If you experience pain during sex, you may feel embarrassed talking to your doctor about it. But there are plenty of treatments for painful intercourse. Having an open discussion with your gynecologist can help you get back to enjoying a healthy and satisfying sex life.
Here’s what you need to know about dealing with painful intercourse.
Is Painful Intercourse Common?
Yes — pain during sex is one of the most common types of sexual dysfunction for women. The American College of Obstetricians and Gynecologists says nearly 75% of women have pain during intercourse at some point in their lives. There’s even a medical term for painful intercourse in women: dyspareunia.
What Causes Pain During Sex in Women?
Pain during sex can have many different causes. They include:
Hormonal changes
When you’re in menopause or perimenopause (the time before menopause), your levels of estrogen drop. Decreasing levels of estrogen may cause vaginal dryness, which can lead to painful sex. Hormonal changes can also affect your body image and reduce your desire for sex.
Health issues
Pain during sex can raise a red flag that something else is wrong in your body. Some health issues can worsen or lead to other problems if you don’t treat them. They include:
- Endometriosis, uterine tissue outside the uterus, which can lead to scarring.
- Fibroid growths in the uterus.
- Inflammation of the vagina (vaginitis) caused by sexually transmitted infections, yeast infection, or bacterial infection.
- An injury to the vagina.
- Health issues such as arthritis, cancer, and diabetes.
- Muscle spasms around the vagina (vaginismus) that cause it to tighten.
- Ovarian cysts.
- Pelvic inflammatory disease.
- Prolapsed uterus. This is when the uterus bulges into the vagina because of a weak pelvic floor.
- Scar tissue from previous surgeries.
- Skin disorders (like contact dermatitis from scented soaps and douches). These can lead to painful cracks in the skin of the vulva.
- A urinary tract infection.
Sexual response problems
Pain during sex may have psychological roots. These problems make it difficult for your body to relax and can lead to discomfort during sex. They include:
- Body image issues.
- Memories of past traumatic events (such as abuse).
- Problems with sexual response (lack of desire or arousal).
- Relationship problems.
- Stress and fatigue.
- Vaginal dryness from a lack of foreplay before intercourse.
- Your mental state. Feeling embarrassment, guilt, or shame can make it hard to relax and become aroused for sex.
- Your partner’s sexual problems. If they take medicine for erectile dysfunction (ED), it can result in long, painful intercourse.
Other causes of pain during sex include:
- A birth control method (diaphragm or cervical cap) that doesn’t fit properly.
- Recent childbirth. If you gave birth within the past few months, you may not have fully healed. Sex can especially cause pain if you had an episiotomy or tear during delivery.
- Side effects of medicines that reduce sexual desire.
Symptoms of Painful Intercourse
Symptoms of painful sex vary depending on the cause. The pain may occur on the skin of the genitals, within the vagina, or deep inside the pelvis.
Pain during sex may happen every time or only occasionally. It may develop gradually or come on suddenly.
Symptoms of painful intercourse include:
- Cramping after sex.
- Extremely tender skin.
- Sharp, burning pain.
- Stinging.
- Vaginal dryness.
Talking to Your Doctor About Painful Sex
You should talk to your gynecologist if pain during sex happens regularly or if the pain is severe. Even if your pain isn’t severe but is still bothering you or interfering with your sex life, you should see a doctor.
Though talking to your doctor about painful sex may feel awkward, know that they have dealt with the issue before. Their job is to diagnose the problem and come up with possible solutions. If you’re honest with your doctor, you’re more likely to find relief and get back to enjoying sex.
Your doctor will ask you about your medical and sexual history, including how long sex has been painful. They’ll ask you about any traumatic sexual events in your past, such as abuse. They’ll also want to know about any medicines you’re taking.
Depending on your symptoms, your doctor will examine your outer genitals and may want to perform a pelvic exam. They’ll use a cotton swab to test for sensitivity to touch.
Your doctor may also want to run tests such as ultrasounds, computed tomography (CT) scans, or x-rays.
Treatment for Painful Intercourse
Treatment for painful intercourse will depend on the cause. Your doctor may suggest a mix of the following therapies.
At home self-care
You may find you can treat sexual pain yourself with some simple remedies.
- Nix perfumed soaps, bubble baths, and douches. Use mild soap and plain water to wash instead. Choose cotton underwear and loose clothing to reduce vulvar irritation.
- Try a vaginal moisturizer. Unlike lubricants, which you apply before sex, over-the-counter vaginal moisturizers offer long-term relief. You use them regularly — whether you’re planning to have sex or not.
- Try different sexual techniques. These might include extending foreplay, switching positions, and ways of getting intimate that don’t involve intercourse. Sexual activity like mutual masturbation or oral sex can help increase blood flow and lubrication.
- Use lubricants before sex if your problem is vaginal dryness. They’re available at drug stores or online. There are many different types of lubricants, so you may have to experiment to find one that works well for you.
Medical treatments
Medical treatment for painful intercourse depends on the cause. Your doctor may recommend:
- Antibiotics or topical corticosteroids for infections or skin problems.
- Surgery for endometriosis or pelvic organ prolapse. However, surgery is usually a last resort for painful intercourse.
- Topical pain medicine. When applied before and after sex, medicines like lidocaine can ease discomfort.
- Vaginal estrogen for dryness. You apply it directly to the skin, and it carries fewer risks of side effects than the pill form of estrogen.
Therapy
Seeing a therapist (either alone or with your partner) may help with the emotional and psychological roots of painful sex. Ask your gynecologist or doctor for suggestions for a counselor or sex therapist.