There can be many, many reasons for pain during sex. A special medical term has been coined for this phenomenon: dyspareunia. This concept includes persistent or recurring genital pain that occurs immediately before, during or after sexual intercourse.
It is worth saying that sexual intercourse refers to vaginal penetration, so penetration of the penis, fingers, sex toys and even tampons can cause pain.
Not ready, what's wrong?
Feel
During penetration, pain occurs, a feeling of tightness and unpleasant friction during friction. After sex, the vagina becomes inflamed or irritated.
Probable Cause
Insufficient lubricant release. Sometimes this happens simply because the woman is not aroused. Perhaps the foreplay is too short. In this case, the problem can be solved without a doctor. However, vaginal dryness can also be caused by taking oral contraceptives, breastfeeding and menopause. In this case, the reason is a decrease in the level of estrogen in the blood, this leads to a sharp thinning of the vaginal mucosa, it becomes susceptible to damage and painful sensations may occur during sexual intercourse. Inna Apolikhina notes that from the age of 30, women’s levels of sex hormones decrease by 1–3% annually; by the age of 50, the drop in hormones is 20%. But this is not scary, the doctor can prescribe suitable medications, estrogen-containing creams, suppositories, various moisturizing substances based on tea tree extracts and extracts, and PH-neutral lubricants. All this helps to moisturize the mucous membrane and reduce discomfort.
Common causes of pain
Not enough lubrication
Most often, vaginal dryness is caused by insufficient foreplay. But there are other reasons: hormonal imbalance or medication. These include antidepressants, blood pressure lowering drugs, sedatives, antihistamines and some contraceptives.
A drop in estrogen levels after menopause, childbirth, or during breastfeeding may also be a cause.
If you are not taking the above medications and have had a blood test done to check your hormone levels, then try extending the foreplay.
Clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, Dr. Jane Minkin, says it takes at least 20 minutes to develop the required amount of lubrication.
This time is necessary for the labia, clitoris and vaginal canal to begin to erect. Perhaps a woman is naturally lacking in natural lubrication: one way to cope with the problem involves the use of water-soluble lubricants.
Surgery, injury, irritation
This may include injury from an accident, pelvic surgery, episiotomy (an incision in the vagina during childbirth to enlarge the birth canal), female circumcision, anatomical changes such as endometriosis, ovarian cysts, or surgical scars.
All of this can be very painful, especially if there is a wound that has not completely healed.
In this case, you will have to stop having vaginal sex, take time for proper treatment and resume sexual activity only when the doctor decides that the wound has truly healed or the injury will not bother you.
Inflammation, infection, irritation
An infection in the genital area or urinary tract can make intercourse painful. Eczema, an allergic reaction, irritation from new soaps, inflammation and irritation from thrush are all also reasons why vaginal penetration becomes painful.
If irritation appears after starting to use something new on a daily basis, it is worth removing the innovation and seeing if the irritation or allergic inflammation goes away. Here's what can cause these symptoms:
- perfumed soap;
- douching;
- vaginal perfume;
- baths with foam or bombs;
- scented toilet paper;
- thongs or other tight synthetic underwear.
Vaginismus
Vaginismus is painful spasms when the vagina opens. May be an involuntary response to stimuli such as painful previous sexual experiences, experiences of violence, unresolved conflicts regarding one’s own sexuality (for example, strong complexes), feelings of shame towards sex due to a conservative upbringing.
This is a condition in which involuntary contraction of the muscles of the vagina and pelvic floor can be so strong that even a tampon cannot be inserted into the vagina.
Dr. Shannon Chavez, a licensed clinical psychologist and certified sex therapist, says that because muscle contraction is involuntary, it can occur even when a person is aroused and wants to have sex. According to her, many women with vaginismus do not share it with doctors or loved ones.
Vaginismus can be caused by either physical or psychological factors, or a combination of both. A gynecologist can help you relax or retrain your muscles. And you will most likely need the help of a psychologist or psychotherapist to cope with the anxiety and stress that sexual intercourse causes.
Congenital anomalies
There is, for example, Mayer-Rokitansky-Custer-Hauser syndrome, a rare disorder of sexual development in which there is no fully formed vagina or vagina at all. Or a person is born with incomplete reproductive organs.
In these cases, attempting penetration can be very painful. Treatment will involve surgery or the use of vaginal dilators, Dr. Minkin said.
Vaginal muscle atrophy due to menopause
Pain caused by vaginal muscle atrophy (thinning of the vaginal walls) is common among postmenopausal women who are not taking estrogen replacement medications.
The secretion of natural lubrication is entirely dependent on changes in estrogen levels. The quickest solution to the problem is to use estrogen vaginal cream. But of course, you need to consult a doctor and choose the most appropriate solution together with him.
Interstitial cystitis
This condition refers to chronic inflammation of the bladder without any known cause. Painful intercourse is a common symptom.
The doctor may perform a cystoscopy (a procedure to look inside the bladder) and stretch the bladder wall to try to improve the patient's condition. Other treatments include bladder flushing with dimethyl sulfoxide, as well as oral medications.
Vulvodynia
This disease causes chronic pain in the vulva. Moreover, according to Dr. Minkin, pain is caused not only by penetration, but also by any other actions that put pressure on the vulva. For example, riding a bike or even just sitting.
Minkin says doctors don't know the exact medical cause, but think it may be inflammation of the nerves that causes hypersensitivity and pain.
There is no cure for vulvodynia, but relief from symptoms is possible. This is a fairly common phenomenon, with up to 9% of women experiencing it at some point in their lives.
Endometriosis
Endometriosis is also one of the most common causes of severe pain deep in the pelvic area during sex.
It takes an average of 9.28 years for a woman to finally receive this diagnosis and be prescribed treatment. This is data from a scientific study, Women's Sexual Pain and Its Management, which explains how women wait out those nine-plus years:
“Anyone who regularly experiences complaints of dyspareunia knows that women tend to continue intercourse if necessary by simply clenching their teeth.”
Endometriosis occurs when the tissue that makes up the uterus grows on other organs, and pain during sex with endometriosis is some of the worst.
There is no cure for endometriosis, but hormone therapy or surgery can be used to improve the condition.
In addition to endometriosis, chronic pelvic pain can be caused by tissue scarring due to infections, uterine prolapse, pelvic inflammatory disease, fibroids, ovarian cysts, and so on. Dr. Minkin says pain deep in your pelvis is definitely a reason to see a doctor because you may need to have fibroids or cysts removed.
Uncomfortable sex position and partner's big penis
It is possible that you feel comfortable and good in some positions, but others cause pain during penetration, especially deep penetration.
In this case, you need to tell your partner about this so that together you can look for new positions that are comfortable for both of you.
A large penis or dildo can also cause discomfort and pain. However, Dr Minkin says it is unlikely that the penis will be "too big" for the vagina or that it will damage the cervix. After all, the vagina can accommodate a child’s head with a diameter of 10 centimeters.
In this case, using more lube and avoiding positions where penetration is too deep and painful may help.
Psychological problems
Fear and anxiety related to penetration can create a mental barrier. This, in turn, can lead to unconscious tension in the pelvic floor muscles during sex, which also creates a physical barrier to penetration.
Perhaps you have had a negative sexual experience, you have experienced sexual violence, harassment, or violation of boundaries. In this case, the body expects pain and discomfort from sex, and the brain goes into combat mode.
Low self-esteem and issues with body acceptance can also reduce arousal and cause tension or nervousness during sex, Dr. Chavez says.
In this case, overcoming these psychological barriers will depend entirely on your readiness for this, because it will require work from you. Only you decide whether you are ready to turn to specialists and undergo, most likely, long-term therapy.
Danger signal
Feel
Wandering pain in the perineum or lower abdomen, frequent urge to urinate, painful urination, and itching may also be observed.
Probable Cause
Urinary tract infections (UTI). Many of them can cause inflammation or neoplasms that provoke discomfort during sexual intercourse, for example, genital warts form on the external genitalia (a consequence of the human papillomavirus). Herpes and trichomoniasis can also cause pain. Such BMIs not only cause inconvenience in your personal life, but can also lead to infertility and even the development of malignant tumors. The sooner a diagnosis is made and treatment is prescribed, the greater the chances of a successful outcome. And of course, after therapy the pain should disappear.
You annoy me!
Researcher Michael Caroll from the University of Manchester, after long-term observations, discovered that itching, burning, pain, inflammation of the mucous membrane after sexual intercourse in 12% of cases is caused by a banal allergy to the sperm of the chosen one! The symptoms are similar to those of sexually transmitted diseases or thrush, but they occur about an hour after sex or immediately, rather than weeks later. In this case, it is enough to undergo a course of treatment with special drugs and you can forget about the problem.
How to treat
First of all, the gynecologist will look at the patient in a chair, take a smear and prescribe an ultrasound. Further tactics depend on the diagnosis. Thus, drug therapy will help to cope with thrush, hormonal drugs are effective for endometriosis, and surgical intervention is required for polyps.
There are many causes of pain in the lower abdomen. You should not look for concomitant signs of all the above pathologies. Only a specialist, having carried out all diagnostic procedures, will prescribe competent treatment. But you don't have to endure the pain! Paying close attention to the health of the body helps to recognize the disease in its early stages, which in most cases makes it easier to treat. Take care of yourself - make an appointment with one of our gynecologists today.
No entry allowed
Feel
When excited, throbbing pain occurs in the labia. Sometimes it can be so strong that sexual intercourse is simply impossible. You can also feel lumps near the entrance to the vagina.
Probable Cause
Bartholinitis is an inflammation of the Bartholin glands (they are located on the inner labia and are responsible for the secretion of lubricant during sexual arousal), while the channels become clogged and swelling and discomfort appear. Similar symptoms are observed with glandular cysts; if they appear on both sides, then entry into the vagina will be extremely difficult. In this case, you need to contact a gynecologist as soon as possible.
Just not there
Feel
With deep penetration during sexual intercourse, sharp pain is observed on the right or left. During menstruation, a pulling sensation may also occur in this place.
Probable Cause
Ovarian cyst. This is a benign formation (a cavity with thin walls filled with liquid). It can be detected using ultrasound. The doctor will prescribe appropriate treatment and possibly laparoscopy. When having sex, until the problem is resolved, it is better to choose positions that allow you to control the depth of penetration - for example, “woman on top”.
Not true to size
There is an opinion that pain may occur due to a discrepancy between the sizes of the penis and vagina. This is very rare, since the vagina is very elastic and easily adapts to shape and length.
When pain is not associated with pathology
Sometimes it is unnecessary to panic, since discomfort in the lower abdomen is due to physiological reasons:
1. Approaching menstruation.
7-10 days before its onset, the sensitivity of the vaginal walls increases several times. A woman complains of heaviness and bloating in her abdomen. Therefore, for many, intercourse during this period will be unpleasant.
2. Too passionate or even rude actions of the partner, lack of foreplay.
Excessive pressure on the vaginal walls and internal organs causes nagging pain after intimacy. You can avoid this by spending enough time on foreplay and talking with your partner about your feelings and preferences.
3. Poorly chosen position and impressive penis size.
Although it is believed that there is no anatomical incompatibility between partners, since the vaginal mucosa is extremely elastic, the first intercourse, when “getting used to” each other, can be very painful. Incorrect posture will complicate the situation. The use of lubricants and the choice of positions in which the woman herself regulates the depth of penetration will help here.
4. Adhesions in the pelvis after previous illnesses, difficult childbirth or operations.
In this case, pain can be observed not only after intercourse, but also in everyday life, even when the weather changes. Look for a position in which the discomfort will go away, use gels and lubricants.
5. Congestion in the pelvic organs due to irregular sexual activity and muscle spasm after orgasm.
The unpleasant sensations are short-term and go away on their own.
By-effect
Feel
Throbbing or spasmodic pain in the lower abdomen. Sharp, piercing and radiating into the leg.
Probable Cause
Any inflammation in the back, pelvis, muscles, tendons or nerves, diseases of the spine, intervertebral hernia can cause similar sensations.
In any case, even if this is precisely the problem, it is worth starting an examination with a gynecologist to rule out varicose veins in the pelvic area (the symptoms are similar). In addition, the doctor will tell you which specialist you should contact.
And men too
Like women, they may experience pain during sexual intercourse. There are many reasons for this, but most often it is due to infectious diseases. With inflammation of the glans penis, with balanoposthitis (the head does not open, the foreskin is motionless), sex turns into torture, as with the appearance of genital warts. But itching and burning can be caused by an allergy, for example, to latex.
When to see a doctor?
Vulvodynia is quite common, although women are reluctant to tell doctors about it.
However, if you experience pain in the genital area, go to the gynecologist. It is important that your doctor rule out other known and treatable causes (such as yeast or bacterial infections, herpes, precancerous conditions, genitourinary menopause syndrome, and other underlying conditions such as diabetes).
Don't try to get rid of the pain on your own by thinking it's "thrush" and taking over-the-counter medications to treat yeast infections. Only a doctor will be able to assess the symptoms and choose treatment tactics, depending on what is identified.
No need for feats
Do not forget that pain is, first of all, a warning signal about disorders in the body, and you should not “endure for the sake of love.” When a woman bravely endures unpleasant sensations, the mucous membrane becomes inflamed and only gets worse. This is reflected in everyday life. Gynecologists note that such troubles often provoke increased irritability and lead to psychological problems. In addition, if the cause is infection, such heroism can lead to infertility. Therefore, you cannot waste time and put off visiting a gynecologist and treatment. Self-medication in this case is unacceptable.
Author: Maria Veselova Published: September 14, 2016
