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What causes painful vaginal intercourse?

The most common causes of painful sex also happen to be the most treatable. For most women who are in good health, painful intercourse is usually the result of vaginal dryness or a vaginal infection. The best treatment is to get checked out by a doctor to confirm whether a bacterial or yeast infection is present and, if so, get treatment. If vaginal dryness is the culprit, a woman may be helped by using a store-bought lubricant or spending more time in foreplay to reach maximum arousal before intercourse. Menopausal women may find that certain vaginal moisturizers recommended by her healthcare provider may be particularly helpful. Another common culprit is that he’s hitting her cervix with each thrust. Often, this indicates that she’s not as aroused as she needs to be. When a woman is maximally aroused before intercourse, she benefits from a vaginal tenting process, in which muscular contractions pull the cervix farther back into the body, lengthening the vaginal canal.

Other common causes of uncomfortable or painful penetration are underlying health issues that require treatment beyond foreplay and a lubricant. These include: endometriosis; a tipped or retroverted uterus; scar tissue from a c-section, hysterectomy or other pelvic surgery; interstitial cystitis; and vulvodynia, a painful condition that is estimated to affect as many as 15% of women. Conditions like dyspareunia can also be a factor, causing genital pain as well as difficult penetration or painful sex.

Keep in mind, too, that many women experience pain as a result of hormonal changes during menopause and after childbirth, especially if a woman is breastfeeding. Certain medications decrease vaginal lubrication, too, including certain antihistamines, antihypertensives, and antidepressants.

When pain is not happening every time a woman has intercourse, it is less likely that a chronic condition is causing the pain, though it’s still possible. If more foreplay and using a lubricant aren’t doing the trick, it is important to make a visit to a healthcare provider and perhaps to get a second (or third) opinion if needed, as many healthcare providers have had little training related to vulvovaginal pain conditions.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.