Why Sex Might Be Painful: Common Causes and Solutions

Pain during sex, known as dyspareunia, affects many people at some point in their lives.

This can be a distressing experience, causing discomfort physically and emotionally.

Whether it’s a one-time occurrence or a recurring issue, painful sex is something that can and should be addressed.

Understanding the common causes and available solutions is the first step toward improving your sexual health and overall well-being.

Keep reading to learn the most popular causes and solutions for painful sex.

Exploring Common Causes of Pain During Sex

Below, we will learn about the most popular pain causes during regular sex.

Vaginal Dryness

Vaginal dryness is a prevalent cause of painful sex, particularly among women experiencing hormonal changes.

This lack of moisture can lead to friction during intercourse, causing discomfort or even pain.

The natural lubrication of the vagina plays a crucial role in facilitating smooth and comfortable penetration.

Various factors can contribute to vaginal dryness, including:

• Menopause: As women approach menopause, estrogen levels decline, which significantly reduces natural lubrication. Vaginal tissues may also become thinner and less elastic, a condition known as vaginal atrophy, making intercourse more painful.

• Pregnancy and Postpartum: Hormonal shifts during pregnancy and after childbirth can temporarily reduce vaginal lubrication. Breastfeeding can also lower estrogen levels, leading to dryness.

• Birth Control Pills: Certain hormonal contraceptives, especially those containing low doses of estrogen, can cause vaginal dryness as a side effect.

• Dehydration: Staying hydrated is essential for overall health, including vaginal health. When the body is dehydrated, it loses electrolytes that can cause cramps after sex. In addition, the body may not produce adequate lubrication, increasing the likelihood of discomfort during sex.

To resolve this issue, in addition to over-the-counter water-based lubricants, lifestyle changes such as increasing water intake and addressing underlying health issues can improve lubrication.

Hormone therapy or estrogen creams are often prescribed for menopausal women.

Infections and Inflammation

Vaginal infections, both bacterial and fungal, can cause pain during sex due to irritation and inflammation in the vaginal or vulvar areas.

Infections that are left untreated can worsen, leading to more severe pain. Some common infections that cause pain during sex include:

• Yeast Infections: They often cause thick, white, clumpy vaginal discharge that usually doesn’t smell or only smells slightly different than normal. Characterized by itching, burning, and abnormal discharge, yeast infections can make the vaginal tissue swollen and sensitive, resulting in painful penetration.
• Bacterial Vaginosis: BV occurs when there’s an imbalance of bacteria in the vagina, leading to irritation and sometimes a foul odor that has a strong fishy smell, particularly after sex. A change to the color and consistency of your discharge, such as becoming greyish-white and thin and watery.
• Sexually Transmitted Infections (STIs): Conditions such as chlamydia, gonorrhea, herpes, and trichomoniasis can cause symptoms like itching, burning, and sores, all of which contribute to painful intercourse.
• Urinary Tract Infections (UTIs): While UTIs primarily affect the bladder and urethra, they can cause pressure and discomfort during sex, particularly if the infection causes inflammation of the pelvic region.

Treating infections promptly with antibiotics, antifungals, or antivirals (depending on the infection) usually resolves inflammation-related pain.

Regular gynecological checkups and practicing safe sex are important preventive measures.

Vaginismus

This is a condition in which the muscles of the vaginal and pelvic floor involuntarily contract during attempts at penetration.

This can make any form of vaginal insertion, including tampons or a gynecological exam, extremely painful or impossible.

Both physical and psychological factors can cause vaginismus:

• Physical Causes: Past pelvic trauma, childbirth injuries, or surgeries can trigger muscle spasms. Conditions such as endometriosis or pelvic inflammatory disease can also lead to chronic pelvic floor tension.
• Psychological Causes: Fear of pain, anxiety about sex, or a history of sexual trauma or abuse can contribute to the development of vaginismus. The anticipation of pain during sex may cause the body to tighten the muscles automatically.

Endometriosis

It is a condition where tissue similar to the lining of the uterus grows outside the uterine cavity, often on the ovaries, fallopian tubes, and other pelvic organs.

This abnormal tissue thickens, breaks down, and bleeds with each menstrual cycle, causing severe pain and inflammation.

For those with endometriosis, sex can be particularly painful, especially deep penetration.

Aside from painful sex, endometriosis causes symptoms such as chronic pelvic pain, heavy periods, and fatigue.

Pain during sex, often described as a deep ache, can occur before, during, or after intercourse.

If left untreated, endometriosis can lead to scar tissue formation and fertility problems.

Emotional and Psychological Factors

Emotional and mental health plays a significant role in how we experience sex. Anxiety, stress, relationship issues, and past trauma can contribute to tension and pain during intercourse.

Psychological problems related to body image, performance anxiety, or negative sexual experiences may manifest physically, causing the muscles to tense up and making penetration painful.

Worrying about sexual performance or the potential for pain can cause involuntary muscle tightening, which exacerbates discomfort during intercourse.

A history of sexual abuse or trauma can also create emotional barriers to intimacy, making sex both physically and emotionally painful.

When to See a Doctor

If pain during sex is persistent, it’s important to consult a healthcare professional.

Sometimes, painful sex is a symptom of an underlying condition that requires medical attention.

A doctor can help identify the cause and recommend treatments tailored to your needs.

They may also refer you to a specialist, such as a gynecologist or pelvic floor physical therapist, for further evaluation.

The Bottom Line

Painful sex is a common issue but not something you have to live with.

By identifying the cause and seeking appropriate treatment, most people can overcome this discomfort and enjoy a healthy, fulfilling sex life.

Whether it’s through lifestyle changes, medical treatments, or open communication with your partner, there are many ways to address and resolve pain during intercourse.

If you’re experiencing pain, don’t hesitate to contact a healthcare provider for support.