Pain During Sex: What Causes it and How To Cope

In movies, sex always goes smoothly: everyone is instantly turned-on, multi-orgasmic, and perfectly-lit. But real life is less predictable. Sex can be awkward, unenjoyable, and sometimes excruciating. In fact, pain during intercourse (dyspareunia, as it’s medically known) is common. In 2010, a large-scale survey by Indiana University’s Center for Sexual Health Promotion found that 30% of women aged 18 to 59 had experienced pain during sex.

If it’s happened to you, too, don’t panic: there’s still hope for better sex in the future. Let’s take a look at some of the most likely causes of pain—from easy fixes to more complex cases—and how to handle them.

Lack of lubrication

You’re probably either not into sex right now (in which case, stop) or your body needs a little more time (in which case, slow down). Lube can help—always use a water-based one with condoms—but if the problem persists, talk to your doctor, as low hormones levels or a change in meds could be a factor.

Allergies

Take care of the skin around your vulva: it’s delicate, so perfumed soap or shampoo can easily irritate it. If you have a rash inside your vagina, you might be allergic to latex condoms. See a doctor to be on the safe side.

Vaginal infections

Bacterial vaginosis (BV) is often triggered by scented products, a change in contraception, or a new sex partner. Aside from discomfort during sex, you’ll also notice itching and a fishy-smelling discharge—all of which antibiotics will clear right up. Yeast infections have similar symptoms but the discharge won’t smell and you’ll need to be treated with antifungals. They can be prevented by avoiding synthetic underwear and keeping your blood sugar under control (it’s more common for diabetics).

Sexually-transmitted diseases

Herpes sores can form close to the cervix and if they become infected, this can lead to discharge, bleeding, and pain during sex. See a doctor asap for antifungals and possibly antibiotics. Genital warts are transmitted by skin-to-skin contact (not only sex) and are usually painless, but not always. Either way, you’ll need a prescription—over-the-counter creams aren’t formulated for delicate body parts.

More worrying, bacteria from chlamydia and gonorrhea can spread from the cervix into the reproductive system, causing Pelvic Inflammatory Disease. This inflames tissues in the pelvic region, making sex intensely painful. Antibiotics are essential as if left untreated, it can lead to infertility.

IBS

As if causing constipation, bloating, and diarrhea weren’t enough, irritable bowel syndrome has also been linked to pain during sex. Addressing the root cause through diet and stress reduction is the best approach—a doctor or nutritionist should be able to help.

Endometriosis

This condition causes small pieces of your womb lining to grow outside the womb, which can exacerbate nerves close to the vagina, meaning sex can vary from uncomfortable to unbearable. There’s no cure, but painkillers, hormonal medication, dietary changes, and acupuncture might lessen the agony.

Fibroids

These benign uterine tumours can cause long, heavy periods, bloating, and painful sex (what a treat). They can be managed by medication (usually anti-inflammatory painkillers and the pill) or surgery.

Ovarian cysts

Most of us have a cyst at some point without even realizing, but if it causes sex (or daily living) to become uncomfortable and doesn’t go away after a few months, you might need (minor) surgery.

Vaginismus

An involuntary muscle spasm, vaginismus tenses up the vagina so sex becomes insufferable, or even impossible. It might be linked to anxiety about sex, perhaps due to past trauma. Treatment options include counselling and vaginal training: inserting increasingly larger cones into the vagina to retrain your body’s response.

Vulvodynia

This catch-all term refers to vulva pain lasting three months or more. It usually occurs during sex but may happen at other times, too. The cause isn’t clear and there’s no cure, but research suggests vibration therapy might help. The National Vulvodynia Association can offer support.

Whatever your exact symptoms, don’t suffer alone. Talk to your partner or a trusted friend and head to your gynecologist or local Planned Parenthood for a check-up. Easier said than done, but try not to stress out, too. Remember that P-in-V sex isn’t the be-all and end-all: there are other ways to give and receive pleasure and there’s no shame in prioritising the sex acts that make you feel good. Anyone who wants to sleep with you but doesn’t agree with that needs to be shown the door, stat.