Painful sex, or dyspareunia, can cause problems in a couple’s sexual relationship. In addition to physically painful sex, there is also the possibility of negative emotional effects, so the problem should be addressed as soon as it becomes evident.
In many cases, a woman can experience painful sex if there is not sufficient vaginal lubrication. When this occurs, the pain can be resolved if the female becomes more relaxed, if the amount of foreplay is increased, or if the couple uses a sexual lubricant.
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In some cases, a woman can experience painful intercourse if one of the following conditions is present:
1. Vaginismus
This is a common condition in which there is a spasm in the vaginal muscles, mainly caused by the fear of being hurt.
2. Vaginal Infections
These conditions are common and include yeast infections.
3. Problems with the cervix
In this case, the penis can reach the cervix at maximum penetration, so problems with the cervix (such as infections) can cause pain during deep penetration.
4. Problems with the uterus
These problems may include fibroids that can cause deep intercourse pain.
5. Endometriosis
Endometriosis is a condition in which the endometrium (tissue lining the uterus) grows outside the uterus.
6. Problems with the ovaries
Such problems might include cysts on the ovaries.
7. Pelvic Inflammatory Disease
The tissues deep inside become badly inflamed and the pressure of intercourse causes deep pain.
8. Ectopic Pregnancy
A pregnancy in which a fertilised egg develops outside of the uterus.
9. Menopause
The vaginal lining can lose its normal moisture and become dry.
10. Childbirth
Intercourse too soon after surgery or childbirth.
11. Sexually Transmitted Infection
These may include genital warts, herpes sores or other STIs.
12. Injury to the vulva or vagina
These injuries may include a tear from childbirth or from a cut (episiotomy) in the perineum (area of skin between the vagina and the anus) that is made during labour.
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How can painful sex in women be treated?
Some treatments do not require medical intervention. For example, in the case of painful sex after pregnancy, wait at least six weeks after childbirth before attempting intercourse. Make sure to practice gentleness and patience. In cases in which there is vaginal dryness or a lack of lubrication, try water-based lubricants.
Some treatments for female sexual pain do require a doctor’s care. If vaginal dryness is due to menopause, ask a healthcare professional about oestrogen creams or other prescription medications. Other causes of painful intercourse also may require prescription medications.
For cases of sexual pain in which there is no underlying medical cause, sexual therapy might be helpful. Some individuals may need to resolve issues such as guilt, inner conflicts regarding sex, or feelings regarding past abuse.
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Call a doctor if there are symptoms such as bleeding, genital lesions, irregular periods, vaginal discharge, or involuntary vaginal muscle contractions and ask for a referral to an SSASSERT-certified sex counsellor if there are other concerns that need to be addressed.
