What are the Causes of Pain During Sex?

The medical term for painful intercourse is dyspareunia, which is defined as persistent or recurrent genital pain that occurs just before, during, or after sex. If you’re having painful intercourse, speak to your healthcare professional— treatments will focus on the cause, and can help eliminate or lessen this common problem.

Many women experience painful intercourse at some point in their lives. You might feel pain upon penetration, deep pain during thrusting, burning or aching pain, or even throbbing pain that persists hours after intercourse.

If the problem is consistent or recurrent however, it may be the result of anything from structural problems to psychological concerns. If you have recurrent pain with sex, talk to your healthcare provider— treating the problem can help your emotional and mental health, your self-image, and the pain itself. The causes of pain with sex can differ depending on whether the pain occurs only at entry, or with deep penetration.

Pain at Entry

This can be associated with many factors, including:

Pain During Deep Penetration

Causes for consistent pain during intercourse or deep thrusting might include:

How Can Painful Intercourse be Diagnosed?

To diagnose whether your discomfort is recurrent, or persistent, you might be subject to a medical evaluation from your healthcare provider. This will usually begin with your medical history, such as asking when your pain began, where it is located, how it feels and if it happens with every partner or sexual position. It is normal to be a little uncomfortable or embarrassed, but don’t let this stop you from answering truthfully. You are not the only person to experience discomfort during intercourse, and by being open with your doctor, they can more accurately discover the cause of your pain.

The next step is usually a pelvic exam, where your doctor will check for signs of irritation, infection, or obvious anatomical complications such as an imperforate hymen. They might also try to locate your pain by applying gentle pressure to your genitals or pelvic muscles. The examination might include the use of a speculum as well, like the kind used during cervical screening or a Pap smear. The vaginal walls will be gently separated to provide a closer look inside. If this becomes painful as well, you can always ask to stop the exam, and there are other options.

For example, your doctor might suspect certain things to be the cause of painful intercourse and recommend a pelvic ultrasound. This will most likely be transvaginal, consisting of a small transducer wand inserted into the vagina to produce sound waves and capture the reflections as images on a video screen. This can help your health provider discover if you are suffering from something like ovarian cysts, or endometriosis.

How Can Pain During Sex be Treated?

Once your doctor has determined the cause and severity of your pain, you will be recommended a treatment. This will usually take the form of medication, or therapy. In some cases, if your pain during sex is revealed as a symptom of a larger problem, you may be recommended surgery— in this way, treating the larger problem will help resolve your painful symptom.

Medical Treatments

For many women, especially post-menopause, painful intercourse can be caused by inadequate lubrication caused by low levels of oestrogen. Often, this can be treated with:

If your pain is diagnosed as a symptom of endometriosis, chronic pelvic pain, or ovarian cysts, you will likely be recommended medical treatments more specifically suited to resolving those conditions. Find out more through the linked articles.

Non-medical Treatments

Sometimes, if the cause of your painful intercourse is psychological, tied to your emotions or stress, the best course of treatment might be non-medical. This might take the form of counselling or sex therapy. If sex has been painful for you for some time, you might have developed a negative emotional response to sexual stimulation— even after medical treatment. If you and your partner have avoided intimacy because of this, you may need help improving communication with your partner to combat your condition together and restore intimacy. Consider seeking out a counsellor or a sex therapist.

Another option is found in desensitisation therapy. Learning simple psychological techniques to change your mindset and reduce pain perception can be a potent tool. Consult a psychologist to receive help preparing yourself to tackle this problem. This can be used in conjunction with physical therapy, aimed at identifying other issues that can arise because of your pain. Together, these can provide a framework of mental and physical exercises to help you cope with your dyspareunia.

If you are experiencing pain during sex, make an appointment with Dr.Nicole Stamatopoulos here.