Why does it hurt when I have sex? Causes and Treatments

Having a healthy sex life is essential for anyone. But when you're having pain during sex, it can take a toll on mental health and relationships. It's estimated that 31% of men and 43% of women have sexual dysfunction, showing the prevalence of sexual pain. (1)

Despite how common painful sex can be, most people don't talk about why sex hurts. Or perhaps live each day wondering what is causing the pain during sex and struggling to find the right treatment. This article will provide answers as to why does it hurt when I have sex?

Cause of painful intercourse

The causes of pain during sex are different for each person. It could be because of a pelvic pain condition or a vaginal infection. Another possible reason is going through menopause or experiencing erectile dysfunction. In some cases, pain with intercourse comes from sexual abuse.

Pelvic pain conditions

Sex pain can happen when you have a pelvic pain condition. (2) Some common pelvic pain conditions include:

• Vulvodynia: It’s stinging or burning pelvic pain around the opening of the vagina. The throbbing pain can be ongoing or comes and goes for no apparent cause. A simple touch or pressure from sexual intercourse can cause unbearable vaginal muscle pain.

• Dyspareunia: It's a pain during sexual intercourse that can come from psychological or medical reasons. Painful sexual penetration can come from deep thrusting or even occur on the surface of the genitalia or pelvic floor.
  
  
• Pelvic radiation therapy: When you have radiation therapy to your pelvis, it can cause the shortening or narrowing of the vagina or vaginal stenosis.  Pelvic radiation can result in scar tissue in the vagina, making sexual intercourse painful.

• Vaginismus: It's the involuntary contraction or spasm of the pelvic floor muscles and vaginal wall. The deep pain can occur from inserting a tampon, having sex, or even undergoing a gynecological exam.
  
  
• Vaginal atrophy: This condition is extreme dryness in the vagina. There are different reasons for vaginal dryness, ranging from having pelvic radiation therapy to experiencing menopause.
  
  
• Vaginal Agenesis: This uncommon condition (1 out of 5,000) is a congenital disability that causes the vagina not to form completely. (3) Some women have a shorter vagina or don't have one at all. Vaginal agenesis can make sex extremely painful during penetration or not even possible. 

Vaginal infections

Vaginal infections can cause it to hurt during sex. The most common vaginal infection is a yeast infection. Vaginal yeast infections usually affect women the most between the age of 20-40 and come from antibiotics, poor hygiene, or tissue damage from radiation therapy. (4)

Another common vaginal infection is a urinary tract infection (UTI). When you have a UTI, you may have a burning or stinging sensation, have a persistent urge to urinate, and cloudy urine. (5)

Sexually transmitted diseases

According to Planned Parenthood, sexually transmitted diseases (STD) are common and can occur from oral, vaginal, or anal sex. (6) Without treatment, STDs can cause  other serious health concerns, such as pelvic inflammatory disease and infertility. The most common sexually transmitted infections are the following:

• Chlamydia
• Genital warts
• Gonorrhea
• Herpes
• Hepatitis B
• Scabies

Some sexually transmitted diseases may come with no symptoms, but some can cause burning or stinging pain during sex.

Interstitial cystitis

Interstitial cystitis is a chronic problem that causes ongoing bladder pain, bladder pressure, and at times pelvic pain and inflammation. It's more common for women to have this condition and can cause frequent urination and pain during sexual intercourse. (7)

Ovarian cysts

Ovarian cysts are pockets of pus on your ovaries that may cause a pressure or bloating on your lower abdomen. (8) Each month, a woman's body produces an egg that's released from the ovaries. As the egg is generated, it puts pressure on the cysts, leading to possible pain and discomfort.

Treatments for painful intercourse

Finding health solutions for why it hurts when you have sex, depends on whether the pain comes from a medical condition that requires medication or one that may benefit from physical therapy.

Vaginal Dilators

Vaginal dilators or vaginal trainers are tube-shaped devices that help stretch and lengthen the vagina and pelvic muscles naturally. It's a kind of physical therapy that occurs in the privacy of your own home at your speed.

Many conditions benefit from using vaginal dilators to ease pain and discomfort so you can have a healthy sex life. When you work with vaginal dilators, you'll discover that vaginismus or vulvodynia disappears. If you have scar tissue from radiation therapy, VuVa™ Dilators break apart the painful tissue to transform sexual intercourse.

Medications

If the problem has to do with lubrication or vaginal atrophy from radiation therapy or menopause, there are treatments available. During menopause, women's hormones fluctuate wildly, and estrogen levels may plummet. Postmenopausal women may develop dyspareunia due to these low levels of estrogen.

Estrogen is an essential female sex hormone responsible for helping to balance menstruation and fertility. Low levels cause vaginal dryness, insomnia, and mood swings (among other symptoms). While controversial, one standard treatment is estrogen hormone replacement therapy (ERT).  You add back the missing estrogen to alleviate the symptoms. (9)

Counseling or sex therapy

In combination with vaginal dilators or medication, you may also benefit from counseling. If your response to sex is harmful and triggers an emotional and physical response that makes the experience painful, sex therapy may help you. 

Experiencing pain during intercourse causes men and women to feel alone and ashamed. There’s no reason to suffer. Vaginal dilators and therapy have helped thousands of people have the sex lives they deserve.

1. Pubmed.ncbi.nlm.nih.gov/11122954/
2. Webmd.com/women/ss/slideshow-pelvic-pain-causes
3. Urologyhealth.org/urology-a-z/v/vaginal-abnormalities-vaginal-agenesis
4. Merckmanuals.com/home/women-s-health-issues/vaginal-infections-and-pelvic-inflammatory-disease/overview-of-vaginal-infections
5. Mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
6. Plannedparenthood.org/learn/stds-hiv-safer-sex
7. Mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357
8. Womenshealth.gov/a-z-topics/ovarian-cysts
9. Mayoclinic.org/diseases-conditions/painful-intercourse/diagnosis-treatment/drc-20375973

VuVa Helpful Links:

7 Reasons for a Tight Vagina and How to Loosen 

How to use Vaginal Dilators 

How to Relax Vaginal Muscles, Vaginismus & Sex 

Vaginal Stretching - Keeping in Shape with Dilators 

Do Dilators Really Work? Yes, and They can Improve Your Sex Life!

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