Penetrative sex can be uncomfortable, but sometimes it really hurts. The medical term for this is dyspareunia, which refers to recurring or persistent pain before, during, or after sex. The pain might only occur upon entry, penetration with anything (like a tampon), deep thrusting, or a combination of those, and the level of pain can range from mild to severe.

Pain is a complex and multifaceted issue, so there isn’t always one single explanation or treatment. And it can be very frustrating when something that’s supposed to be pleasurable causes pain and discomfort instead. In this article, we will discuss 13 common causes for pain during sex for women.

13 Must Know Causes for Pain During Sex for Women

An Active Vaginal Infection

An outbreak of genital herpes, UTIs, yeast infections, chlamydia, and gonorrhea are all examples of vaginal infections that can make sex painful and uncomfortable. These infections can cause inflammation or irritation of the vulva and vaginal canal, which makes entry and penetration really hurt. Some infections can also affect the cervix and uterus, which may cause deeper pain with thrusting.

Injuries Or Irritation To The Vulva And Vagina

The skin of the vulva and vaginal opening is very delicate and sensitive, so it’s not uncommon for injuries to happen. These injuries could be caused by an accident, surgery, pelvic trauma, female circumcision, piercings gone wrong, or an incision made to widen the birth canal (episiotomy). They can cause tears and scarring that make sex very painful upon entry, especially if there’s a wound that isn’t fully healed.

Vaginismus

Vaginismus is a condition in which there’s involuntary contraction of the vaginal and pelvic floor muscles, and there can be so much tension that it doesn’t even allow for entry. So in addition to making sex painful, vaginismus can cause the muscles to spasm and clench to the point where you can’t insert anythingin the vagina, even a tampon. Since the tightening of these muscles is involuntary, it can happen even when a person is aroused and wants to have sex, so the condition can be incredibly frustrating. Many women with vaginismus suffer in silence.

A Chronic Pain Condition Like Vulvodynia or Vestibular Vulvitis

The big thing that causes pain upon entry is vulvodynia or vestibular vulvitis, which causes chronic pain in the vulvar region. This can cause a lot of pain during penetration and also any other activity that puts pressure on the vulva, such as bike riding or even just sitting.  There is no cure for vulvodynia, but you can treat the symptoms.

Abnormal Anatomy

Some people are born with an anatomical defect that either changes the shape of the vagina or makes it so there is little or no opening. You’ve probably heard of the hymen, a membrane that partially covers the vaginal opening, and the myths about how it “breaks” during intercourse. When someone has an “imperforate hymen, it means that the membrane is abnormally thick or tight, which can make sex very painful or even impossible. Sometimes there’s no opening at all, so these women don’t even bleed during their period and the blood can collect in the vagina. In these cases, attempting penetration can be super painful.

Conditions Like Endometriosis

Endometriosis occurs when the tissue lining the uterus grows on other organs, and it’s a common culprit when it comes to pain during sex. There’s no cure, but treatment can include hormone therapy or surgery.

Vaginal Dryness Caused By Hormones, Medication, Or Stress

When sex is painful during penetration, it could mean that you aren’t sufficiently lubricated. Moisture is key and without it, penetrative sex can cause friction that leads to micro-tears and irritation. The vulvar tissue is already fragile, but vaginal dryness can cause a lot of pain during penetration.

Not Enough Lube

Even if you don’t have a problem with vaginal dryness, sometimes the vagina’s own lubricant isn’t enough to last throughout sex. And that can lead to discomfort, friction, and pain during penetration or deep thrusting. Therefore, you can use lube during foreplay and penetration.

Lack of Foreplay And Stimulation

The vagina is self-lubricating, but it takes a little work and dedication to get the liquids flowing. It takes a woman’s body at least 20 minutes to become fully aroused, which includes engorgement of erectile tissue in the labia, clitoris, and vaginal canal. Talk to your partner and ask for more stimulation and foreplay, and don’t rush into penetrative sex.

Certain Positions

In some positions, you might feel perfectly fine and good but other positions can really cause a lot of pain during penetration and deep thrusting. You should try to find positions that are comfortable and that work with your partner.

Lack Of Connection Or Relationship Issues

Pain and discomfort during sex can also be caused by a personal issue between two partners. Lack of attraction, relationship issues, and poor communication can all affect a person’s mental state and result in a lack of arousal or decreased lubrication. It’s important to communicate with your partner and let them know what you do and do not like, and remember, consent is key.

Psychological Factors Such As Anxiety, Fear, or Self-Esteem Issues

Fear and anxiety around penetration can create a mental barrier, which can lead someone to unconsciously tense up their pelvic floor muscles during sex, which causes a physical barrier for penetration-based activity. Maybe they had a negative sexual experience so they anticipate pain and discomfort, or they have experienced trauma such as sexual abuse, violation of boundaries, sexual assault. As a result, the mind can go into fight-or-flight mode, which can cause the body and pelvic floor muscles to clench up.

Ignoring The Pain

Pain is a communication from the body, so always listen to what the pain is telling you. Do not ignore it, because it’s better to address it sooner than later and avoid further discomfort to the body. So if you have recurring pain during sex, you should see a doctor who can help pinpoint the cause and suggest treatment.

And finally, don’t feel alone. Pain during sex is actually so common, but it’s also so isolating because a lot of women feel like everyone else in the world is having great sex so there must be something wrong with them. If you do have pain during sex, know that it’s common and you have a lot of options and many different specialists out there who can help.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638059/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5969816/