Patient Education

Discomfort During Intercourse

Sexual intercourse should be an enjoyable activity between both partners. However, some women experience discomfort during intercourse. This condition is called dyspareunia, and it affects almost 2 out of 3 women during their lives. There are different causes of pain during sex, and the actually pain itself can range from being mild to severe. This page should cover the basic information of pain during intercourse. 

WHY MIGHT I FEEL DISCOMFORT DURING SEX?

Physical pain during sex can have both physical and mental causes. Understanding what happens to your body during during sex can help you also learn about why pain occurs. Usually, there is a pattern of sexual changes your body goes through when you have sex. There are four stages of arousal: 

  1. Desire- The feeling that you want to have sex 
  2. Arousal- Several physical changes take place:
    • Vagina and vulva get moist 
    • Muscles of the vagina relax 
    • Clitoris swells and enlargens 
    • Uterus lifts up 
    • Vagina gets deeper and wider 
  3. Orgasm- The muscles of the uterus and vagina contract to create a strong feeling of pleasure, that can also be felt in the clitoris. This is the peak of sexual response
  4. Resolution- the vagina, uterus, and clitoris return to their normal size and state.

During the sexual response cycle, the arousal stage is especially important, because this is the time when your vagina readies itself for your partner to enter. If you do not go through the arousal stage, you may feel pain or discomfort during sex. 

WHAT TYPES OF DISCOMFORT DO WOMEN FEEL DURING SEX?

A woman may feel discomfort during intercourse deep inside of her, just inside the vagina, at the vaginal opening, or in the vulva (outside). Deep pain can be felt in the pelvic region, the bladder, or the lower back. Each different type of pain may have a different cause behind it, depending on where the pain is located. It is important to talk to your doctor about pain during intercourse, because it may indicate a problem that might need further investigation. 

  • Vulvar Pain: Pain can occur when some part of the vulva is touched. This may be from-
    • Irritation from soaps, douches, or vaginal sprays 
    • Scars 
    • Cysts 
    • Infection 
  • Vaginal Pain: There are several different causes of pain at the vaginal opening or midway inside-
    • Vaginal dryness: This is the most common cause of pain during intercourse. Oftentimes, it comes from not being aroused enough before engaging in penetration. It can also occur from certain medications, or from certain times in your life, like right after pregnancy, breastfeeding, or during menopause. This is because these times in your life are times when your estrogen levels are extremely low, which causes vaginal dryness. Oftentimes, using a lubrication or jelly can help ease the dryness and make safe less painful for you. 
    • Vaginitis: This is an inflammation of the vagina. It has several different causes, including a bacterial or yeast infection, as well as an allergic reaction from soaps or douches. Vaginitis can often be cured by medication that is placed in the vagina or taken orally. Symptoms of vaginitis include discharge, itching, and burning of the vagina or vulva. 
    • Vaginismus: This is a condition in which the muscles of the vagina spasm when your partner tries to enter your vagina, resulting in pain. It can also happen during normal pelvic exams at your doctor’s office. There are several causes of vaginismus, including-
      • Infections of the vulva or vagina Irritation from douches or latex 
      • Scars in the vagina from injury or childbirth 
      • Mental blocks about sex from a past uncomfortable sexual encounter, or the fear of getting pregnant, or a past trauma like rape or abuse 
  • Deep Pain: Pain that occurs deep inside of you may be evidence of a problem of another bigger problem. Pain from the erection touching cervix can have several different causes:
    • Pelvic Inflammatory Disease (PID) 
    • Problems with the uterus 
    • Endometriosis 
    • A pelvic mass 
    • Bowel or bladder disease 
    • Scar tissue (adhesions) 
    • Ovarian cysts 

If you are experiencing deep pain, your doctor may suggest performing more tests on you to find out what the cause may be. You may have to undergo a laparoscopy or hysteroscopy, two procedures that allow the doctor to look inside you and treat the problems that are causing your deep pain. 

CAN ANY OF MY SEXUAL PAIN BE FROM EMOTIONS?

Usually, pain during intercourse is combined with a physical factor and a certain negative state of mind that makes sex less pleasurable. Your state of mind during sex is very important, because in order to get sexual pleasure, you need to relax and enjoy yourself. However, sometimes fears, emotional blocks, or worries can get in the way of having a good time. Sometimes, women are worried about getting an STD or becoming pregnant, which makes them tense during sex. Other times, they are preoccupied with their jobs, or any other tasks they may have to do later that are stressing them out. Sometimes, fears of past traumas such as sexual abuse or rape can keep a woman from enjoying herself and letting herself be aroused. Also, if a woman is fighting with her partner, she may be temporarily unable to connect with him on an emotional level, making sex uncomfortable and unenjoyable. If you are experiencing pain during sex, it is not only important to talk to your doctor, but also to your partner, so you two can work on making sex enjoyable and pain free for both people. 

IN CONCLUSION

Pain during intercourse is a common female problem that has many different causes possible. However, it may be indicative of a deeper problem, so it is important to always talk to your doctor about pain during sex, even if you don’t want to. The sooner you talk to your doctor, the sooner the pain can be treated and stopped.