It Shouldn’t Hurt When You Have Sex

Sex is more than just how we reproduce — it’s important to our personal happiness and overall health. The intimacy and pleasure derived from sex can help improve heart health, burn calories, lower blood pressure, strengthen muscles, and increase libido. 

Sex can also boost your immune system, help you sleep better, and relieve headaches.

Unfortunately, dyspareunia (painful intercourse) is more common than it should be, affecting up to 20% of women in the US. In fact, almost 3 in 4 women experience painful sex at least once. You shouldn’t have to deal with pain during sex; treatment and management are available.

At offices in Wellesley and Hudson, Massachusetts, Dr. Neeraj Kohli and the skilled medical team at BostonUrogyn are here to help women seeking relief from painful sex and other urogynecological problems.

Symptoms and causes of pain during sex

Dyspareunia includes symptoms like:

  • Pain at the vaginal opening

  • Pain with inserting anything in your vagina (such as a tampon)

  • Deep pain during penetrative sex

  • Burning or aching pain

  • Throbbing pain that lingers after intercourse

The reasons why sex can be painful range from psychological issues to structural problems in your reproductive system. They include:

Entry pain

Lack of lubrication can cause pain during penetrative sex. This can result from medications (antidepressants, blood pressure drugs, sedatives, antihistamines, and birth control pills) and changes in hormone levels from pregnancy, breastfeeding, or menopause. 

Other causes include vaginal injuries, irritation, infection, skin disorders, and even problems present at birth such as vaginal agenesis and imperforate hymen.

Deep pain

Pain during deep penetration, which can worsen in specific positions, can be caused by conditions like endometriosis, pelvic inflammatory disease (PID), uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome (IBS), and ovarian cysts. 

Scarring from pelvic surgeries like hysterectomies can cause painful intercourse, as can cancer treatments like radiation and chemotherapy.

Emotional pain

Sex is as much an emotional experience as a physical one. A history of sexual abuse, stress, anxiety, depression, self-doubt about your appearance, and fear of intimacy can affect whether you experience pain during sex.

Any source of painful sex can also cause you to tense up, which can make the experience more painful and cause you to avoid it altogether.

How is painful sex treated?

Treatments vary depending on the cause of your pain and include medications, therapies, and lifestyle changes. If the pain is caused by another condition or infection, there are medications to treat those specific concerns.

Ospemifene treats mild to moderate pain from vaginal dryness. Prasterone, another medication that can help with pain, is placed in the vagina daily.

Therapies include desensitization therapy, which uses vaginal relaxation exercises to relieve pain, and couples therapy to overcome communication problems and help restore intimacy. Cognitive behavioral therapy can help modify negative behaviors that contribute to the pain. 

Lifestyle changes can help, including using lubricants, changing positions, letting foreplay last longer to stimulate full arousal, and communicating during sex to determine what hurts and what doesn’t. 

Don’t let painful intercourse ruin your sex life. Call the BostonUrogyn office nearest you today or book your appointment online, and we can help.

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