
- Negative body image
Certain treatments and surgeries can also contribute to painful intercourse. Cancer treatments like radiation therapy, hysterectomies, and other pelvic surgeries may change sensation or create scar tissue that causes discomfort.
Age-related changes play a significant role. After menopause, decreased estrogen levels often lead to genitourinary syndrome of menopause, causing thinning of vaginal tissues, reduced lubrication, and increased sensitivity during intercourse.
Medications can sometimes contribute to the problem. Some antihistamines, antidepressants, blood pressure medications, and birth control pills may reduce natural lubrication or affect sexual response.
