Intercourse pain, or dyspareunia, can cause problems in a couple’s sexual
relationship. Painful intercourse can have negative emotional effects in
addition to the physical pain, so the problem should be addressed as soon as it
becomes evident.
What causes female sexual pain?
In many cases, a woman can experience pain during sex if there is not
sufficient vaginal lubrication. In these cases, the pain can be resolved if the
female becomes more relaxed, if the amount of foreplay is increased, or if the
couple uses a sexual lubricant.
In some cases, a woman can experience painful intercourse if one of the
following conditions is present:
- Vaginismus — This is a common condition in which there
is a spasm in the vaginal muscles, mainly caused by the fear of being hurt.
- Vaginal infections — These conditions are common and
include yeast infections.
- Problems with the cervix (opening to the uterus) — The
penis can reach the cervix at maximum penetration. Therefore, problems with
the cervix (such as infections) can cause pain during deep penetration.
- Problems with the uterus — These may include fibroids that
can cause deep intercourse pain.
- Endometriosis — A condition in which the endometrium
(tissue lining the uterus) grows outside the uterus.
- Problems with the ovaries — Such problems might include
cysts on the ovaries.
- Pelvic Inflammatory Disease — The tissues deep inside
become badly inflamed, and the pressure of intercourse causes deep pain.
- Ectopic pregnancy — A pregnancy in which a fertilized
egg develops outside of the uterus.
- Menopause — The vaginal lining can lose its normal
moisture and become dry.
- Intercourse too soon after surgery or childbirth.
- Sexually transmitted diseases — These may include
genital warts, herpes sores, or other STDs.
- Injury to the vulva or vagina — These injuries may
include a tear from childbirth or from a cut (episiotomy) in the perenium
(area of skin between the vagina and the anus) that is made during labor.
How can sexual pain in women be treated?
Some treatments for female sexual pain do not require medical intervention. For example,
in the case of painful intercourse after pregnancy, wait at least six weeks after childbirth
before attempting intercourse. Make sure to practice gentleness and patience. In
cases in which there is vaginal dryness or a lack of lubrication, try
water-based lubricants.
Some treatments for sexual pain do require a doctor’s care. If
vaginal dryness is due to menopause, ask a health care professional about
estrogen creams or other prescription medications. Other causes of painful
intercourse also may require prescription medications.
For cases of sexual pain in which there is no underlying medical cause,
sexual therapy might be helpful. Some individuals may need to resolve issues
such as guilt, inner conflicts regarding sex, or feelings regarding past abuse.
When does female sexual pain require a doctor's care?
Contact your doctor if there are symptoms such as bleeding, genital lesions,
irregular periods, vaginal discharge, or involuntary vaginal muscle contractions.
For pain with no underlying medical cause, ask the doctor for a referral to a
certified sex counselor.