Read below about painful sex, including causes, treatment options and remedies. Or get a personalized analysis of your painful sex from our A.I. health assistant. At Buoy, we build tools that help you know what’s wrong right now and how to get the right care.

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Painful Sex Symptoms

Painful sex, or dyspareunia, is recurring genital pain that happens before, during or after sexual intercourse [1]. Dyspareunia is often associated with woman; it is more common in the female population, but men can also experience symptoms of painful sex [2].

Symptoms associated with dyspareunia in women include:

  • Pain upon sexual penetration
  • Pain with any penetration, such as putting in a tampon
  • Pain that worsens with deep thrusting
  • Burning or aching pain
  • Throbbing pain that persists after intercourse

Symptoms associated with dyspareunia in men include:

Such painful sex symptoms can be worrisome and often a topic that most men and women do not want to discuss, but in order to get the appropriate treatment, you should talk to your physician if you are experiencing any of these symptoms.

Painful Sex Causes Overview

Causes of painful intercourse range from structural problems to psychological concerns. Seeing your doctor promptly once you notice symptoms will allow you to get the appropriate diagnosis and care.

Inflammation-related causes:

Inflammation in the genital area in both men and women can often cause painful sex symptoms [3].

  • Infection: Bacteria and fungi that normally inhabit the vagina can overgrow and cause infection that can cause vaginal swelling and burning of the entire vaginal area. Furthermore, many sexually transmitted bacteria such as trichomoniasis and chlamydia can cause symptoms of pain during intercourse. Viral infections such as herpes can also cause similar symptoms and result in clusters of small, painful blisters that can swell and are painful upon contact.

  • Irritation: Eczema or other skin problems of the genital tract can become exacerbated by friction from sexual intercourse.

Hormonal causes:

Often, painful intercourse in women is triggered by hormonal imbalances and changes in the body.

  • Menopause: Menopause is the cessation of a women's menstrual cycle for at least 12 months. Women in their 40s to 50s experience symptoms such as vaginal dryness or thinning of the vaginal wall (atrophic vaginitis) that often results in dyspareunia [4].

    • Uterine conditions: Conditions of the uterus that occur as a result hormonal imbalances such endometriosis can result in dyspareunia [5]

Environmental/emotional causes:

Situations and factors in a person's daily life that reduce sexual desire or influence arousal can also result in dyspareunia.

  • Stress: During times of stress the body can tense up and lose its natural lubrication abilities.
  • Sexual abuse or history of sexual abuse: Sexual abuse is a serious and sensitive topic that can traumatize both men and women and influence sexual situations after the abuse.
  • Psychological issues: Depression, physical appearance concerns and problems with intimacy can result in discomfort and pain.
  • Medications: Some medications such as antidepressants, blood pressure medications and antihistamines are known to affect sexual desire and arousal.

A.I. Health Assistant Causes for Painful Sex

The list below shows results from the use of our A.I. Health Assistant by Buoy users who experienced painful sex. This list does not constitute medical advice.

  1. 1.Bacterial Vaginosis

    Bacterial vaginosis (BV) is an infection caused when too much of certain bacteria change the normal balance of bacteria in the vagina. BV is not a sexually transmitted infection and is not caused by poor hygiene (in fact, excessive washing of the vagina may increase the risk). Its symptoms are usually mild, consisting primarily of a white-gray vaginal discharge that has a fishy smell.

    5-7 days antibiotic treatment. May resolve on its own.

    Rarity:
    Uncommon
    Top Symptoms:
    vaginal itch or burning, vulvovaginal odor, bloody vaginal discharge, white/gray vaginal discharge, thick vaginal discharge
    Urgency:
    Primary care doctor
  2. 2.Gonococcal Cervicitis

    Gonorrhea is a common STD and 350,000 cases occur each year in the United States. It is transmitted through unprotected sex.

    1 week with treatment

    Rarity:
    Uncommon
    Top Symptoms:
    vaginal discharge, vaginal bleeding, painful sex, yellow pus vaginal discharge, heavy menstrual flow
    Symptoms that never occur with gonococcal cervicitis:
    improving vaginal discharge
    Urgency:
    Primary care doctor
  3. 3.Symptoms of Menopause

    Menopause is the point in life where your period stops. This happens when the ovaries stop making hormones that keep your cycle going. The transition into menopause is called peri-menopause and can include symptoms like hot flashes, shortening of menstrual cycle and mood fluctuations.

    Hot flashes typically peak approximately 1 year after the final period and last 4-10 years. Most women stop having hot flashes 4 years after they start, but 10% of women may have hot flashes up to 12 years after their last period.

    Rarity:
    Common
    Top Symptoms:
    fatigue, delay in or irregular periods, vaginal discharge, anxiety, trouble sleeping
    Symptoms that always occur with symptoms of menopause:
    delay in or irregular periods
    Urgency:
    Self-treatment
  4. 4.Pelvic Inflammatory Disease

    Pelvic inflammatory disease (PID) is an infection of the female genital structures like the uterus, fallopian tube, ovary, and the surrounding abdominal wall. It is typically caused by N. Gonorrhoeae or C. Trachomatis.

    Prognosis after treatment within 3 days of symptom onset is great (88%-100%). Those that are hospitalized, older, or have had gynecological surgery have a worse time with this infection.

    Rarity:
    Common
    Top Symptoms:
    fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain
    Symptoms that always occur with pelvic inflammatory disease:
    fever, abdominal pain or unusual vaginal discharge
    Urgency:
    In-person visit

    Painful Sex Checker

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  5. 5.Uterine Fibroids

    Uterine fibroids are noncancerous tumors in the uterus. They are common in women of childbearing age.

    Treatment ranges from medication to surgical removal of the fibroid.

    Rarity:
    Common
    Top Symptoms:
    vaginal bleeding, pelvis pain, abdominal cramps (stomach cramps), painful periods, irregular period
    Urgency:
    Primary care doctor
  6. 6.Ruptured Ovarian Cyst

    Ovarian cysts are common in women of reproductive age. A ruptured cyst occurs when cyst ruptures and releases cyst fluid or blood.

    Outcome depends on severity of illness and treatment used.

    Rarity:
    Rare
    Top Symptoms:
    stomach bloating, pelvis pain, lower abdominal pain, being severely ill, severe abdominal pain
    Urgency:
    Hospital emergency room
  7. 7.Lichen Sclerosus

    Lichen sclerosus is a chronic inflammatory disease of unknown cause. It's most commonly on the genital region and occurring in women who are post menopausal.

    Can be lifelong; however, symptoms will come-and-go with treatment

    Rarity:
    Common
    Top Symptoms:
    vaginal itch or burning, vaginal pain, painful sex, dry skin on the outside of the vagina, painful urination
    Urgency:
    Primary care doctor
  8. 8.Chlamydia Infection

    Chlamydia is a common bacterial infection that is spread through unprotected sex. Each year, over 1 million Americans are diagnosed with this STD.

    The infection should clear in 1-7 days after treatment.

    Rarity:
    Common
    Top Symptoms:
    vaginal discharge, vaginal bleeding, sudden urgency to urinate, bleeding after sex, frequent urination
    Symptoms that never occur with chlamydia infection:
    improving vaginal discharge
    Urgency:
    Primary care doctor
  9. 9.Atrophic Vaginitis

    Atrophic vaginitis is an inflammation of the vagina and surrounding structures. It is caused by decreased levels of estrogen which causes the endometrial and vaginal lining to thin and vaginal pH to increase, causing symptoms like dryness, burning, and itching.

    Treatment will effectively manage symptoms.

    Rarity:
    Common
    Top Symptoms:
    vaginal discharge, vaginal bleeding, delay in or irregular periods, vaginal itch or burning, signs of urinary tract inflammation
    Symptoms that always occur with atrophic vaginitis:
    delay in or irregular periods
    Urgency:
    Primary care doctor

Painful Sex Treatments and Relief

Since dyspareunia can be related to both physiological and psychological conditions, your physician may suggest a multifactorial approach to treating your painful sex symptoms.

For inflammatory painful sex conditions your doctor may suggest the following:

  • Antibiotics or antifungals: These medications will combat bacteria and fungi that may be contributing to your symptoms.

  • Dermatologic treatments: If your symptoms are related to a skin condition in your genital area, your doctor may prescribe topical steroids that reduce inflammation.

  • Sitz baths: These are warm-water baths with salt added. They are helpful in alleviating pain and discomfort, and kits can be bought at the pharmacy. You can sit in the bath several times per day for a week.

For hormonal painful sex conditions your doctor may prescribe:

  • Estrogen therapy: This will restore imbalances in estrogen in women who are transitioning or have started experiencing symptoms of menopause. Estrogen therapy is often used to treat dryness from atrophic vaginitis.
  • Contraceptives: Birth control methods do a wonderful job in controlling hormone levels and preventing conditions such as endometriosis.

For environmental/emotional causes of dyspareunia, try some of these lifestyle and home remedies:

  • Change positions: Try multiple different positions during sexual intercourse in order to better regulate depth of penetration and recognize positions that cause you less pain.
  • Use lubricants: A personal lubricant can make sex more comfortable.
  • Communicate and don't rush: Communicate with your partner about any discomfort or pain you may be feeling. Also taking time during foreplay or delaying penetration until you feel completely aroused can help reduce pain.

FAQs About Painful Sex

Here are some frequently asked questions about painful sex.

Why does it burn while having intercourse?

A variety of factors can cause pain during intercourse. For men, pain in the penis during intercourse may be caused by an obstruction of the urethra. For women, vaginal pain during intercourse is more common. It may occur due to a lack of lubrication (e.g. caused by progestin-only pills), pre-existing inflammation of the vagina, or infections, including sexually-transmitted (STIs) and non-sexually-transmitted infections.

What causes stomach pain during sex?

In women, abdominal pain during sex can be caused by endometriosis, fibroids, infections, or — if you are engaging in penetrative sex — pressing on the cervix. Endometriosis is a disorder in which some of the lining of the uterus moves to other areas of the body and tends to grow and shrink in concert with the menstrual cycle. Fibroids can also cause pain in the uterus that can be manifested during sex [6].

Why do I have painful sex during my period?

Endometriosis is often worsened during the menstrual cycle. It occurs when the lining of the uterus spreads to other areas of the female genital tract. It can cause tender areas in the cervix or a tender uterus when disrupted by the uterus. It can be treated in a gynecologist's office with a routine cauterization of the tissue. It should be evaluated as other causes of pain during sex may be more dangerous.

What does it mean when you have pelvic pain after intercourse?

Pelvic pain after intercourse can be caused by straining of the pelvic muscles or bruising of the tissue surrounding the pelvis. This may be prevented by stretching. Bruising can be prevented by proper communication and altered positioning. Inflammation or fibroids can also cause pelvic pain.

Can STDs cause painful sex?

STDs (sexually transmitted diseases, also known as STIs or sexually transmitted infections) can cause painful sex. Gonorrhea, Chlamydia, and other STDs can cause painful sex from inflammation of the vaginal canal which is tender upon penetrative sex. The external vagina can also be affected by sore blisters during a herpes infection. Additionally, a long-standing infection can track into the uterus causing pelvic inflammatory disease.

Questions Your Doctor May Ask About Painful Sex

  • Q.Do you feel pain when you urinate?
  • Q.When was your last menstrual period?
  • Q.Do you bleed after having sex?
  • Q.Do you use birth control beside condoms?

If you've answered yes to one or more of these questions, try our painful sex symptom checker to find out more.

Painful Sex Quiz

Painful Sex Symptom Checker Statistics

  • People who have experienced painful sex have also experienced:

    • 10% Vaginal Discharge
    • 9% Vaginal Itch or Burning
    • 6% Bloody Vaginal Discharge
  • People who have experienced painful sex were most often matched with:

    • 50% Gonococcal Cervicitis
    • 37% Bacterial Vaginosis
    • 12% Symptoms of Menopause
  • Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

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References

  1. Sorensen J, Bautista KE, Feranec J, et al. Evaluation and Treatment of Female Sexual Pain: A Clinical Review. Cureus. 2018;10(3):e2379. NCBI Link.
  2. Wabrek AJ, Wabrek CJ. Dyspareunia. Journal of Sex & Marital Therapy. 1975;1(3):234-241. NCBI Link.
  3. Sexually Transmitted Diseases. U.S. National Library of Medicine: MedlinePlus. Updated September 12, 2016. MedlinePlus Link.
  4. Kingsberg SA, Kellogg S, Krychman M. Treating Dyspareunia Caused By Vaginal Atrophy: A Review of Treatment Options Using Vaginal Estrogen Therapy. International Journal of Women's Health. 2009;1:105-111. NCBI Link.
  5. Danny E, Mann CH. Endometriosis-Associated Dyspareunia: The Impact on Women's Lives. Journal of Family Planning and Reproductive Health Care. 2007;33(3):189-193. NCBI Link.
  6. Fibroids: Signs and Symptoms. UCSF Health. UCSF Health Link.