Dyspareunia: what to do if you experience pain during sex

Health Tips

Despite the fact that dyspareunia also occurs in men, women are most often affected by this problem. According to the American College of Obstetricians and Gynecologists, 3 out of 4 women experience pain during sex at least once in their lives.

Dyspareunia and its symptoms

Dyspareunia is pain before, during, and sometimes after sex. This pain can be both superficial and deeper and will spread not only to the vaginal area, but also to the labia, the head of the clitoris, the perineum, the uterus, the bladder and even the lower back.

The most common symptoms of dyspareunia include:

  • Pain during vaginal penetration with a penis, vibrator, or tampon
  • Deep pain during friction
  • Burning or dull pain during intercourse
  • Throbbing pain that lasts several hours after intercourse

Possible causes of pain

Vaginal dryness

It happens when there is not enough vaginal lubrication. This can happen for a number of reasons: decreased libido, not enough time for foreplay, low estrogen levels, lactation, and taking certain medications.

Inflammatory and infectious diseases

Thrush, urinary infections, sexually transmitted diseases, eczema and other skin problems in the genital area, and even an allergic reaction to underwear can all cause painful intercourse.

Vaginal injury or irritation

Pain during sex can be caused by trauma to the vagina, female circumcision, scarring from episiotomy and hysterectomy. The use of spermicides and syringes often causes irritation of the vagina, thereby increasing pain during sexual intercourse.

Gynecological diseases

Deep penetration pain is most commonly caused by problems such as vaginismus, endometriosis, vaginal prolapse, uterine tilt, fibroids, cystitis, irritable bowel syndrome, hemorrhoids, and ovarian ovarian cysts.

Emotional Factors

Our emotions are deeply intertwined with sexuality and cannot but affect the quality of sexual intercourse.

So anxiety, depression, dissatisfaction with one’s appearance, fear, guilt, shame, embarrassment – all these factors negatively affect libido and prevent relaxation, which, in turn, prevents arousal and causes pain during sex.

Problems in relationships with a partner also do not contribute to healthy sex. Interestingly, the most common sexual difficulty in partner relationships is the mismatch of sex drive. So, if your partner insists on having sex when you don’t feel like it at all, it’s no wonder that the body can rebel and respond with pain to an unwanted sexual intrusion.

Time to sound the alarm

Although sexual intercourse can be uncomfortable in some cases, especially the very first time, it should never be painful.

However, it is sometimes too difficult to understand and feel where the line between discomfort and pain lies. Due to the prevailing stereotype of sex as an endless source of pleasure and a series of never-ending orgasms, women stop trusting their bodies and question the presence and intensity of the pain they experience: is it really painful for me, or is it normal?

To prevent dyspareunia from developing into a serious psychological problem, it is necessary to consult a specialist at the first of its symptoms.


Due to its specificity, dyspareunia is not always easy to diagnose. It cannot be felt or examined with an ultrasound machine. The diagnosis is made on the basis of the subjective feelings of the woman and the analysis of the symptoms.

Diagnosis can also be difficult due to the fact that many women, for various reasons, deliberately keep silent about the symptoms, preferring to remain alone with their problem. Whereas it is very important to be completely frank with your doctor. The smallest detail matters. For example, subtleties such as the location and nature of the pain, whether it be with a simple touch of the genitals, at the entrance to the vagina, or with deeper penetration, are the key to diagnosing the causes that cause painful symptoms.

As a rule, during the consultation, the doctor asks a series of standard questions. The reception will be much more effective if you prepare the answers to them in advance:

  • Have you ever had painless intercourse or have you always suffered from dyspareunia?
  • Do vases have enough natural vaginal lubrication, or do you have to use pharmacy lubricant to improve the symptoms of vaginal dryness?
  • How regular are your periods, do you experience hot flashes and vaginal dryness? – History of your sexual contacts to determine if you are at risk for sexually transmitted infections.
  • Whether you have ever been sexually assaulted or subjected to genital trauma.

The second part of the diagnosis of dyspareunia is a gynecological examination, during which the doctor examines the vagina for dryness, inflammation, genital warts, scarring, as well as signs of endometriosis and pelvic tumors.

Treatment and prevention

As such, there is no specific treatment for dyspareunia. In each case, it is selected individually and is aimed at eliminating the causes that cause painful symptoms.

For example, to relieve the symptoms of vaginal dryness, which is not a side effect of menopause and medication, pre-stimulation of the clitoris or the use of a pharmacy lubricant will help.

To treat thrush, your doctor will likely prescribe an antifungal medication. And loose cotton underwear and adequate hygiene will help reduce the risk of this trouble in the future.

If a urinary tract infection is found, you will be prescribed antibiotics. To prevent this problem in the future, do not neglect hygiene and make it a rule to urinate after each sexual intercourse.

Warm baths with soothing pharmaceutical herbal preparations will help relieve inflammation.

With endometriosis, try to avoid too deep penetration of the penis into the vagina. To do this, it is better to choose poses in which you yourself can control this process. It is advisable to plan sexual contact in the first two weeks after menstruation, when the condition tends to be less painful.

Text: Elizaveta Petrova

Photo: vostock-photo

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