Sex is supposed to be pleasurable, but for some women, the experience can be painful. Whether you experience pain every time you try to have intercourse or it only happens occasionally, it is important to explore what could be causing the problem so you can take steps to address it. Here is a look at some of the most common reasons women experience painful sex and how you can alleviate it.
What Is Painful Sex?
Painful sex, also known as dyspareunia, is characterized by pain in the area of the pelvis, labia, or vagina that is felt either during sexual intercourse or immediately afterward. It is so common that it has been described in medical literature as far back as the ancient Egyptian scrolls. However, it is not known precisely how many women experience it because the symptoms can vary, and many women are not comfortable discussing it with their doctors.
The pain may manifest in several ways. Some women report a deep pain, while others experience a sharp pain, a burning sensation, or a feeling of great discomfort. Some women might also experience symptoms such as muscle tightness, muscle spasms, or pelvic cramping.
Types of Painful Sex
There are many types of dyspareunia, so the condition is often broken down into different categories depending on its location and duration.
Location of Painful Sex
First, the location of the pain is considered. There are two main types: entry pain and deep pain.
Also known as superficial or introital dyspareunia, this pain is felt around the vaginal entrance during initial penetration. It may be related to an infection, injury, or inadequate lubrication.
Sometimes referred to as collision dyspareunia, this pain is felt during deep penetration and may be worse in specific sexual positions. It may be felt in the cervix or the lower abdomen, and it is sometimes linked to previous surgery or a medical condition.
Duration of Painful Sex
Painful sex is also described in terms of its duration.
- Primary Pain: Pain during intercourse that you have always experienced since you first became sexually active.
- Secondary Pain: Pain that develops after a time of painless sex.
- Complete Pain: You experience pain every time you have sex.
- Situational Pain: You only experience pain at certain times during sex.
Causes of Painful Sex
Here are some of the most common causes of painful sex.
Insufficient Vaginal Lubrication
Many cases of painful sex can be traced to insufficient vaginal lubrication. There is often a psychological component to this; women may find that relaxing a bit before sex or engaging in prolonged foreplay can help them reduce or eliminate pain. You can also purchase sexual lubricant and apply it prior to having sex.
The lining of the vagina can sometimes lose thickness and moisture and may even become thin and dry. This can be due to hormonal changes, medication, or menopause. A gynecological exam can diagnose vaginal atrophy, and the treatment will depend on the cause identified. Hormone therapy and lubricants are two common recommendations for women with this issue.
Vaginismus occurs when the muscles of the vagina automatically tighten up out of fear of vaginal penetration. It is a reaction that cannot be controlled, and it can even occur in women who have previously enjoyed painless sexual penetration. However, it does not always impact the ability to get aroused or enjoy other forms of sexual contact. It is often caused by worries your vagina may be too small to accommodate your partner, negative beliefs about sex, a bad sexual experience, or a medical condition.
There are several possible treatments for vaginismus. Psychosexual therapy, a type of talk therapy that helps you understand your feelings about sex and your body and make changes, is one helpful approach. Pelvic floor exercises, physical therapy, vaginal trainers, and relaxation techniques such as mindfulness can also help you relax the vaginal muscles.
Injury to the Vagina or Vulva
For some women, painful sex can be attributed to injuries to the vagina or vulva, particularly for women who have given birth in the past. These injuries could include a tear that occurred during childbirth or a cut from an episiotomy made during labor to facilitate childbirth.
In addition, having intercourse too soon after childbirth or surgery can also cause painful sex, and this will often go away on its own if you give yourself sufficient time to heal.
Pelvic Inflammatory Disease
In pelvic inflammatory disease, or PID, the tissues deep within the vagina and pelvis experience severe inflammation, and this causes the pressure of intercourse to lead to deep pain. This is usually caused by a sexually transmitted infection, and symptoms include pain in the lower abdomen and stomach as well as lower abdominal pain. It can usually be treated with antibiotics, but your partner should get tested and treated to avoid a recurrence.
Keep in mind, however, that PID is not always sexually transmitted. For example, sex itself can sometimes allow bacteria to enter the reproductive system and infect your organs.
Reach Out to the Women’s Wellness Team
If you are experiencing painful sex, reach out to the women’s healthcare team at Raleigh Gynecology & Wellness to set up an appointment. Their highly trained gynecologists and nurses can help manage a broad range of gynecological conditions and issues.