Why It Hurts During Sex
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Why It Hurts During Sex

Find out the common causes of sandpaper sex, plus easy ways to relieve the pain.

Sex is supposed to be pleasurable and intimate, and yet nearly three out of four women will experience painful intercourse, otherwise known as dyspareunia, at some point in their lives, reports The American College of Obstetricians and Gynecologists.  Not all pain is permanent, but it’s important to learn how to deal with it for your sake, and your partner’s. We talked to Tonya Wright, MD, OBGYN at Tulane Medical Center in Metairie, Louisiana to learn what causes painful sex, how you can prevent it and ways to ease the pain so you can enjoy being intimate again.   

Causes of Painful Sex — And What May Help

1.  Insufficient lubrication: Dr. Wright says the number one reason women have pain during intercourse is because the area down there isn’t wet enough. A lack of lubrication causes the vagina to be dry.

If you’re feeling dry down there, Wright recommends you use a water-based lubricant to help. You also want to be sure you allow time for arousal and foreplay before penetration. “For women, arousal usually takes a little longer than it does for men, so keep that in mind,” says Wright.

Menopausal women have an especially hard time becoming aroused because their hormones prevent the vagina from lubricating. “Talk to your doctor about vaginal estrogen creams that can help restore the vagina,” says Wright.

If you’re still experiencing dryness see your doctor so they can test for yeast infections or vaginosis.

2. Certain health conditions: Certain health problems may make intercourse uncomfortable. If you have any of these conditions and sex is painful, talk to your doctor to discuss how you can make intercourse enjoyable.

  • Bacterial vaginosis, herpes and gonorrhea may cause irritation and dryness inside or outside of the vulva
  • Bladder infections can cause pelvic pain and discomfort   
  • Yeast infections will cause pain inside the vagina
  • Fibroids cause pelvic pain during deep penetration 
  • Endometriosis causes pelvic pain during deep penetration
  • Skin disorders such as contact dermatitis may cause itching, burning and pain
  • If a woman has an episiotomy or tear in the perineum during childbirth, this may cause pain

3. Psychologic factors: Women who have had negative experiences with intercourse, like sexual assault or rape, may have trouble getting into the act again, says Wright. “These are things that may lead to negative emotions or anxiety when it comes to sex. This will make it difficult to feel aroused.”

If something negative is preventing you from enjoying intercourse, sexual therapy is the best place to start. If you have fear or anxiety, your vaginal muscles may spasm. Kegel exercises can help strengthen and relax the pelvic floor, says Wright.

Communicating with your partner is the key to enjoying your time in the sack. Let him or her know what feels good and what doesn’t, and leave time for sex — you’ll feel best when you’re both relaxed. Massages and warm baths may help get you aroused, and can relax your mind and body. Taking time for foreplay like kissing, breast and nipple action and clitoris stimulation will help get you in the mood, too.

4. Relationship problems: Couples who are going through relationship challenges may have problems feeling sexually stimulated. And not all couples have the same sexual drive — one partner may want to have sex more frequently than the other.

“Couples should definitely consider counseling or sex therapy to work through any of those conflicting feelings. They’ll be able to relax during sex, be with each other, and have a positive experience,” says Wright.

Can’t get to your doctor? Apply a frozen gel pack wrapped in a towel to the vulva after intercourse to relieve sexual pain.

When to see your doctor
It’s not unusual for women to experience some level of pain or discomfort during intercourse, but pain that lingers after sex or anything that feels unusual may yield a trip to your doctor, says Wright. 

“Pain that's not relieved after intercourse should be evaluated. It may signify more serious conditions such as uterine fibroids, endometriosis or ovarian cysts,” Wright explains.

If you have abnormal discharge, itching or burning bring those things to your doctor’s attention, too. Lumps and bumps that are painful on the outside of the genitals should also be examined.

Take care of your lady parts
Good vaginal hygiene will help prevent some of the discomfort. “Proper hygiene will help decrease your risk for things like yeast infections, which could lead to intercourse discomfort,” says Wright.

She also says to avoid super tight clothing, and recommends cotton underwear instead.

Vaginal douching, or a washing of the area, can be dangerous because it rids the area of good bacteria that fights infections, and can cause irritation and dryness, says Wright.