Painful sex: What are the causes of pain during intercourse and how to seek help?

Pain during intercourse is a problem that many people struggle with, although it is often difficult to talk about. Painful sex can be due to both physiological and emotional reasons, so it is important not to ignore this signal from the body. It can have various causes, so it is important not to ignore this signal from the body. Feelings of discomfort can affect our intimate relationships and well-being, so it’s worth talking openly about it with your partner and seek help from specialists. Consulting a doctor or therapist is the first step in understanding the problem and finding an appropriate solution. Taking care of your intimate health is the key to improving the quality of your sexual and emotional life.

Painful sex – causes

Have you ever experienced a moment when rapprochement, which was supposed to be a moment of intimate closeness, instead of bringing pleasure, caused pain? Instead of the expected feeling of satisfaction and tenderness, there was something completely different – discomfort, tension and sometimes even a feeling of disappointment? What was supposed to be a natural, heartwarming moment suddenly became difficult to bear?

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Pain during sex can be an experience that affects not only the body, but also the psyche. With each successive attempt, there can be doubt, fear of the next rapprochement, and even anxiety that something is not as it should be. Such a moment can trigger an internal storm of emotions – from frustration, to uncertainty, to a sense of alienation in one’s own body.

Sometimes it’s a gentle feeling of tension, sometimes it’s severe pain that makes the whole intimate moment lose its charm. You may begin to wonder if this problem is something unique, just yours, or if other women experience it as well. This feeling that something that should be natural and beautiful suddenly becomes unattainable can be extremely overwhelming. Physical pain that interferes with intimacy can have a much deeper impact on your life than it might seem at first glance.

What are the causes of pain during intercourse?

The causes of pain during intercourse, also known as dyspareunia, can be complex and result from many factors, both physical and psychological. Here are the main medically recognized causes of pain during intercourse:

1. physical causes

Vaginal dryness: Insufficient vaginal lubrication, can cause friction and discomfort. Vaginal dryness is often associated with estrogen deficiency, such as during menopause, after childbirth or during breastfeeding, and can also result from the use of certain medications (e.g., birth control, antihistamines).
Infections: infections of the reproductive tract, such as bacterial vaginosis, vaginal ringworm (candidiasis), or vaginal cilia infection, can lead to inflammation, irritation, and pain. Urinary tract infections can also affect the sensation of pain during intercourse.
Inflammation of the vaginal vestibule (vulvodynia): This is a chronic inflammation in the vulva that causes pain when touched or pressed. It is often associated with hypersensitivity of the nerves in the vaginal area.
Endometriosis: This is a condition in which endometrium-like tissue (the lining of the uterus) grows outside the uterus, which can cause pain during penetration, especially deep penetration. Pain associated with endometriosis often increases before or during menstruation.
Painful bladder syndrome (overactive bladder syndrome, interstitial cystitis): A chronic condition that causes pain in the bladder area and can also affect the experience of pain during intercourse.
Uterine myomas and ovarian cysts: Uterine tumors, or cysts in the ovarian area, can lead to experiencing pain during deep penetration.
Scars after surgeries or childbirth: scars resulting from a perineal incision during childbirth (episiotomy) or after gynecological surgeries, can cause pain at the site.
Pelvic Floor Muscle Tension Syndrome: Excessive tension in the muscles surrounding the vagina and pelvis can lead to pain and difficulty during penetration.

Discomfort in sex — Photo. Depositphotos

2. hormonal causes

Menopause and hormonal changes: The decline in estrogen levels, typical of menopause, leads to vaginal atrophy, a decrease in the thickness of the vaginal mucosa. The result is a reduction in vaginal elasticity, which can cause soreness during intercourse.
Hormonal contraception: The use of certain types of hormonal contraceptives, such as birth control pills, can lower estrogen levels, leading to vaginal dryness and decreased libido.

3. anatomical factors

Congenital an atomical abnormalities: Some women may have anatomical abnormalities such as vaginal septa that can cause pain during penetration.
Vaginal stenosis: Can be the result of post-surgical changes, after radiation therapy or trauma, making penetration difficult and causing pain.
Pelvic organ prolapse: prolapse of the uterus, bladder or rectum (prolapses) can cause changes in pelvic anatomy and pain during intercourse.

4 Psychological factors

Stress and anxiety: Reduced arousal associated with stress, fear of pain or traumatic sexual experiences, can affect pain during intercourse.
Vaginismus (vaginismus): A condition in which the muscles of the vagina involuntarily contract in response to an attempt at penetration, which can lead to pain or make intercourse impossible.
Sexual traumas: Experiences of sexual violence or other traumatic experiences, can lead to difficulties in intimate relationships and pain during sex.

5. external factors

Using improper hygiene products: Some intimate hygiene products, perfumes, or detergents can irritate the delicate skin of the vulva, causing pain and discomfort during intercourse.
Inappropriate condoms or contraceptives: Allergy to latex or chemicals used in condoms, can lead to allergic reactions, causing pain.

How to seek help?

Seeking help for pain during intercourse is a key step in regaining comfort and intimate health. First of all, it’s a good idea to start by talking openly about the subject, both with your partner and with yourself, to understand what emotions and feelings accompany the problem. Then, the most important step is to consult a doctor – preferably a gynecologist, who is able to conduct a thorough physical examination, taking into account both the condition of the reproductive organs and other possible factors contributing to the pain.

When visiting a gynecologist, it is a good idea to describe in detail all complaints, not only about intercourse itself, but also any other symptoms, such as burning, vaginal dryness, irregular periods, infections or discomfort in the genital area. The doctor may order additional tests, such as vaginal cultures, a pelvic ultrasound, and sometimes even hormonal tests, to better understand the source of the problem. It’s a good idea to be prepared with questions about your sexual past, contraceptive methods used, and any previous health problems.

If the doctor does not find physical causes, the next step may be a referral to other specialists, such as a sexologist, psychologist or physiotherapist who specializes in pelvic floor muscle therapy. A sexologist or therapist can help identify psychological factors that may be contributing to pain during intercourse, such as stress, anxiety, trauma or lack of acceptance of one’s own body. Therapy, especially when combined with sex education, can help you understand how your body responds to different stimuli and how to manage intimate situations comfortably.

Physiotherapy with a pelvic floor muscle specialist can help if the pain is due to excessive muscle tension in the area. A therapist can teach relaxation techniques and exercises to help strengthen and relax muscles, which can ultimately relieve pain. In some cases, relaxation methods such as yoga, meditation or massage can also be helpful.

Seeking help should be a multi-step process, in which each successive consultation can bring you closer to understanding the causes of your pain and finding the right treatment. It is important to be patient, open to different therapeutic approaches and understand that solving the problem may require the cooperation of several specialists. Do not underestimate the problem or postpone a visit to the doctor, as a quick response can significantly improve the comfort of life.