If you are experiencing regular pain during sex this can be a source of embarrassment and concern. Something that is enjoyable and a source of pleasure has become uncomfortable. Painful intercourse, also known as dyspareunia, has many causes and affects nearly all women at some point during their lifetime. While it may be a fleeting issue for some, for others this problem may become long term.

Causes of Painful Sex

If you suddenly experience pain during sex this could be a sign of a gynecological problem such as fibroids, endometriosis, or ovarian cysts. Other causes of painful sex include:

• Hormonal fluctuations (e.g. perimenopause)
• Vaginitis: inflammation of the vagina
• Vaginismus: tightening of the muscles near the opening of the vagina
• Skin conditions
• Urinary tract infections
• Vulvodynia: a pain disorder that affects the vulva

Pain can take on many different forms. Some women experience deep vaginal pain, while others may notice muscle spasms or cramping during or after sex. While painful sex may often be physical, when there are no physical problems it’s also important to consider that the problem may be psychological.

The goal of your gynecologist is to pinpoint what’s causing pain during intercourse as soon as possible so that a treatment plan can be created. During your checkup, your OBGYN will ask you questions about your symptoms, as well as medical history. From there, a physical examination and pelvic exam is performed to check for signs such as cysts or fibroids, which could be leading to pain. Depending on your sexual history and the symptoms you are experiencing, your doctor may also recommend getting STD testing to rule out any sexually transmitted infections.

Sometimes an ultrasound or other diagnostic testing is needed to further evaluate the reproductive organs to pinpoint problems. There are some simple measures you can take to try and alleviate pain during sexual intercourse. Some of these options include:

• Taking a warm bath prior to sex
• Using a lubricant
• Talking with your partner
• Applying an ice pack to the area if burning occurs after intercourse

The treatment that your gynecologist will recommend will depend on the cause of your pain. For example, a urinary tract infection can easily be treated with medication. If women experience pain as a result of the effects of menopause they may be given an estrogen vaginal cream to treat atrophy of the vaginal walls. Vaginal relaxation exercises and behavioral therapy may be recommended for certain conditions such as vaginismus, to reduce muscle contractions and tightening around the vagina.

If you are experiencing persistent pain during sex that is taking the enjoyment out of being intimate with your partner it’s important that you turn to an OBGYN who can help you figure out what’s going on and how to best treat it.