When Sex Is Painful – What Does It Mean?

Believe it or not, painful intercourse has a specific medical term, dyspareunia. It can occur for a wide range of reasons, ranging from the psychological to the physical. While the very occasional occurrence of discomfort or pain during sex is normal, it is always worth discussing the issue with your OB/GYN.

If you experience painful intercourse on a more regular basis, don’t ignore it. Make an appointment with your gynecologist so she can help you get to the bottom of it. Painful intercourse is not only physically debilitating, it may be the sign of a more serious condition that requires treatment. Also, it can begin to erode healthy romantic relationships and will detract from your ability to enjoy sex.

Common symptoms of painful intercourse include:

• Burning or aching pain during or after sex.
• Pain that occurs only during sexual insertion.
• A deep pain that seems to occur during thrusts. It may feel like something is being shoved or bumped.
• Pain with any kind of insertion, including inserting a tampon.
• Pain or discomfort that only occurs in certain positions, with specific partners, and/or in certain scenarios.
• A new pain that begins after a history of pain-free intercourse

What are the causes of painful intercourse?

Insufficient lubrication. Lubrication is nature’s way of decreasing friction against the vaginal tissues. While a little friction is a good thing, too much can be incredibly painful. Insufficient lubrication can be the result of insufficient foreplay. The more turned on you are, the more lubrication your body secretes in preparation for intercourse. Hormonal changes can also alter natural lubrication, common for women experiencing menopause, pregnancy, or breastfeeding. It can also be a sign you are not psychologically comfortable with the situation. Try using a water-based lubricant from your local pharmacy and consult your OB/GYN.

Peri-menopause and menopause. If you are in your 30s or beyond, there is a good chance your pain is linked to peri-menopause (the beginning stages of menopause) or actual menopause. One of the side effects of the rampant hormonal changes that occur during this time is a decrease in natural lubrication and a decrease in vaginal tissues, which can make them particularly sensitive. Both of these conditions can usually be treated or greatly improved.

Potential medical conditions. There are several diagnosable conditions that can cause pain during sexual intercourse. Some of these include:

• Pelvic inflammatory disease
• Endometriosis
• Ovarian cysts
• Vaginal, cervical or uterine infections
• Issues pertaining to the ovaries
• An ectopic pregnancy
• Injury or irritation around the vulva, clitoris, vaginal wall or cervix
• Having sex too soon after childbirth or surgery
• Pelvic organ prolapse (POP)

Psychological reasons for pain during sexual activities

Sometimes, pain or discomfort during sex is the mind and body’s way of warning us that something needs to be addressed. Women who have been sexually abused, or have had negative experiences with sexual intercourse, can begin to experience pain or discomfort, even when they’re with a partner who is loving and caring. Other times, painful sex is the body’s way of saying it is not okay with the particular person, activity, and/or scenario involved in that particular experience. Pay attention to your body’s cues and seek help from a trusted doctor, therapist, or friend. In most cases, pain caused psychologically can be treated.

How is painful intercourse treated?

If your pain is related to a psychological connection or experience, a therapist is probably your best bet. Even talking to one of your best friends or a trusted female elder might be enough to help.

If painful intercourse is caused by a physical condition, don’t assume you will need medical intervention. Sometimes it is simply a matter of using a lubricant, increasing foreplay (few women have ever complained about that!), or giving your body extra time to heal from an infection, surgery, or childbirth. There are cases where treatment for sexual pain may require a doctor’s assistant, in which case your treatment will depend on the cause of the pain.