No Need to Abstain to Save Yourself from Pain — What Can Cause Pain During Sex?

Painful sex can put a damper on your relationship. The medical term for this condition is dyspareunia. It can occur for many reasons, some physical and some psychological. If you're experiencing pain before, during, or after sex, it's essential to have it treated as soon as possible. If you put off treatment, you may start to avoid intimacy with your partner. It can lead to problems in your relationship and with your self-image. 

Is It Normal To Have Pain During Sex?

pain during sex

Though sex may be uncomfortable the first time, it shouldn't hurt. So, what does painful sex mean? There are several possible answers to that question, and you should talk to your healthcare provider about it. There are many different causes and treatment options available to help you.

How Many Women Experience Painful Sex?

Although pain during sex is not considered normal, it is pervasive. If you're wondering whether it's normal to have painful sex, you aren't alone. Almost 3 out of 4 women experience painful intercourse at some point in their lives. Sometimes it is a temporary issue, but it can become a long-term problem. 

What Are the Symptoms of Painful Intercourse? 

The symptoms of painful intercourse can be different depending on the cause. Some people only experience pain with penetration. Others may experience pain with thrusting or a burning, aching pain. The pain may be throbbing for some women and can last for hours after intercourse is over. 

What Is the Most Common Cause for a Woman to Feel Pain During Sex? 

Sometimes it's difficult to know what can cause pain during sex, but some of the most common causes are: 

  • Relationship problems. If you and your partner are out of sync about your desire for sex or have other issues, it can cause problems with your sexual response.

  • Medicine. Certain medications can reduce sexual desire, including birth control methods and pain medicines.

  • State of mind. If you're feeling guilt, shame, or embarrassment about having sex, it can be hard to relax. When you can't relax, it isn't easy to become aroused. It can also be difficult to become aroused if you are stressed or tired.

  • Partner's sexual issues. If your partner takes medicine for erectile dysfunction, they may have delayed orgasms, leading to long, painful sex.

  • Other medical or surgical conditions. Conditions such as diabetes, cancer, thyroid problems, or arthritis can indirectly affect sexual desire. If you've had surgery that has negatively changed the way you feel about your body, it can lead to a decreased appetite for sex. 

What Causes Pain During Sex?

what can causes pain during sex

Various physical or emotional conditions can cause pain during sex. Some physical causes include:

  • Vaginal dryness
  • Allergy to spermicide, douches, or clothes
  • Vulvar vestibulitis, which is an inflammation around the vaginal opening
  • Side effects of some drugs such as antihistamines and tamoxifen
  • Endometriosis, which is a condition that causes the tissue of the uterine lining to grow abnormally
  • Skin diseases that affect the vaginal area, including lichen planus and lichen sclerosis 
  • Yeast infection
  • Sexually transmitted diseases
  • Urinary tract infection
  • Atrophic vaginitis, which is a condition that causes the vaginal lining to thin in postmenopausal women

Psychological causes can include: 

  • Anxiety
  • Depression
  • Concern about your physical appearance
  • Relationship problems
  • Fear of intimacy 
  • Stress
  • History of sexual abuse

What Should You Do if You Are Experiencing Pain During Sex?

If you have severe or frequent pain with sex, you should see a gynecologist or other healthcare provider. It's crucial to find an answer to why you're having pain during sex. It would help if you ruled out underlying medical conditions that could be causing your pain. 

How Can You Treat Pain During Sex at Home?

While you should see your doctor if you're having painful intercourse to rule out any underlying medical issues, here are some tips on how to alleviate pain from sex: 

  • Communication. Let your partner know about your pain, including where and when it occurs. You should also discuss what parts of sex you do enjoy.

  • Lubricant. Use an oil during sex. You can use a water-based one if you are prone to irritation or sensitivity. Silicone-based lubricants last longer and are more slippery. If your partner uses a condom, don't use any baby oil, mineral oil, or petroleum jelly since they can cause condoms to break.

  • Timing. Choose a good time for sex when you and your partner are both relaxed and rested.

  • Prevention. Try some preventative steps before sex, such as taking an over-the-counter pain reliever and emptying your bladder. You might also find a warm bath relaxing before sex.

  • Alternatives. Instead of intercourse, try some sensual and sexual activities that aren't painful, such as massage, mutual masturbation, or oral sex.

  • Aftercare. If you have burning pain after intercourse, apply an ice pack wrapped in a towel to your vulva. 

When Should You See a Doctor for Pain During Sex?

see a doctor after sex pain

You should see your doctor if you're having recurrent pain during intercourse. The causes of painful sex are often treatable, and your doctor can help you learn how to make sex less painful. Treating pain during sex can improve your sex life, emotional intimacy, self-image, and relationship. 

What Might a Doctor Check for To Determine the Cause of Pain During Sex? 

Your healthcare provider will talk with you about your medical and sexual history and do a physical exam to help determine what is causing your pain. It's important to distinguish between pain in touching your genitals from the pain that occurs with deeper penetration. It will help narrow down the cause. 

In addition to asking you questions about your symptoms and sexual history, your doctor will perform a physical exam. During the physical exam, you will be checked for any problems with your vaginal wall, including inflammation or irritation. An internal pelvic exam will help your doctor determine if you have any abnormal pelvic masses, tenderness, or endometriosis symptoms. 

How Do You Prevent Pain During Sex Moving Forward? 

If you have a medical issue that's causing pain during intercourse, such as a urinary tract infection or yeast infection, treating it may be all that's necessary to prevent pain in the future. If the painful intercourse is caused by medicine, your healthcare provider may switch you to another medication.

prevent sex pain during

For women with vaginal lubrication problems due to low estrogen, an estrogen cream can be applied directly to the vagina. The FDA has approved two drugs to treat dyspareunia in women with vaginal lubrication problems. The first is Ospemifene, which acts like estrogen on the vaginal lining. The second is Prasterone, a capsule you place inside the vagina.

There are also nonmedical treatments that can help with painful sex. Desensitization therapy involves learning vaginal exercises that can help with the pain. If there are psychological reasons for painful intercourse, sex therapy or counseling may help you. 

Regardless of why you are having pain during sex, you might want to explore other ways to be intimate with your partner while it's being treated. Try exploring sensual massage, oral sex, and mutual masturbation until penetration is more comfortable. There are many different ways to satisfy each other. Dyspareunia doesn't have to interfere with your emotional and sexual intimacy with your partner.

References:

Painful Sexual Intercourse (Dyspareunia). (March 2019). Harvard Health Publishing. 

When Sex Is Painful. (September 2017). American College of Obstetricians and Gynecologists. 

Painful intercourse (dyspareunia). (February 2020). Mayo Clinic.  

Dyspareunia. (January 2021). StatPearls.

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