Painful Intercourse

Pain during intercourse can be the result of many issues, including problems as minor as uncomfortable positions to more serious complications, such as structural problems or sexually transmitted diseases. Common reasons for painful sex include:

• Allergic reactions or irritation, which can be caused by soap, shampoo, latex condoms or spermicides
• Constipation
• Emotional issues or anxiety that interferes with intercourse
• Endometriosis
• Infections, such as thrush or sexually transmitted infections like chlamydia, genital herpes or gonorrhea
• Irritable bowel syndrome
• Menopause, which commonly causes vaginal dryness
• Pelvic inflammatory disease
• Uterine fibroids
• Vaginismus, tightening of the vaginal muscles

The main symptom of painful intercourse is pain. It may be mild, or it may be severe. You may feel stinging, stabbing or soreness. The pain can be in the inner or outer genitals. The pain may be occasional, or you could have chronic pain.

• Health issues that cause sexual pain should be examined and treated by a physician.
• If the cause of painful intercourse is vaginal dryness, you may benefit from extended foreplay or using a water-based lubricant.
• If you experience vaginal irritation or allergies, you can stop using the products that cause the issue.
• Psychological guidance from a counselor may help if there is an emotional issue or anxiety interfering with sexual enjoyment.
• If positioning is to blame for the pain, work with your partner to find a position that is comfortable for you.

• A history of anxiety or depression
• Allergies to latex can result in pain when a latex condom is used.
• Fear or physical trauma associated with the vaginal area, such as issues related to sexual abuse or relationship issues
• Hygiene issues, such as not properly cleaning the vulva area, can lead to irritation. Avoid using products that contain perfume, such as douches and bubble baths, and wear cotton underwear and loose clothing.
• Multiple sex partners or new partners can lead to sexually transmitted diseases or infections.
• Perimenopause or menopause
• Previous diagnosis of reproductive organ health issues
• Previous diagnosis of skin diseases of the genital area

Medical history. As awkward as it may be to discuss your sex life with your doctor, you need to be fully honest about your symptoms and how long you have experienced them. 

Physical exam. You will likely receive a pelvic exam. An ultrasound or other imaging studies may also be needed.

Referral. You may be referred to a specialist such as a dermatologist, physical therapist or counselor who specializes in talking about sex and relationships.

If your pain during sex is related to hormonal changes from menopause, you may be prescribed estrogen. Other treatments for certain conditions may require prescription medications or surgery. If pain during sex stems from a psychosomatic condition, intensive therapy may be able to help.

Follow the guidance of your provider for the appropriate ongoing care for your condition.