Pain during sexual intercourse is very common—an estimated 3 out of 4 women experience it at some point in their lives, according to the American College of Obstetricians and Gynecologists. Painful sex (called dyspareunia) comes in several different forms: Some women only have pain at penetration while others experience problems only during deep thrusting. In certain cases, pain occurs any time something enters the vagina, including a tampon.
These are some of the most common causes of dyspareunia and their treatments.
Conditions Involving the Vagina
There are several different conditions or injuries to the vaginal area that can be responsible for painful intercourse, according to the Cleveland Clinic. These include:
This is a bacterial or yeast infection causing burning, discharge and itching. We can determine the source of the problem and prescribe appropriate medication. Please remember that an antibiotic will only be successful if the source of the problem is bacterial, and over-use of these medications can make it more difficult to treat these infections in the future.
These are most often related to childbirth, especially due to tears or an episiotomy, and they can affect the vulva as well. If you’ve recently had a baby, and have experienced dyspareunia, you should wait a bit longer before continuing sexual activity.
Any structural issue present since birth can cause dyspareunia. Some women have a condition called vaginal agenesis, or a vagina that has not fully formed. Another abnormality is the development of an imperforate hymen, although this is a relatively rare condition, according to the U.S. National Library of Medicine.
During menopause, the vagina loses some of its elasticity and moisture. Treatments may include hormonal replacement therapy, the use of water-soluble lubricants, or extended foreplay. There are also other alternatives such as estrogen creams, rings or other medications.
This condition causes the vaginal muscles to spasm and contract. Not only does it make sex painful, but it can also cause problems when trying to insert a tampon or during a Pap test.
While vaginismus is relatively common, many women are embarrassed to talk to their doctor about their condition, so researchers believe that it affects more women than preliminary statistics demonstrate.
According to the Cleveland Clinic, both physical and psychological conditions can contribute to vaginismus, such as:
- Being a survivor of past sexual abuse
- Anxiety or fear of sex
- Being a survivor of sexual assault
- Negative emotions toward sexual activity
We customize each treatment to best serve our patients and their individual needs. In general, treatment may involve:
- Kegel exercises
- Vaginal dilators
- Anesthetic creams that can be used temporarily
- Survivors of sexual abuse may benefit from seeing a counselor who specializes in treating the psychological affects that result from being violated
Conditions involving the uterus
When there are abnormalities in the uterus, sex can become uncomfortable or very painful. These conditions include:
- Fibroid tumors, which may need to be treated by a procedure called a myomectomy. (For more information on myomectomy, you can peruse this information from the Mayo Clinic.)
- Endometriosis, which may require hormonal treatments or excision surgery.
- An ectopic pregnancy, which may be treated with medications or surgery.
Other causes of painful intercourse include…
- Cervical infections
- Sexually transmitted illnesses
- Pelvic inflammatory disease
- Genital skin disorders
- Ovarian cysts
Sex doesn’t have to be painful
At Chapel Hill OBGYN, we want to assure our patients that they can – and should — speak to us about any medical condition or problems with their sexual health, no matter how “embarrassing” it may seem. As your health care providers, we are partners in your care, and want you to be healthy and have a rewarding sex life.
A pleasurable, healthy sex life creates a bond between you and your partner. There are several potential causes of dyspareunia and they are treatable. Please speak with us if you have experienced pain during sex so we may listen to your concerns and discuss your treatment options.
For more than 40 years, Chapel Hill OBGYN has served women in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment, please contact us.
The American College of Obstetricians and Gynecologists. “Frequently Asked Questions: Gynecologic
The Cleveland Clinic. “Female Pain During Sex.”
The Cleveland Clinic. “Vaginismus.” Online.
The Mayo Clinic. “Painful Intercourse.” Online.
The Mayo Clinic. “The Vagina: What’s Normal and What’s Not.” Online.
U.S. National Library of Medicine. Pan Afr Med J. 2013; 15: 28.
Published online 2013 May 21.