Teen Sex Pain
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Cedars-Sinai
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What Women Need to Know About Pain During Sex
Sexual health is worth prioritizing
Dryness is a common cause of pain during sex
Many conditions may cause pain during sex
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What Women Need to Know About Pain During Sex
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Sep 12, 2018
Cedars-Sinai Staff
Pain during sex is a common problem for women.
As many as 75% of women will experience pain during sex at some point, according to the American College of Obstetricians and Gynecologists. For many women, the pain is rare or happens only once, but for others it’s persistent.
"Some women may have experienced sexual joy, but then at some point in their life, it becomes painful," says Dr. Karyn Eilber . "They may stop having sex with their partners. Whether your pain is mild or severe, if it bothers you and it’s inhibiting you from having sex, you should definitely talk to you doctor."
Dr. Eilber and Dr. Alexandra Dubinskaya treat women with sexual dysfunction and study its causes. Here’s what they think women should know about painful sex:
"Like mental health, sexual health can carry a stigma. Mental health is slowly losing that stigma, and sexual health needs to follow that trend. We can look at these things as health conditions and normalize having these conversations as part of our regular healthcare."
Just because painful sex is very common, that doesn’t mean you have to accept it as "normal." Occasional minor soreness is likely nothing to worry about, but intense or frequent pain is worth having a conversation with your doctor.
Sex should be a pleasurable experience, and if it’s not, don’t hesitate to speak up to your partner and your doctor.
Many women are hesitant to bring up sexual problems with their doctors, Dr. Eilber says.
"It can feel embarrassing," she says. "It’s difficult enough to share with our partners and friends, so telling a doctor—a stranger—can feel intimidating."
"Like mental health, sexual health can carry a stigma," she says. "Mental health is slowly losing that stigma, and sexual health needs to follow that trend. We can look at these things as health conditions and normalize having these conversations as part of our regular healthcare."
Dryness is one of the most common causes of painful sex, and it can occur in any woman at any age. While it is more common in peri-menopausal and post-menopausal women, younger women can experience it as well.
In addition to making sex painful, dryness can throw off the vagina’s balance of good bacteria, which can result in infections that contribute to painful sex. Dryness can happen for many reasons including birth control use, breastfeeding and menopause.
"It’s normal to use a personal lubricant," says Dr. Dubinskaya. "There are studies that show women who use their personal lubricant while having intercourse experience more pleasure.
I think it’s important for people and their partners to recognize that just because a woman isn’t lubricating does not mean she isn’t aroused."
Drs. Eilber and Dubinskaya suggest approaching lubricants in the same way many women consider skin care products: Pay attention to the ingredients and test it on a small patch of skin first to make sure it doesn’t cause irritation.
Dryness is the most frequent reason, but there are many other reasons sex might become painful. Some conditions that can be at the root of the problem:
Painful sex usually has a cause, and once it’s identified, it’s likely treatable. If you’re avoiding sex, it’s time to see your doctor. Your gynecologist is often the best place to start, as they’re likely to be able to accurately diagnose the cause of the pain.
Many women are reluctant to talk about any issues they're having in the pelvic region, whether it's a prolapse , incontinence or painful sex. Many don't open up to friends or loved ones about these issues, and as a result, these problems seem kind of mysterious to the average person.
"I think as women, we often tend to blame ourselves," Dr. Eilber says. "That can definitely contribute to the pain and to sexual dysfunction. I think the more resources we can make available, and the more we’re able to talk openly about these issues, the more beneficial it will be."
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Authored by Gillian Harvey · Reviewed by Dr Sarah Jarvis MBE 26-Jan-18 · 5 mins read
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Whilst it's not a topic many of us discuss, sex can sometimes prove a real pain for some women. In fact, around a third of younger and half of older women have experienced pain during sex, according to the Sexual Advice Association . As well as discomfort, painful sex can lead to problems in relationships, loss of intimacy and even depression .
The good news is that many of these problems can be treated effectively by your GP or after a referral to a gynaecologist - so don't suffer in silence!
Many women suffer a degree of discomfort or pain during sex from time to time, but when should we seek help for our symptoms? "If you experience pain once, unless it is accompanied by other symptoms such as smelly, offensive discharge , it's probably better to wait to see if it resolves itself," explains consultant obstetrician and gynaecologist Dr Pandelis Athanasias from London Women’s Centre . "But if it happens more than three times, you should seek specialist help."
Sex is supposed to feel good for all involved, but when you start to experience pain during inte...
Whilst lubricants might be helpful, Anthanasias recommends women seek help rather than try to manage the problem themselves. "Sometimes continuing sexual intercourse can cause further problems," he explains. "For example, if you have a laceration or a tear, this can take some time to heal - and if the patient keeps having intercourse, it may become a more serious issue."
There are many different causes of painful sex, including infection, an abnormal growth such as a fibroid , an injury or even a psychological problem.
"Problems can often have multiple causes," explains Anthanasias. "Sometimes, women are sure that the problem is purely physical, but often a referral to a psychosexual counsellor can be very helpful."
"When looking at the causes of painful sex, it's helpful to separate the types of pain into superficial - affecting the vulva and the entrance of the vagina - to deep pain, which comes from the pelvis," he explains.
It's also important to tell your doctor if you've ever been able to have sex without pain. If you haven't they're likely to be looking for different causes, such as a partially intact hymen. Likewise, if the pain has started after a specific event such as childbirth, it could be due to scarring.
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Alongside infection, one of the most common causes of pain during sex is a condition known as vulvodynia . This condition causes pain in the vulval area and can be caused by a nerve problem.
"Vulvodynia can be a neuropathic condition," explains Anthanasias. "For some reason, women have more sensitive nerve endings in the vaginal area, which can cause pain." Vulvodynia may be classed as "provoked" or "unprovoked" - with some women experiencing almost constant pain, despite avoiding sexual intercourse.
Jane Barker, 32, from Hertfordshire suffered from vulvodynia whilst at university. "The first time I experienced pain after intercourse, I didn't worry too much," she explains. "However, I began to suffer lasting pain that didn’t resolve after sex. In the end I went to my GP."
"The GP examined me to check for injury, and took swabs to rule out infection. When this came back clear, she referred me to a specialist clinic at the local hospital."
There, doctors diagnosed vulvodynia, along with inflammation - and they also detected that some of Jane’s vaginal muscles had gone into spasm. However, as there isn’t a specific treatment for this condition, it continued for some time.
"The doctors tried various medicines and creams, including antidepressant medication," explains Jane. "In the end, a combination of pelvic floor exercises to help me to regain control of my vaginal muscles and an oestrogen-based cream brought relief."
Despite having had her condition treated effectively, Jane still suffers from flare-ups of the condition from time to time. "In my case, there's definitely an element that is triggered by stress ," she says. "Having vaginal pain and being unable to have intercourse with your partner can be incredibly distressing, so it’s really important to have it treated."
Another cause of sexual pain and difficulty is vaginismus. "This is caused by the abnormal contraction of the pelvic muscles," explains Anthanasias. "Patients are unable to release the muscles, which can cause pain during sex or even make penetration impossible."
Finally, women who are postmenopausal may be suffering from a condition called vaginal atrophy . "This is where a lack of oestrogen causes the vaginal tissue to become very thin and dry," explains Anthanasias. "This can cause soreness, itchiness and painful intercourse."
Rather than experiencing pain externally, many women complain of deep, pelvic pain during sexual intercourse. "The most common cause of deep pain is endometriosis ," explains Anthanasias. "This is a condition where the lining of the womb is found outside the womb. It causes scarring, nodules and pain on deep penetration."
Causes of pelvic pain during intercourse are often 'mechanical' in nature. "A big ovarian cyst , for example, or a mass," explains Anthanasias. "Or another structure like a big fibroid that occupies the pelvis."
Also, although pelvic inflammatory disease often leads to other symptoms, including low abdominal pain, vaginal discharge, abnormal bleeding and fever, deep pain during sex is sometimes the main feature.
Whilst both types of pain can be equally distressing, this deep pain is "more likely to have a surgical treatment" than the more superficial, external pain.
Whilst pain during sex can be distressing, it is rarely an urgent issue. "Urgent help is only required when any pain is combined with severe bleeding," explains Anthanasias.
The first port of call for women suffering from painful sex is usually the GP, who will check for infection or injury and make a referral to a specialist if necessary. However, those suffering from painful sex can also visit a genitourinary medicine (GUM) clinic .
GUM clinics offer a range of services, including testing for STIs and other genital infections, often with results received on the same day.
We may not enjoy talking about sexual problems, but if you're suffering from pain during sex, it's important to visit your doctor earlier rather than later. "Quite often, patients who come to me have had symptoms for months, or even years!" agrees Anthanasias.
Assess your symptoms online with our free symptom checker.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions .
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Medical Author:
John G McManus Jr, MD
Coauthor:
Richard D Warren, MD
Medical Editor:
Melissa Conrad Stöppler, MD
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Bachmann, and Richard J. Santen. "Patient Education: Vaginal Dryness (Beyond the Basics)." UpToDate.com. Oct. 24, 2018. .
Heim, Lori J. "Evaluation and Differential Diagnosis of Dyspareunia." American Family Physician 63.8 (2001): 1535-1545.
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Painful intercourse or painful sex can be experienced as pelvic pain , vaginal pain, or pain in the labial or vulvar areas during sex. Pain may be experienced as deep pain, sharp pain, or a burning sensation.
Pain during intercourse is one of the most common causes of problems of sexual dysfunction. The prevalence of such pain seems to be increasing over time. Possible reasons for this apparent increased prevalence include the following:
Symptoms of pain related to sexual intercourse can occur when entry is attempted or during and/or immediately following sexual intercourse.
Pain during intercourse may be described as primary or secondary; as complete or situational; and as superficial-entrance or deep thrust types.
A woman may perceive pain during intercourse even without any physical cause. Sexual pain without an apparent physical cause may have a psychological origin.
A woman should always consult a health care professional if she is experiencing new or worsening p
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