Addressing Painful Sex

The OB/GYNs at North Florida's All About Women discuss the common causes of painful intercourse and how to resolve them

Dyspareunia is the medical term that refers to painful intercourse. While many women have had painful sex at some point, it's important for all women to remember that sex shouldn't be consistently painful. Female sexuality is a complex issue —your thoughts can affect your body's level of arousal, being tired or certain medications can hinder your body's sexual response— but sometimes the cause of pain during sex can be an underlying health problem.

You should always talk to your OB/GYN if you are experiencing recurrent painful intercourse, as treatment may be available. Here are some of the most common reasons women experience such pain, according to the American Congress of Obstetricians and Gynecologists:

Underlying Health Conditions

Some health conditions you wouldn't associate with women's health can cause sex to be painful. Women with arthritis, thyroid conditions, diabetes, or cancer may experience painful sex or lack of arousal.

Women who suffer from irritable bowel syndrome (IBS) or constipation may also feel deep pain within the pelvis during sex.

Beyond these general health conditions, painful sex can actually be an identifying symptom for certain reproductive health conditions. This pain is usually felt deep in the pelvis during the thrusting motions of sex:

  • Fibroids

If you experience painful intercourse and have abnormal periods, you may be suffering from one of these conditions. You should always talk to your provider if your periods are abnormally long, heavy, or painful. Your doctor may need to perform a pelvic exam, ultrasound, or laparoscopy to determine your condition and course of treatment.

Motherhood and Menopause

Certain significant events in a woman's life can cause painful sex, particularly in regards to motherhood and menopause. You may experience painful sex:

  • When taking hormonal birth control: Hormonal birth control, like the pill, can result in lower sexual arousal, making sex painful. You may want to switch birth control types if you think your current option is affecting your sex life.

  • After childbirth: After delivering a child, your tissues can take a while to recover, particularly if you've had any tearing or an episiotomy. If sex is painful, wait longer for your body to heal. It could take several months for the pain to cease. Make sure you're sticking to your follow-up checks with your obstetrician or midwife to assess the healing of your tissues.

  • For the duration of breastfeeding: When nursing a baby, a woman's estrogen levels drop, which means that sexual lubrication can also drop. Water-based lubricants can help.

  • During and after menopause: Perimenopause marks the time when a woman's body stops making significant amounts of estrogen. Women experiencing menopause may look into lubricants, vaginal moisturizers, or hormone replacement therapy to treat painful sex. Learn more about vaginal changes in menopause.

Conditions Affecting the Vagina or Vulva

Sometimes sex is painful upon entry. Usually this type of pain is caused by a problem with the vulva or vaginal walls:

  • Contact dermatitis or eczema: If you have eczema, it could cause painful sex. For all women, simply using harsh soaps or underwear made of synthetic fibers can cause enough irritation to your vulva and vagina to cause painful sex. Changing your self-care habits can help relieve the pain.

  • Vaginitis: Vaginitis encompasses itching of the vagina and vulva caused by a yeast or bacterial infection. Generally, these are short-term conditions that can be treated with medication.

  • Vulvodynia: Vulvodynia refers to pain that affects the vulva. This pain may feel like burning, stinging, and rawness. There are many ways that vulvodynia can be treated, from self-care measures, to therapy, to medications and surgery.

  • Vaginismus: This condition is caused by involuntary spasms of the vaginal wall muscles that make penetration very painful. Vaginismus can be treated with therapy.

Sexual Trauma

Last, but certainly not least, a history of sexual violence or abuse can lead women to have problems with sexual arousal and pain during intercourse, even in committed relationships later on in life. It's important for you to tell your healthcare providers about your history so you can get help and heal.

Take Control of Your Sex Life

Again, while female sexuality is complicated, it doesn't have to involve painful sex. Furthermore, painful sex could indicate an underlying health issue like endometriosis that can affect your fertility.

If you regularly experience painful sex, the women's health experts at Gainesville and Lake City's All About Women can help. Contact us today to make an appointment in a confidential, comfortable setting.