Female Pain During Sexual Intercourse (Dyspareunia): Causes & Treatments

Written by WebMD Editorial Contributors

• What Causes Painful Sex in Women?
• How Can Painful Sex In Women Be Treated?

Intercourse pain, or dyspareunia, can cause problems in a couple’s sexual relationship. In addition to the physically painful sex, there is also the possibility of negative emotional effects. So the problem should be addressed as soon as it arises.

In many cases, a woman can experience painful sex if there is not sufficient vaginal lubrication. When this occurs, the pain can be resolved if the female becomes more relaxed, if the amount of foreplay is increased, or if the couple uses a sexual lubricant.

In some cases, a woman can experience painful sex if one of the following conditions is present:

• Vaginismus. This is a common condition. It involves an involuntary spasm in the vaginal muscles, sometimes caused by fear of being hurt.
• Vaginal infections. These conditions are common and include yeast infections.
• Problems with the cervix (opening to the uterus). In this case, the penis can reach the cervix at maximum penetration. So problems with the cervix (such as infections) can cause pain during deep penetration.
• Problems with the uterus. These problems may include fibroids that can cause deep intercourse pain.
• Endometriosis. This is a condition in which the tissue similar to that which lines the uterus grows outside the uterus.
• Problems with the ovaries. Problems might include cysts on the ovaries.
• Pelvic inflammatory disease (PID). With PID, the tissues deep inside become badly inflamed and the pressure of intercourse causes deep pain.
• Ectopic pregnancy. This is a pregnancy in which a fertilized egg develops outside the uterus.
• Menopause. With menopause, the vaginal lining can lose its normal moisture and become dry.
• Intercourse too soon after surgery or childbirth.
• Sexually transmitted diseases. These may include genital warts, herpes sores, or other STDs.
• Injury to the vulva or vagina. These injuries may include a tear from childbirth or from a cut (episiotomy) made in the area of skin between the vagina and anus during labor.

• Vulvodynia. This refers to chronic pain that affects a woman’s external sexual organs — collectively called the vulva — including the labia, clitoris, and vaginal opening. It may occur in just one spot, or affect different areas from one time to the next. Doctors don’t know what causes it, and there is no known cure. But self-care combined with medical treatments can help bring relief.

Some treatments for painful sex in women do not require medical treatment. For example, painful sex after pregnancy can be addressed by waiting at least six weeks after childbirth before having intercourse. Make sure to practice gentleness and patience. In cases in which there is vaginal dryness or a lack of lubrication, try water-based lubricants.

Some treatments for female sexual pain do require a doctor’s care. If vaginal dryness is due to menopause, ask a health care professional about estrogen creams or other prescription medications. Other causes of painful intercourse may also require prescription drugs.

For cases of sexual pain in which there is no underlying medical cause, sexual therapy might be helpful. Some individuals may need to resolve issues such as guilt, inner conflicts regarding sex, or feelings regarding past abuse.

Call a doctor if there are symptoms such as bleeding, genital lesions, irregular periods, vaginal discharge, or involuntary vaginal muscle contractions. Ask for a referral to a certified sex counselor if there are other concerns that need to be addressed.

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Overview

For some women, pain during sex is all too common. As many as 3 out of 4 women in the United States have reported feeling pain during intercourse at some time during their lives.

“Dyspareunia” is the scientific medical term for painful intercourse. It refers to pain that can be felt before, during, and after sex.

The pain may occur anywhere in your genital area. For example, many women with this symptom report pain that occurs:

• in and around the vulva
• in the vestibule, which is the very opening of the vagina
• in the perineum, which is the delicate area of soft tissue between the vagina and the anus
• within the vagina itself

Some women report also feeling pain in their lower back, pelvic area, uterus, or even bladder. This pain can make sexual intercourse difficult to enjoy. In fact, an international study found some women will avoid sex altogether.

Diagnosing dyspareunia can be extremely difficult for doctors because the condition is so often complicated by emotional discomfort and shame. Many women feel embarrassed to tell their doctors that they’re avoiding sex because it hurts too much.

There are many possible causes of dyspareunia, ranging from simple infections or vaginal dryness to more complicated conditions such as ovarian cysts or endometriosis. Natural life events, such as childbirth or aging, can also cause dyspareunia. Even so, many women associate painful sex with a fear of sexually transmitted infections or feelings of failure.

If you’ve been experiencing painful sex, you’re not alone. Here’s a closer look at some conditions linked to painful sex, along with their symptoms.

Contact dermatitis

Contact dermatitis is a skin issue that can cause tears or cracks in the delicate skin of your vulva. This makes sex very painful. It’s often brought on when women have allergic reactions to perfumed soaps, lubricants, condoms, or douches.

Endometriosis

Endometriosis occurs when the tissue that normally lines the inside of your uterus is found in other parts of your body, usually the pelvic region. Symptoms may appear in ways that make it difficult to diagnose the condition. For example, symptoms can include an upset stomach, diarrhea or constipation, upper body pain, excessive urination, or a painful stabbing sensation. This array of symptoms is often mistaken for other conditions, such as appendicitis, irritable bowel syndrome, mental illness, or ovarian cysts.

Vulvodynia

This condition occurs when chronic pain in your vulva lasts for more than three months, and isn’t linked to a general infection or medical condition. The sensation felt is generally described as burning, and it can be irritated simply by sitting for too long.

Vaginitis

Some women with vaginitis experience painful inflammation. It’s often caused by a bacterial or yeast infection. Others develop the condition during menopause or after contracting a skin disorder.

Vaginismus

Vaginismus is a condition that causes vaginal muscles at the opening of your vagina to painfully spasm and tighten involuntarily. This makes it difficult or even impossible for a penis or sex toy to enter. This condition can have both physical and emotional causes. These causes can include hormonal changes, fears about sex, injuries, or skin conditions. Many women with vaginismus have difficulty using tampons and getting pelvic exams.

Ovarian cysts

If women have larger ovarian cysts, they can be aggravated by the penis during sex. These cysts are sometimes even torn open, leaking fluid. Ovarian cysts can be caused by another underlying condition, such as endometriosis, or can develop during a pregnancy.

Pelvic inflammatory disease (PID)

PID leaves the fallopian tubes, ovaries, or womb inflamed. In turn, this makes sexual penetration very painful. This condition is often a sign of a larger issue caused by an infection. It should be treated right away.

There are a range of other reasons painful sex may occur, including:

• vaginal dryness
• extreme fatigue
• problems within a romantic relationship
• uncertain feelings toward sex that might stem from shame, guilt, fear, or anxiety
• everyday life stresses around work or money
• changing estrogen levels or atrophy caused by perimenopause or menopause
• allergic reactions to perfumed soaps or douches
• medications that effect sexual desire, arousal, or lubrication such as certain birth control drugs

If you’re experiencing painful sex, it may be helpful to consider if using a lubricant would help. Think about whether you’ve started using any new products recently that might be irritating your skin.

If your symptoms don’t improve, it’s important to seek medical advice. Your doctor can determine if you might have a health condition that needs treatment.

Your doctor can help you determine what may be causing you pain during sex. When talking to your doctor, it’s helpful to be specific. Try to provide details about exactly where the pain is coming from and when it occurs. For example, does it occur before, after, or during sex?

Some women find keeping a journal that documents their recent sexual history, feelings, and pain levels to be helpful. If you take notes about your symptoms, you can bring them to your appointment. Remember, your doctor wants to help figure out what’s causing the pain, and to help make it stop.

Sex is supposed to be pleasurable, and it can be frustrating when it’s not. If you’re experiencing pain during sex, you’re not alone, and it’s not your fault. Talking to your doctor may be the first step you take toward learning what’s causing your pain and ultimately finding a treatment.

Pain during sex, common causes and symptoms

Most people think that the word “sex” should only evoke positive associations. This is tenderness, pleasure, unity of lovers and incredible pleasure. It is, but when women experience discomfort during intercourse, it is difficult to enjoy. Such a problem as pain during sex is quite common. According to surveys by the American Congress of Gynecologists, 75% of sexually active women periodically complain of pain during sex.

Undoubtedly, discomfort or pain during sexual intercourse affects the emotional state of a woman and the relationship of partners. To prevent this from happening, you need to find out as soon as possible why pain occurs during sex and eliminate all possible causes. Qualified gynecologists of the UROSVIT medical center will help to do this, because the causes of pain during intercourse and ways to eliminate them have long been known. Consider the most common of them.

Skin problems

Very often, pain during intercourse occurs due to problems with the mucous membranes and delicate skin of the female genital organs. It could be ulcers, dermatitis, or allergic reactions to certain skin care products that have caused the pH imbalance. In such cases, doctors recommend looking for the cause in perfumed soap and other intimate hygiene products. The cause of skin problems can also be the use of lubricants, some components of which sometimes cause allergic reactions.

Inflammatory diseases

The most common inflammatory disease that causes pain in the lower abdomen is cystitis – inflammation of the bladder. This disease is accompanied by a large number of unpleasant symptoms, such as sharp pain, burning and frequent urge to urinate. In women in this state, as a rule, sexual desire disappears, and during sexual intercourse, pain and discomfort are exacerbated. It is important to identify the disease, its causes and prescribe treatment in time, otherwise cystitis can become chronic and cause inflammation of the kidneys.

Another inflammatory condition is vaginitis, an inflammation of the vagina caused by a bacterial or fungal infection. Very often accompanied by specific discharge and discomfort and requires immediate treatment.

Vaginal dryness

Dryness of the mucous membranes can cause discomfort during intercourse. As a rule, such a symptom is observed in women during periods of menopause or premenopause. In this case, vaginal dryness is considered normal, and to alleviate the symptoms, there are various life hacks to reduce pain, in particular the use of lubricants (special lubricant gels that help moisturize the genitals when their mucous membranes are dry). However, vaginal dryness can also occur in young women. Often the cause is a hormonal imbalance, in particular low estrogen levels.

Since dryness affects sexual life and entails the risk of various infections, you should consult a doctor to solve the problem.

Vaginismus

Vaginismus is a condition in which there is an involuntary spasm of the muscles of the vagina that prevents penetration of the penis and causes pain. Most often, this condition occurs during the first attempt to have sex, which is caused by the girl’s fear. However, research suggests that about 1% of women suffer from vaginismus periodically. Often it is caused by psychological problems and is treated with behavioral therapy.

Latex condom allergy

Every woman is unique. Therefore, not always the same product is equally suitable for every woman. There is a small percentage of the fair half of humanity who are allergic to latex or other materials used in the manufacture of condoms. Such women experience discomfort already at the beginning of the act with the introduction of the penis and, as a rule, do not enjoy sex. In this case, it is worth changing the type of contraceptives. If you can not do it yourself, you should consult a gynecologist.

Endometriosis and adenomyosis

Endometriosis is a common disease in women of reproductive age, which can have different localization and symptoms. Very often, these are pains during intercourse, discomfort of a different nature during menstruation and other periods of the menstrual cycle, fatigue, decreased performance. It is important to recognize the symptoms in time and consult a doctor, because in the early stages, successful drug treatment is possible without the use of surgery.

Similar in symptoms and course to the aforementioned disease, there is another one – adenomyosis. And although experts call it a benign pathological condition, it still requires prompt treatment.

Psychological causes

Very often, the occurrence of discomfort during intercourse is caused by psychological problems. As a rule, a woman feels a certain tension and cannot fully relax if her thoughts are occupied with problems at work, household chores, or she feels shame, stress, anxiety.

Relationship problems with a partner can be another factor of tension. Lack of trust, mutual understanding, care on the part of a man can affect the decrease in a woman’s sexual desire and cause discomfort during sex.

Such reasons can be easily solved by expressing your fears and worries in a conversation with a partner. If the problems lie deeper and cannot be solved on their own, you should contact a psychologist.

causes and what to do?

Problems in intimate life due to pain or discomfort are experienced by a large number of women. Feelings of discomfort during intercourse and the desire to stop it as soon as possible can be signs indicating the development of a pathological process, which can only be diagnosed by a specialist. However, the delicacy of the issue does not always allow the fair sex to seek help.

It is worth noting that embarrassment and a sense of shame should not stop and delay a visit to the doctor, it is better not to. After all, pain during intimacy can not only lead to serious problems with self-esteem, to depression, but can also cause complications. Dyspareunia (pain during sexual contact) sometimes acts as a sign of diseases of an inflammatory and non-inflammatory nature.

Inflammatory diseases

• Inflammation of the uterine appendages. This disease is called adnexitis, salpingoophoritis. Most often, this pathology develops against the background of a decrease in immunity or hypothermia. During sex, a woman experiences aching pain in the lower abdomen, bilateral or unilateral (depending on the side of the lesion of the fallopian tubes or ovaries). The pain may also radiate to the sacrum. It is worth noting that in addition to painful intercourse, the disease is also characterized by general symptoms in the form of fever, “weakness”, and malaise.
• Vulvovaginitis is an inflammation of the vulva and vagina. Pain during intercourse is caused by swelling and inflammation of the tissues of the female genital organs. Particularly unpleasant sensations occur during the introduction of the penis. The causes of vulvovaginitis are many: from non-specific bacterial and fungal infections to sexually transmitted diseases. In addition to painful intercourse, vulvovaginitis accompanies a number of symptoms, such as itching, burning, redness and swelling of the external genitalia, vaginal discharge with an unpleasant odor.
• Cervicitis is an inflammatory disease of the cervix that develops under the influence of various agents, both infectious and non-infectious. There can be many reasons for the appearance of cervicitis: most often it is caused by sexually transmitted infections: gonococcus, chlamydia, Trichomonas, herpes simplex virus, as well as various gynecological diseases, allergic reactions and reduced immunity. Symptoms of this pathology: grayish, pale yellow or spotting, pain in the lower abdomen, temperature, dyspareunia. Most often, cervicitis is diagnosed in women who are sexually promiscuous, often changing sexual partners, and have a history of sexually transmitted diseases.

There are non-inflammatory diseases that can provoke dyspareunia.

• Endometriosis. Often confused with the endometritis described above. However, the differences are enormous. Endometriosis is a chronic disease of the female reproductive system, characterized by the growth of tissue very similar to the lining of the uterine cavity – the endometrium – beyond it. Endometriosis is manifested by chronic pain syndrome and infertility. Scanty spotting begins, as a rule, a few days before the start of a new menstrual cycle and is accompanied by pain in the pelvic area, dyspareunia.
• Atrophy of the female genital mucosa. This is a condition in which the vaginal epithelium becomes drier and thinner. Most often, this phenomenon occurs during peri- and postmenopause due to a decrease in estrogen production. Also, vaginal atrophy is diagnosed in women after the removal of the ovaries or with a decrease in their function. With such a pathology, sex is unlikely to give pleasant sensations.
• Cervical erosion is one of the most common gynecological diseases, which is manifested by a violation of the integrity of the mucous membrane of the cervix. It is almost asymptomatic, sometimes there is contact bleeding during sexual contact, as well as pain or discomfort during sex.
• Violations of the integrity of the epithelium of the vulva and vagina cause discomfort in the intimate area (itching, burning, irritation). Too active sexual intercourse, discrepancy between the anatomical features of sexual partners, childbirth, etc. can provoke damage to the mucous membranes and skin. In the presence of injuries and microcracks, having sex is very careful. And some experts even recommend sexual rest until the tissues are completely restored.

In addition to all of the above, pain during sexual contact may be due to adhesions in the pelvic area. Pain sensations are dull and aching in nature, and their intensity may decrease or increase depending on the chosen body posture.

The main thing in the case of dyspareunia is not to self-medicate, even if it is very embarrassing and embarrassing to go to the doctor. There are many causes of dyspareunia, so you may need the help of several doctors at once. Often a woman experiencing pain during sexual intercourse communicates with a gynecologist, but sometimes it is necessary to take into account the presence of psychosomatic disorders. Here you can not do without a sex therapist. The profile specialist will collect an anamnesis, conduct an examination. Most likely, additional laboratory and clinical studies will be prescribed: ultrasound of the pelvic organs, blood and urine tests, a vaginal smear, and others.

Sex doesn’t have to be painful. But sometimes it happens that changes in the body or external factors lead to pain during sex. If the pain is associated with swelling, dryness, itching, burning, discomfort of the vulva and vagina, or the presence of microdamages, Epigen Intim Spray can become your ally in the fight against dyspareunia.

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Epigen Intim Spray is a drug that contains activated glycyrrhizic acid synthesized from licorice root. The drug has a complex therapeutic effect: anti-inflammatory, immunostimulating, antipruritic and regenerating.

The medicine helps to eliminate edema and inflammation, restore the skin and mucous membranes of the external genital organs, relieve itching.