Advise Me

What to Do if Sex Is Painful

Sexual activity with your partner should feel good, but for some women it can be painful. When sex begins to feel less pleasurable for you, it could be a sign of a larger issue. From hormonal and physical changes to illnesses or trauma, nearly 3 out of 4 women experience some pain during sex at some point in their lives.

The good news? Sex isn’t supposed to hurt, and the pain can be preventable and treatable. Here are several common causes for pain during sexual intercourse and ways to get them treated.

Some common causes of pain during sex

  • Vaginal dryness: Postpartum, menopausal and nursing women may experience dips in estrogen levels, which can cause vaginal dryness and pain during sex.
  • Vaginal infections: Bacterial, yeast infections, urinary tract infections (UTIs) or a sexually transmitted infection (STI) can cause pain during sex and usually other symptoms, such as discharge and itching.
  • Skin sensitivity: Conditions like dermatitis or vulvodynia can cause pain in the area around the vaginal opening. These are usually brought on by reactions to perfumed soaps, lubricants, condoms and douches. Postmenopausal women may suffer from lichen sclerosis, a condition in which the skin on the genitals becomes scaly and inflamed.
  • Injury, trauma or tear: You could experience pain due to an accident, pelvic surgery or cut during childbirth (episiotomy). Women who have experienced sexual trauma might associate sex with pain, leading to tense vaginal muscles.
  • Certain illnesses: Endometriosis, pelvic inflammatory disease, fibroids, hemorrhoids and ovarian cysts can all cause pain during intercourse.
  • Emotional factors: Mind and body are intricately woven together. If you experience anxiety, depression, stress or are the victim of sexual abuse, these may play a role in chronic pain during sex.

How to treat pain during sex

“The most important thing to remember is that if you feel pain, you have pain. Period. Don’t ignore it,” says Nichole Mahnert, an OBGYN at the Women’s Institute at Banner Health. “Pain with intercourse isn’t normal, so speak with your primary care physician or OBGYN if sex hurts to the point where you’re avoiding sex or want to stop.”

With your doctor, you’ll discuss your sexual history and perform a pelvic exam to test for possible infections and look for internal or external lesions that may be contributing to your pain. However, if you are suffering from vaginal dryness, Dr. Mahnert recommends the following:

  • Use silicone-based lubricants.
  • Take it slow with your partner with foreplay.
  • Make sure your partner is aware of what is happening and can support you.

“Some women want to hide the pain from their significant other – and worry that there is something wrong with them – but it is important to have an open and honest conversation with your partner regarding your symptoms and your feelings,” Dr. Mahnert.

Getting help for sexual abuse

If you have suffered from sexual abuse or trauma, your doctor can refer you to a psychiatrist or therapist.

If you are still experiencing sexual pain, schedule an appointment with one of our Banner Health OBGYNs.

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Women's Health Gynecology Sexual Health