Pain during sexual intercourse is a common concern experienced by many individuals at some point in their lives. The underlying reasons may range from anatomical or structural issues to emotional or psychological factors. The medical term for this condition is dyspareunia, which refers to ongoing or repeated pain in the genital area that occurs before, during, or after sexual activity.
While it may be uncomfortable to talk about, consulting a healthcare provider is essential. Identifying and treating the cause of painful intercourse can significantly improve your well-being and quality of life.
What are the symptoms of dyspareunia?
Painful intercourse can manifest in various ways. Pain may be felt only at the point of penetration, such as in vulvodynia or vestibulodynia. Some people experience pain during every type of penetration, including tampon insertion. Others report deep pelvic pain during thrusting. Sensations may include burning, aching, or throbbing pain that can last for hours after sex.
When should you see a doctor?
If you are experiencing pain during sex on a regular basis, it should not be ignored. Recurrent discomfort during intimacy can negatively affect emotional connection, sexual satisfaction, and body image. Early diagnosis and treatment can help address both the symptoms and the underlying causes.
Exploring the causes of painful intercourse
The cause of dyspareunia depends on whether the pain occurs at the point of entry or deeper during penetration. In many cases, physical and emotional factors are interconnected.
Pain at the point of entry
Pain at the vaginal opening may be related to insufficient lubrication, which is often caused by inadequate arousal or foreplay. Reduced estrogen levels associated with menopause, childbirth, or breastfeeding can also lead to vaginal dryness. Certain medications may reduce libido or arousal, contributing to decreased lubrication and discomfort. These include antidepressants, blood pressure medications, sedatives, and antihistamines.
Pain may also result from injury, trauma, or irritation, including accidents, pelvic surgery, female genital cutting, or episiotomy. Vaginismus, which is involuntary tightening of the vaginal muscles, can make penetration painful or impossible. Inflammatory or infectious conditions such as vaginal or urinary tract infections can cause pain during sex. Skin conditions like eczema affecting the genital area may also contribute. Congenital anatomical differences can be a factor. These include vaginal agenesis, where the vagina is incompletely formed from birth, and imperforate hymen, where a membrane completely covers the vaginal opening.
Deep penetration pain
Pain felt deeper in the pelvis, particularly during thrusting or in certain positions, may be caused by conditions such as endometriosis, pelvic inflammatory disease, uterine fibroids, ovarian cysts, irritable bowel syndrome, pelvic floor dysfunction, hemorrhoids, or uterine prolapse.
Previous pelvic surgery, including hysterectomy, may lead to internal scarring that causes discomfort. Cancer treatments such as radiation therapy and chemotherapy can also alter tissues and contribute to pain during intercourse.
Emotional and psychological factors
Emotional health plays a significant role in sexual experience. Anxiety, depression, body image concerns, fear of intimacy, and relationship difficulties can reduce sexual arousal and contribute to pain. Stress can cause involuntary tightening of the pelvic floor muscles, leading to discomfort during intercourse. A history of sexual abuse may also be a contributing factor for some individuals. It is not always easy to identify the emotional component of dyspareunia. Initial pain can create anxiety about future sexual activity, leading to muscle tension and a cycle of increasing discomfort. Over time, this may result in avoidance of sex altogether.
Pain during sex is not something that should be tolerated as normal. Persistent discomfort is a valid reason to seek medical help. A healthcare provider can evaluate symptoms, identify the underlying cause, and recommend treatment options tailored to physical, emotional, or combined factors.