Why Women Experience Dyspareunia and Pelvic Pain After Sex
If sex feels uncomfortable or painful, you're not alone. This Pelvic Awareness Project blog explores common causes of pelvic pain during intimacy, including pelvic floor dysfunction, endometriosis, scar tissue, and hormonal changes. Learn why pain happens, when to seek help, and how to find relief so that intimacy can feel good again.
What To Do If Sex Hurts Or Pain After Sex
Sexual intimacy is supposed to feel good. If it doesn’t, it’s time to seek help.
Painful intercourse is known as dyspareunia, and is defined as lasting or recurrent genital pain that occurs just before, during, or after sex.
If you’re suffering from painful intercourse, it could be a sign of an underlying condition, and it can be treated.
Here’s what you need to know about dyspareunia, including possible causes and how to find relief and enjoy sex again.
Why Does Sex Hurt?
Many women feel embarrassed to ask this question. But if you’ve asked yourself this, there’s nothing to be ashamed about. In fact, this is a common female health problem that often goes neglected.
The pain known as dyspareunia can happen at various times:
- Only at sexual entry, called penetration.
- Any time there is penetration, including putting in a tampon.
- Deep pain during thrusting.
- Burning pain or aching pain.
- Throbbing pain lasting hours after sex.
Dyspareunia doesn’t necessarily cause bleeding. You should see a doctor immediately if you have bleeding during sexual intercourse, as it could be a sign of an underlying medical issue that may or may not be related to the pain.
You’re Not Alone
Dyspareunia can affect up to 28% of women in a lifetime, and can have a significant effect on physical and mental health, as well as quality of life.
That’s because positive sexual intimacy is one of the most fundamental types of social relationships, long recognized as an essential aspect of human life.
Satisfaction with a sexual relationship may improve relationship quality, and enhance life satisfaction and happiness. A strong relationship in general can boost women’s health, including immune system and cardiovascular function.
If you suffer from pain during intercourse, or pain after sex, don’t despair. You can find relief.
Causes of Dyspareunia
There are a variety of possible causes for pelvic pain during sex. Causes can sometimes be linked to the kind of pain and when it happens.
Entry pain, for instance, can be caused by a lack of lubrication, which can be the result of a number of factors:
- Contraceptives can cause inadequate lubrication.
- Decreased estrogen after menopause can thin the vaginal membrane that is responsible for promoting vaginal secretions.
- A drop in estrogen after childbirth or during breastfeeding can be a cause.
- Certain medicines can affect sexual desire or arousal, decreasing lubrication.
Entry pain can also be the result of vaginismus, or involuntary spasms of the muscles of the vaginal wall, a structural issue with the vagina, or a skin disorder or inflammation.1 Another possible cause is called hypertonic pelvic floor, which is when tight pelvic floor muscles cause pain during sex.
Deep pain could be a sign of a serious underlying issue. Here are some possible causes.
Endometriosis
This is when tissue similar to the lining of your uterus grows outside of the uterus, such the fallopian tubes or abdomen.
Interstitial Cystitis
Also known as bladder pain syndrome, this condition causes long-term discomfort, pain, or pressure in your bladder area. Other bladder issues, like a urinary tract infection, can cause pain during sex too.
Pelvic Inflammatory Disease
This infection impacts your uterus, fallopian tubes, or ovaries, and is typically caused by sexually transmitted infections. Besides pain during intercourse, other symptoms include stomach pain, lower abdominal pain, and vaginal discharge.
Uterine Prolapse
This happens when your uterus drops from its usual position, and can cause pain during sex. Other conditions of the uterus can also cause pain, like uterine fibroids.
Pelvic Floor Dysfunction
This is when you suffer from problems with the muscles and ligaments in your pelvic floor, which can lead to pain during sex.
Other possible causes include a retroverted uterus, irritable bowel syndrome, scarring from surgery like after a hysterectomy, other pelvic floor conditions, or hemorrhoids.
Want to know more about pelvic health in general? Here’s an overview of how to prevent pelvic health problems, including warning signs to watch for like pain during sex.
Emotional Factors Impact Sex
It’s also possible that there are emotional factors at play, since feelings and emotions play a role in intimacy.
For instance, if you’re suffering from anxiety, depression, if you have concerns about your physical appearance, if you suffer from fear of intercourse, or you’re having relationship issues, this can all contribute to difficulty during sex.
A history of sexual abuse can play a role in how you feel about sex. Severe stress can cause your muscles to tighten, making enjoyment difficult.
It can also be a cycle, when initial pain may lead you to be afraid to have sex, or have trouble relaxing enough to enjoy intimacy. Pain might cause you to avoid sex altogether.
Suffering from pain during sex can also lead to emotional issues. It may cause anxiety or depression or lead to relationship problems. One or both of you may end up feeling frustrated or disconnected.
And if the issue is an unresolved medical condition that has been left undiagnosed or untreated, then the complications could be serious. For instance, if the pain is caused by a sexually transmitted infection, it could lead to infertility.
See A Doctor if Sex Hurts
As you can see, pain during intercourse can have a number of causes, including underlying medical issues that can and should be treated. Recurring pain before, during or after sex is worth investigating.
Dyspareunia is not something you should ignore. If sex hurts, you should see a doctor. Use the Pelvic Awareness Project’s Physician Finder, a tool that allows you to find a doctor near you with expertise in women’s health. Search the directory of pelvic health physicians and specialists near you so that you can receive a diagnosis and treatment for your pain.
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1- https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967
2- https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse
3- https://www.ncbi.nlm.nih.gov/books/NBK562159/
5- https://my.clevelandclinic.org/health/diseases/15735-interstitial-cystitis-painful-bladder-syndrome
6- https://my.clevelandclinic.org/health/diseases/9129-pelvic-inflammatory-disease-pid
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