All Pain, No Pleasure?

All Pain, No Pleasure? Painful Sex

Pain during sex really is bothersome, and can totally ruin the moment. Painful sex is called dyspareunia (dis-puh-ROO-nee-uh) in medical terms. It’s defined as persistent or recurrent genital pain that occurs just before, during or after intercourse. Men and women can experience it, but it’s more common among women.


The foremost symptom of dyspareunia is, of course, pain — but there could be different kinds of pain, ranging from moderate to severe. The pain may occur:

  • in the vagina, urethra, or bladder
  • during penetration
  • during or after sex
  • deep in the pelvis during sex
  • after pain-free sex
  • only with specific partners or circumstances
  • with tampon use
  • along with burning, itching, or aching
  • with a feeling of stabbing pain, similar to menstrual cramps


There are a lot of possible factors — both physical to psychological — that can contribute to dyspareunia.

Physical Cause: Entry Pain

Vaginal dryness. When sexually aroused, the glands at the vaginal entry produce fluids to prepare the vagina for sex. A few factors may affect this.

Not enough foreplay and decreased estrogen levels after menopause or childbirth or during breastfeeding may affect the vagina’s capability of producing fluids. With too little fluid, sex becomes painful and uncomfortable.

There are some medications that can affect sexual desire or arousal, and decrease vaginal lubrication as well. These include antidepressants, high blood pressure medications, sedatives, antihistamines, and certain birth control pills.

Genital injury or trauma. Some examples are pelvic surgery, female circumcision, and childbirth.

Inflammation or infection. Inflammation around the vaginal opening (which is called vulvar vestibulitis) makes sex painful. Infection in the genital area or urinary tract, such as yeast infections, urinary tract infections (UTIs), and sexually transmitted infections (STIs), may also lead to dyspareunia.

Skin disorder. This includes eczema, lichen planus, lichen sclerosus, and other skin problems in the genital area.

Vaginismus. This refers to the involuntary contractions of the vaginal wall, which makes penetration painful.

Abnormalities at birth. Vaginal agenesis (when the vagina isn’t fully developed) and imperforate hymen (when the hymen completely covers the vaginal opening) can cause dyspareunia.

Physical Causes: Deep Pain

Deep pain usually happens during deep penetration, and maybe worse in certain positions. Medical treatments or medical conditions usually cause this type of pain.

Certain illnesses and conditions. These may be endometriosis, pelvic inflammatory disease (PID), retroverted uterus, cystitis, uterine prolapse, ovarian cysts, irritable bowel syndrome, hemorrhoids, and uterine fibroids.

Medical treatments or surgeries. Pelvic surgery, hysterectomy, radiation, and chemotherapy make changes in the body that lead to dyspareunia.

Emotional Factors

Emotions are closely tied to sexual activity, and so they could also lead to painful sex.

Psychological issues. Anxiety, depression, low self-esteem, and fear of intimacy or relationship problems can hinder sexual arousal, and lead to discomfort and pain during sex.

Stress. Pelvic floor muscles tend to tighten as a result of stress, and make sex painful.

History of sexual abuse. Not all cases of dyspareunia result from a history of sexual abuse. But if you have been abused, it can contribute.


There are some treatments available, depending on the underlying cause of dyspareunia.

Counseling. Emotions and psychological issues shouldn’t be ignored. Counseling may help individuals who have trauma or other issues. Couples may also get counseling if painful sex has been causing problems in their relationship.

Medication. The doctor may prescribe medication for pain caused by an infection or medical condition.

Lifestyle changes. There are a few things that you can do to possibly help prevent pain and discomfort during sex.

  • Use water-based lubricant (such as EZ Lubricating Jelly)
  • Allot more time for foreplay
  • Communicate to your partner what you feel and experience
  • Try other comfortable positions to minimize pain
  • Practice good hygiene
  • Practice safe sex — use a condom! (this is very important)
  • Attend regular medical check-ups to help prevent genital and urinary tract infections
  • Do kegel exercises

The solution to dyspareunia totally depends on what’s causing it, so it’s highly recommended to consult an OB-GYN when you frequently experience pain during sex. Treating what’s causing it can help your sex life, self-esteem, relationship with your partner, and of course, your physical health.




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