Medically Reviewed By: Dr. Rukayat Salawu, Resident Obstetrician And Gynecologist.
Feeling temporary pain during sex is not totally uncommon—we have all felt the twinge that follows when we are not sufficiently aroused when sexual intercourse begins. But for some of us—regardless of the level of our arousal, pain during sex is intense, frequent, and persistent.
“Persistent or recurrent pain during sex is known as Dyspareunia, and it is divided into superficial and deep dyspareunia,” Dr. Rukayat says, “Superficial is what a woman feels when a man is trying to penetrate. It is usually caused by inadequate lubrication or inflammation from mild infections of the vaginal bulbs. While deep dyspareunia is pain felt after deep penetration, which is more medically worrisome as it’s due to lesions on the cervix or within the vagina wall.”
Here are the most common reasons you might feel pain during sex with insight from Dr. Rukayat Salawu, Resident Obstetrician and Gynecologist. This article breaks down what might be causing you pain—and how you can alleviate or eliminate it:
You’re not lubricated enough
When it comes to having pleasurable sex, regardless of your preferences, there is one golden rule: the wetter, the better. This leads us to one of the most common causes of painful sexual intercourse: lack of lubrication—your vagina is not wet enough for any penetration. This may be as a result of not enough foreplay, or it may be that you naturally don’t get ‘wet’—could be as a result of stress, certain medications, menopause or just your individual sexual stimulation level.
What to do about it: Your not being wet enough is a strong indicator that you’re not sufficiently aroused. To get things started, spend more time on foreplay in the bedroom. And if you believe you still need more time to be ready, know that foreplay can begin way before physical touch occurs. Foreplay is flirty texts, voice notes, video chats and intentional performance of your love languages. If this is you, make sure you communicate this with your partner.
For many other women, foreplay isn’t enough, and they may need some extra help to get things started (and that’s perfectly fine). Lube—a liquid or gel that helps to prevent unwanted friction during sex— is that extra help. When picking what lube to use, peruse the ingredients to ensure it doesn’t irritate your skin.
As a pro tip, stay hydrated. Drinking eight to six glasses of water a day will keep your tissues hydrated, including those ‘down there’.
You have an infection
Yeast infections, Sexually Transmitted Infections (STIs), and Urinary Tract Infections can make sex extremely uncomfortable. These conditions, especially when left untreated, can disrupt the natural balance of the vaginal flora, causing itching, burning, and soreness that make intercourse painful. Additionally, infections often present additional symptoms, such as abnormal discharge, a foul odor, or pelvic pain.
What to do about it: Seek prompt medical evaluation and treatment. This is essential in addressing the underlying infection, alleviating symptoms, and preventing further complications.
You have an undiagnosed gynecological condition
Pain during sex might indicate that you may have a health issue affecting your reproductive system that is yet to be identified and treated.
Common conditions include: Vestibulodynia, an inflammatory disorder that occurs in the tissue at the vaginal opening. The condition causes pain when the sensitive area is stimulated in any way, sexual or not—by a tampon, sitting, or playing sports. Endometriosis is where tissue similar to the uterine lining grows outside the uterus. It causes chronic pain and heavy menstrual bleeding;
Vaginismus is a condition where the muscles of the vaginal wall involuntarily tighten when penetration is attempted. The muscle contractions can occur during sexual intercourse, a pelvic exam, or even when inserting a tampon, and may cause pain, discomfort, or even make penetration impossible. Vaginismus is often described as a burning sensation, or like the penis is “hitting a wall.”; Uterine fibroids located near the cervix can trigger anything from mild discomfort to severe pain (including bleeding) during sex.
What to do about it: Never ignore pain or strange symptoms during and after sex—visit your health care centre immediately. Even in situations where your medical practitioner dismisses or trivializes your pain, ensure you insist on getting to the root of the issue.
You used a new personal care product
In case you have not gotten the memo, there is no need to clean your vulva (the external female genitalia) with soap or feminine hygiene washes. All you need is water.
However, if you opt for such products and you are experiencing pain during sex, it may be because of it. Many feminine hygiene products on the market can harm your vulvovaginal health, especially with everyday use. These products contain ingredients like fragrances, dyes, or harsh chemicals, which may disrupt the natural balance of the vaginal area, leading to allergic reactions, dryness, increased sensitivity, irritation, or inflammation, thereby causing discomfort during intimacy.
What to do about it: If pain arises after trying or with constant use of a feminine hygiene product, discontinue it and switch to hypoallergenic or pH-balanced options. These can help restore comfort and prevent further irritation. Better still, wash with water.
You’re constipated or bloated
Sexual dysfunction, including painful sexual intercourse, is reported by a disproportionately high number of patients (both men and women) with Irritable Bowel Syndrome, an intestinal disorder that can cause constipation, diarrhea, stomach cramps, and bloating).
Hypothetically, the reason why constipation and bloat cause painful intercourse is because of the role visceral hypersensitivity plays in IBS. This sensitivity may be unique to visceral organs—gut and glands—including the vagina—causing discomfort in such areas.
What to do about it: Maintain a high-fiber diet, stay hydrated, and avoid foods that trigger your constipation. Engage in regular physical activity to promote healthy bowel movements. Practice relaxation techniques to ease pelvic tension. Consider medications or treatments recommended by a healthcare provider for IBS or chronic constipation, and if the issue persists, consult a doctor for a personalized treatment plan to manage IBS and its impact on your sexual health.
You’re tensing your muscles because of a psychological issue.
Psychological factors, like anxiety, Post-Traumatic Stress Disorder (PTSD), and depression, can play a significant role in causing pain during sex, often leading to involuntary muscle tension.
Emotional stress or anxiety stemming from concerns about body image, sexual performance, cultural stigma, religious guilt, or unresolved relationship issues can create a mental barrier to relaxation, making the experience uncomfortable. Past sexual trauma or abuse may trigger PTSD, resulting in heightened fear or avoidance of intimacy. Mental health conditions like depression can also dampen sexual interest and increase physical discomfort during intercourse. Additionally, the fear of pain itself can cause the pelvic muscles to tighten reflexively, thereby intensifying discomfort during sex.
What to do about it: See a therapist to work through whatever issue that may be. Communicate openly with your partner and practice relaxation techniques, such as deep breathing techniques or pelvic floor exercises, which help alleviate the tension you are experiencing and improve your overall sexual experience.
You’re reacting to your birth control pills
Besides the most obvious and undeniably amazing benefit of taking the pill—reliable contraception—there are other numerous bonuses: alleviation of menstrual cramps, light periods, and reduction in the risks of certain cancers.
On the flip side, there is a (long) list of scary side effects like blood clots, stroke, nausea, headaches, increased risk of breast cancer, depression, and the less commonly discussed sexual side effects.
Your birth control pill may be affecting your sex life. One common side effect is vaginal dryness, which occurs when lowered testosterone levels impact lubrication and genital tissue health, sometimes causing discomfort or pain during intercourse. Continued use of birth control pills may also lead to Vaginal atrophy. It is a condition that occurs when the vaginal walls thin, dry out, and become inflamed due to a decrease in estrogen levels. This can cause painful sex. Additionally, the Pill can lead to bleeding during or after sex. While these side effects are not as severe as others, they can significantly impact sexual comfort and satisfaction.
What to do about it: Switching to a different contraceptive pill or exploring alternative methods, such as IUDs, can help manage these symptoms. Apply an estrogen-testosterone compound and engage in physical therapy. If symptoms persist, consult a healthcare provider to fully address the issue and maintain good sexual well-being.
You have an injury in your vagina.
Injury or trauma to the vagina or vulva can lead to persistent pain during sexual intercourse. These injuries may include a cut from shaving, a tear from childbirth (such as episiotomy—a surgical incision made to widen the vaginal opening or perineal tearing—tears in the tissue between the vagina and anus), can cause long-lasting discomfort), circumcision or vaginitis (inflammation of the vagina that can cause discharge, itching, and pain).
What to do about it: Speak with a healthcare provider to explore the best options.
Pain during sex is not the norm, and with these tips, you can improve your sex life. However, be sure to consult a gynecologist for repeated and consistent pain.
