Pain during intercourse: causes and doctors advice

Pain during intercourse can be caused by physical or psychological causes. Pain during intercourse is understood as genital pain of a persistent or recurrent nature, occurring immediately before, during or after intercourse. There are now treatments that target the cause and can help eliminate or reduce these discomforts.

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• 1. Painful symptoms often appear during intercourse
• 2. What causes pain during intercourse?
• 3. How to diagnose pain during intercourse?
• 4. Methods to treat pain during intercourse
• 5. Your doctor's lifestyle recommendations for you

1. Painful symptoms often appear during intercourse

If you have painful intercourse, you may experience sensations such as:

• Pain is only present when there is sexual penetration
• Pain with any penetration, including tampon insertion
• Deep pain sensation, appearing when “push”
• Burning or aching pain
• Sharp pain that lasts many hours after intercourse

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2. What causes pain during intercourse?

The cause of painful intercourse varies from person to person and depends on the circumstances, such as pain that occurs during penetration or pain that occurs during deep thrust. Emotional factors may also be involved in different forms of dyspareunia.

2.1 Causes of pain on penetration

Penetration pain can be related to a variety of factors, including:

• Insufficient lubrication:  This is often caused by insufficient foreplay. In addition, the decrease in estrogen levels that occurs after menopause, during childbirth or breastfeeding can also be a cause of this problem. Certain medications that affect sex drive and feelings of euphoria also reduce lubrication and cause pain during sex.
• Trauma or irritation: This condition often occurs after an accident, pelvic surgery, clitorisectomy, or vaginal incision during childbirth.
• Inflammation, infection, or skin disease: An infection of the genital or urinary tract can cause pain during intercourse. Eczema or other skin problems in the genital area can also cause it.
• Vaginitis : Involuntary contractions of the muscles in the vaginal wall can make penetration painful.
• Congenital abnormalities:  Abnormalities discovered soon after birth can also cause painful intercourse, such as incomplete vaginal formation or the existence of a diaphragm that stops the opening of the vagina (hymenorrhea).

Pain during intercourse can have many causes

2.2 Causes of deep pain

Deep pain usually occurs after deep penetration. In some places, more pain may appear. Causes of this condition include:

• Certain diseases and health conditions:  This condition can be caused by conditions such as endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome , pelvic floor dysfunction, hemorrhoids and ovarian cysts.
• After surgery or medical treatment:  Scars from pelvic surgery, such as after a hysterectomy, can cause pain during intercourse. Cancer treatments, such as radiation and chemotherapy, can also cause changes that make sex painful.

2.3 Emotional factors

Emotions are closely related to sexual activity. Therefore, emotions are also a contributing factor to pain during intercourse. Emotional factors that may influence include:

• Psychological problems:  Emotions such as anxiety, depression , low self-esteem, fear of intimacy or relationship problems can be a factor in decreased arousal levels and, as a result, feelings of emotional distress. discomfort or pain.
• Stress: The pelvic floor muscles tend to tighten in response to the stresses of life. This condition can contribute to pain during intercourse.
• History of sexual abuse

It can sometimes be difficult to know if emotional factors are involved in painful intercourse. The initial pain can lead to a fear of feeling pain again. This condition makes it difficult to relax and as a result, even more pain. Later on, you can start avoiding intercourse because you think it causes pain.

Self-image contributes to pain during intercourse

3. How to diagnose pain during intercourse?

Your doctor will evaluate the following factors:

• History and past medical history:  Your doctor will ask when the pain first appeared, where it was, what it felt like, and if it happened with all sex partners and all sexual positions. Your doctor will also ask about your previous sexual relationships, history of surgery, and childbirth. You should answer these questions honestly so that your doctor can find the exact cause of your pain.
• Pelvic exam: Your doctor will check for signs of skin irritation and infection. Examine for problems associated with structural abnormalities. Your doctor will also order a pelvic ultrasound if you suspect that the pain is due to some other cause.

4. Methods to treat pain during intercourse

4.1 Drug use

If an infection or illness is contributing to your pain, treating these causes can resolve the pain. Changing medications that cause insufficient lubrication is also a solution.

For many postmenopausal women, pain during intercourse is primarily due to insufficient lubrication because of low estrogen levels. Usually, this condition can be resolved by applying estrogen directly into the vagina.

The Food and Drug Administration in the United States has also approved ospemifene (Osphena) for the treatment of moderate to severe pain during intercourse in women with pain caused by inadequate lubrication. Ospemifene acts similarly to estrogen on the vaginal lining. However, the limitations of these drugs are that they cause hot flashes, increase the risk of stroke or blood clot formation, and the risk of endometrial cancer.

Another medication used to relieve pain during intercourse is prasterone (Intrarosa). It comes in the form of a capsule to be placed in the vagina every day.

Vaginal pill to relieve pain during intercourse

4.2 Other treatments

Some non-drug treatments may also help:

• Desensitization therapy:  You will be taught relaxation exercises to relieve pain.
• Sex counseling or sex therapies: If sex has been painful for a long time, you may have negative feelings about sexual stimulation even after treatment. If you and your partner are already avoiding intimacy because of pain, you may need help to fix the problem and restore intimacy. Talking to a sex counselor can help you deal with these issues. In addition, cognitive-behavioral therapy is also helpful in changing negative thoughts and behaviors.

5. Your doctor's lifestyle recommendations for you

You and your partner can minimize pain with the following habits:

• Change positions: if pain occurs when pushing deeply, try changing positions.
• Communicating with your partner: mention what feels good and what doesn't. Speak up if you need your partner to slow down.
• Don't rush: longer foreplay can help stimulate natural lubrication.
• Use lubricants: make sex more comfortable. You can try different brands to find what works for you.

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Pain during intercourse can be caused by physical or emotional factors. Feeling pain not only affects sexual satisfaction, but in the long run can also cause decreased sex drive and avoidance of sex. Therefore, you should go to the doctor to find out the cause and fix the pain during intercourse, to avoid the consequences later. Hope the above information of SignsSymptomsList helps you understand and know how to fix this sensitive issue.

Doctor Vu Thanh Do