Painful Intercourse

What causes pain during sexual intercourse?

A good sex life is important to many women. A problem that can be hard to talk about is painful sex. The pain may be at the opening of the vagina and vulva, inside the vagina, or deeper in the pelvis. Sex should never be painful. When it is, it might mean that something is wrong. A number of different things can cause pain during sex.

You may feel pain at the opening of your vagina or in the vulva, which is the area around the vaginal opening. Even a gentle touch in this area may cause pain. The pain can be caused by:

  • infection  

  • irritation from soaps, spermicides, or other chemicals  

  • a problem called vulvar dystrophy, which is a thinning or thickening of the skin of the vulva  

In many cases, simple things can be the cause, such as a lack of moisture in the vagina. Possible causes of vaginal dryness are:

  • a lack of natural moisture resulting from not enough foreplay  

  • hormonal changes such as those that happen during breast-feeding or during or after menopause  

  • psychological factors that affect your level of sexual arousal, such as a fear of intercourse, getting pregnant, or being hurt  

Examples of other problems that can cause pain in the vaginal or vulvar area are:

  • Bartholin’s gland cyst, which is a swelling of a gland near the opening of the vagina  

  • scarring of tissues from a pelvic infection, childbirth, or surgery  

  • injury to the vaginal area  

  • muscle spasms and tightening that make the opening of the vagina smaller  

Tightening of the opening of the vagina because of spasms is called vaginismus. It causes pain, and the penis may not be able to go into the vagina. Psychological factors, such as fear, may cause the vaginal muscles to tighten.

You may feel pain deep inside your vagina during intercourse. This can be caused by problems such as:

  • an awkward position during sex  

  • movements that are too forceful  

  • bladder that is too full  

  • infection of the bladder, vagina, or pelvis  

  • growths in the uterus called fibroids  

  • ovarian cysts (fluid-filled sacs in or on an ovary)  

  • endometriosis, which is an abnormal growth of the uterine lining tissue outside of the uterus  

  • prolapsed (fallen) uterus, meaning the uterus has dropped or moved from its normal position down into your vagina  

  • scarring from a pelvic infection  

  • previous injury to the vagina from childbirth or sexual abuse.  

How is it diagnosed?

Your Reddy Urgent Care healthcare provider will ask about the pain. You may have a pelvic exam and tests to look for infection or other problems.

How is it treated?

Treatment depends on the cause of the pain.

  • If you have an infection, your Reddy Urgent Care healthcare provider will prescribe medicine for it.  

  • If vaginal dryness is the cause, your provider may recommend using a vaginal lubricant every day or every time you have sex. Lubricants, such as K-Y Jelly, can lessen pain or discomfort. They can be purchased at drugstores.  

  • During or after menopause, an estrogen cream for the vagina may be prescribed.  

  • Kegel exercises and dilators of the vagina can help vaginismus.  

Other possible treatments are counseling or surgery.

How can I take care of myself?

  • If you have itching, burning, pain, or other symptoms of irritation or infection, see your healthcare provider. Follow the treatment prescribed or recommended by your provider.  

  • Use a water-based vaginal lubricant when you have sex.  

  • Avoid using soaps, spermicides, or other chemicals that can irritate the skin of the genital area.  

  • Talk to your partner about what might help to make sex more comfortable.  

  • If psychological or emotional problems appear to be contributing to the problem, see a therapist or marriage counselor.