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Dealing with Painful Intercourse

Thursday, March 27th, 2014

Pain felt during sex is known as dyspareunia, and it can cause a number of problems for you and your relationship. Besides the physical discomfort, painful intercourse can have emotional side effects as well, so this problem should be dealt with as soon as you become aware of it.

Causes of Painful Intercourse

Sometimes the reason for pain during intercourse is as simple as insufficient vaginal lubrication. Taking more time with foreplay or using a water-based lubricant will often solve the problem. However, sometimes there is a condition responsible for the discomfort that needs to be addressed. Conditions that may cause dyspareunia include:

  • Vaginal infections, such as a yeast infection or bacterial vaginosis
  • Menopause, which can cause a significant reduction in natural lubrication, as well as thinning of the vaginal tissues which can lead to discomfort
  • Vaginal dryness not caused by menopause – this can also be triggered by breastfeeding and certain medications
  • Injury to the vagina or vulva, such as a tear or episiotomy from childbirth, or
  • A sexually transmitted infection (STI)
  • Vaginismus, a condition in which the vaginal muscles contract involuntarily
  • Endometriosis, in which the tissues that normally line the inside of the uterus grow elsewhere
  • Problems involving the uterus, such as myoma (fibroid tumors)
  • Problems involving the ovaries, such as cysts
  • Problems involving the cervix, such as infection
  • Ectopic pregnancy

Treatment for Painful Intercourse

If you aren’t sure why you are experiencing pain during intercourse, a visit to your gynecologist is in order. For example, in the case of dryness caused by menopause, your doctor can prescribe estrogen creams or other medications. Most infections and endometriosis can be treated by your doctor as well.

When no apparent cause is found, therapy might be helpful. Sexual activity is deeply intertwined with emotion; therefore any type of negative emotion such as anxiety, depression, fear, or feelings of low self-esteem can play a role in painful intercourse. Issues such as guilt, negative emotions regarding past abuse, or conflicting feelings about sex can also cause physical reactions that make sex unpleasant. It can be difficult to tell whether pain has psychological or physical causes (or a combination), so a conversation with your doctor about all possible issues is the best course of action.

When you see your doctor, be sure to mention additional symptoms that you may be having in addition to pain, such as bleeding, irregular periods, genital lesions, unusual discharge, or involuntary contractions of the vaginal muscles, that may give him or her the clues needed to diagnose and treat your problem effectively.

– Yvonne S. Thornton, M. D., M. P. H