Report Pain During Intercourse by AskDocWeb

About Pain During Sex

Painful sex, which your doctor may call dyspareunia, is a burning, ripping, tearing, or aching sensation associated with penetration. The pain can be at the vaginal opening, deep in the pelvis, or anywhere in between. Pain during sex is a warning sign that something is wrong. If not treated, you could lose interest in any sexual activity, which is not only bad for you but also destructive to your relationship. The medical term for painful sex is dyspareunia and it affects men as well as women.

There are dozens of possible causes and fortunately, many of them aren’t too serious, but a few are.

Causes of Pain During Sex

  • Intercourse too soon after surgery or child birth
  • Vaginal dryness or inadequate lubrication (for example, from insufficient foreplay)
  • Menopause (vaginal lining loses its normal moisture and becomes dry)
  • Vaginal infection or Pelvic inflammatory disease (PID)
  • Reaction to the latex of a diaphragm or condom
  • Genital irritation from soaps, detergents, douches, or feminine hygiene products
  • Herpes sores, genital warts, or other sexually transmitted diseases
  • Urinary tract infections
  • Endometriosis is a common disorder that often affects the womb and surrounding tissues. It makes them very tender, particularly near period times. The pressure of the penis on an area of endometriosis may cause intense, deep pain.
  • Infections of the cervix and tender places on it can cause pain during deep penetration.
  • Ill fitting diaphragm
  • Sexual abuse or rape – Experiences like these understandably make women fearful of sex and of being hurt.
  • Hemorrhoids
  • Fibroids and other womb disorders can cause deep intercourse pain.
  • Ovary problems: cysts on the ovary can cause deep pain. Pain may also be caused if the tip of the penis hits an unusually positioned ovary.
  • Ectopic pregnancy: this means a pregnancy outside the womb, usually in the Fallopian tube. Pressure on it can be very painful.
  • Certain medications
  • Prostatitis – inflammation of the man’s prostate
  • A restrictive childhood
    • A woman was brought up to view sex as nasty or dirty.
    • A woman was given the idea that the vagina is very narrow and so sex must be painful.
  • Vaginismus — involuntary contraction of the vaginal muscles caused mainly by fear of being hurt; this may be a result of ongoing painful intercourse as well as being a cause

Vaginismus is often so painful that intercourse is impossible, sometimes for years. This condition arouses strong emotions and women who have it are sometimes very angry with partners, doctors and themselves but the condition is no one’s fault. Some women with vaginismus have never been able to have full sex or even use tampons. They also tend to be very fearful of vaginal examinations and so may never have a smear test.

Pain during sex is distressing and may well make you tighten up down below. And this tightening up will very likely make the pain worse next time. This is a good reason to do something about it now before it gets worse.

Home care for painful sex after pregnancy

Wait at least 6 weeks after childbirth before resuming sexual relations. Remember to be gentle and patient.

For vaginal dryness/inadequate lubrication:

  • Try water-based sex lubricants. Apply the lubricating gels to the outer sexual organs, including the vulva and labia, and in the vagina to ease pain during intercourse. Sex toys, such as vibrators or dildos, may also be useful.
  • For hemorrhoids, try stool softeners.
  • If you are going through menopause and lubricants don’t work, talk to your doctor about estrogen creams or other prescription medications.

Other causes of painful intercourse may require prescription medications or, rarely, surgery.

Sex therapy may be helpful, especially if no underlying medical cause is identified. Guilt, inner conflict, or unresolved feelings about past abuse may be involved which need to be worked through in therapy. It may be best for your partner to see the therapist with you.

Home care for Men

Painful intercourse in men is usually caused by prostatitis.

  • Soak in a warm bath.
  • Drink plenty of fluids, but avoid alcohol and caffeine.
  • Take acetaminophen or ibuprofen.
  • Antibiotics may be required for urinary tract infections or sexually transmitted diseases.

When to Contact Your Doctor

1. Call your doctor if home remedies are don’t work.

2. You have other symptoms with painful intercourse, like bleeding, genital lesions, irregular periods, discharge from penis or vagina, or involuntary vaginal muscle contraction.

3. If you are a victim of a sexual assault, report the crime to the police and go to the emergency room immediately. Get a trusted friend to accompany you. DO NOT change, bathe, shower or even wash your hands before the ER evaluation. The temptation to do so will be great, but it is important to not lose any evidence in order to help find, charge, and convict the perpetrator.

What to Expect at Your Office Visit

Your doctor will take your medical history and perform a physical examination. The medical history questions may include:

  • When did the pain begin or has intercourse always been painful?
  • Is intercourse painful every time that it is attempted?
  • Is it painful for your partner as well?
  • At what point during (or after) intercourse does the pain begin? Upon entry/penetration? During ejaculation?
  • Where, specifically, is the pain?
  • Does anything make the pain better?
  • Do you have any other symptoms?
  • What are your attitudes towards sex in general?
  • Have you had a significant traumatic event in the past (rape, child abuse, or similar)?
  • What medications do you take?
  • What illnesses, diseases, and disorders are you being treated for?
  • Have you had a significant emotional event recently?
  • Have you ever had pain-free sex with this partner? With any partner?
  • It may be best to see the doctor together with your partner. Physical examination may include a pelvic examination (for women), a prostate examination (for men), and a rectal examination. If a physical problem is suspected, appropriate tests will be ordered.

Antibiotics, painkillers, or hormones are amongst the treatment options that may be considered.

Misconceptions about Dyspareunia

It is a common misconception that women with dyspareunia dislike sex altogether. In fact, many women with this condition enjoy closeness with their partners. Many get great pleasure from loving foreplay and some are able to reach orgasm in this way but the enjoyment ceases when penetration is suggested or attempted.

Another common misconception is that the woman is guilty or uneasy with their partner – perhaps at an unconscious level for something they have done. Such a view does not help and only adds to the problem.

Prevent Pain During Sex

Good hygiene and routine medical care will help to some degree.

Adequate foreplay and stimulation will help to ensure proper lubrication of the vagina.

The use of a water-soluble lubricant or K-Y Jelly may also help. Vaseline should not be used as a sexual lubricant because it is not compatible with latex condoms (it causes them to break), it is not water soluble, and it may encourage vaginal infections.

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