Pain during sexual intercourse, medically known as dyspareunia, refers to persistent or recurrent pain in the genitals. The painful sensations can occur before, during, or after sex, and they can have numerous causes ranging from physical changes in the genitals to psychological factors. If you experience pain during sexual intercourse, you should discuss your symptoms with your doctor — the treatment must be modified to address the specific root cause of your dyspareunia.
Symptoms of Painful Intercourse
- Genital pains during penetration
- Genital pains during every act of entry, including tampon usage
- Deep genital pains while thrusting
- Burning sensations in the genitals
- Dull aching sensations in the genitals
- Throbbing pains that last long after the intercourse
- Genitals pains that spread into other parts of the body
Root Causes of Painful Intercourse
Physical Causes
- Insufficient Lubrication: You might experience entry pains during penetration if you’re not sufficiently lubricated. Insufficient lubrication can happen due to a lack of arousal and foreplay or a drop in estrogen levels due to weight fluctuations, childbirth, menopause, nursing, and other factors.
- Medication Usage: Certain medications dull your appetite for sex and reduce lubrication, leading to entry pains. These usually include birth control pills, sedatives, antidepressants, and high blood pressure medications.
- Injuries or Trauma: You might experience entry pains due to injuries, trauma, or irritation on the genital regions. This might happen due to accidents, falls, wounds, pelvic surgeries, or childbirth.
- Skin Infections: Painful intercourse often occurs due to anomalies, infections, inflammations, or other forms of disorder on the genital skin or urinary tract.
- Vaginismus: This condition leads to involuntary pelvic muscle contractions, leading to painful sensations during intercourse.
- Congenital Problems: Some women experience painful intercourse due to structural problems they’ve had since birth, such as developing a membrane at the vaginal opening or an insufficiently developed vagina.
- Underlying Conditions: Deep genital pains can happen due to various underlying medical conditions, such as ovarian cysts, endometriosis, uterine prolapse, uterine fibroids, pelvic floor dysfunction, hemorrhoids, pelvic inflammatory disease, retroverted uterus, cystitis, irritable bowel syndrome, and adenomyosis.
- Pelvic Surgery: You might experience deep genital pains during sexual intercourse after pelvic surgeries like hysterectomies or cancer treatments.
Emotional Causes
- History of Sexual Abuse: Not everyone with a history of sexual abuse experiences dyspareunia. However, in some situations, a history of sexual abuse can create a mental barrier to sexual intercourse in general, leading to the experience of painful sensations.
- Stress: Women who lead stressful lives often experience discomfort during sex. That’s because stress releases hormones and chemicals that trigger the contraction of pelvic floor muscles, leading to painful intercourse.
- Underlying Psychological Issues: Painful sexual intercourse can also be traced to psychological issues, such as depression, anxiety, fears, body dysmorphia, and other factors that lead to stress and low arousal.
Diagnosing the Root Cause of Painful Intercourse
If you experience persistent or recurrent genital pains during intercourse, you should contact a reliable doctor. During your medical evaluation, the doctor might ask about your symptoms, sexual health history, lifestyle habits, medical history, childbirth, surgeries, and other personal information. It’s extremely important to provide accurate reports and answers without fear of shame or stigma. You may also have to discuss the frequency of your sexual encounters, the number of sexual partners, and sexual positions that cause pain.
It’s extremely important to provide accurate reports and answers without fear of shame or stigma.
The discussion will be followed by a pelvic examination. Your doctor will examine the pelvic region to look for signs of skin disorders, infections, inflammations, and structural problems that might cause discomfort. They might also pressure your pelvic muscles or genitals to identify the true locus of the pain.
Finally, they perform a visual examination of the vaginal canal using an instrument called a speculum. This device separates the vaginal walls, allowing the doctor to visualize the inner walls of your vagina. Some women experience mild discomfort during pelvic exams, but you should freely express how you’re feeling at every point.
In some cases, if the doctor suspects underlying health conditions, they might order additional tests, such as a pelvic ultrasound, CT scans, X-rays, etc.
Solutions for Painful Intercourse
Medications
If you experience painful intercourse due to underlying medical conditions, the doctor might prescribe medications to address the root cause. If you experience a loss of lubrication due to your current medications, you may be prescribed alternative medications. If your body doesn’t produce sufficient lubrication due to menopause or hormonal factors, you might receive topical estrogen for lubrication.
Osphena is an FDA-approved drug that treats moderate to severe dyspareunia in women with insufficient lubrication. While it helps with lubrication, it might also cause hot flashes and other side effects. Intrarosa is another suitable medication for women who experience painful lubrication. The medication is a capsule placed inside the vagina once a day to reduce pain during intercourse.
Therapy
If you experience painful sexual intercourse due to emotional or psychological factors, you might benefit from sex therapy or counseling. Cognitive behavioral therapy helps change negative thoughts and patterns, overcoming the mental barriers that keep you from enjoying sex. Furthermore, if the discomfort arises from intimacy issues with your partner, sex therapy might help you communicate better and overcome the pain.
Other Treatments
If you experience painful intercourse due to underlying medical conditions, such as uterine fibroids, pelvic floor dysfunction, hemorrhoids, pelvic inflammatory disease, etc., your doctor might recommend other treatments for the specific problem. Since the painful intercourse results from the medical condition, treating the root cause will allow you to resume your sexual activities comfortably.
Tips to Overcome Sexual Intercourse Discomfort
- Try different sexual positions to see which one works best.
- Communicate with your partner and clearly express what does or doesn’t feel good.
- Extend your foreplay to give your body plenty of time to lubricate.
- Use lubricants during sex to ensure a smooth passage.
- Masturbate to liberate yourself from another individual’s expectations and desires.
- Use clitoral suction sex toys, like our Namii, that provide indirect stimulation, minimizing the need for penetration.
- Explore non-vaginal forms of sexual intercourse, such as oral sex, mutual masturbation, etc.
