Love Hurts: 10 Common Causes of Painful Sex

Why sex might hurt — and how to resolve the issue.

1. The Symptom

A burning sensation that comes along with cottage-cheese-like discharge and severe itching.

10 Common Causes of Painful SexPossible Causes: Various yeast infections (a.k.a vaginal candidiasis) are very common – three out of four women get one in their lifetime. Pain and swelling associated with such infections just take sex off the list. Furthermore, having sex before you are fully cured can make the infection spread to your partner’s body. Such symptoms can also be associated with bacterial vaginosis (often accompanied by a fishy smell, but will cause no symptoms) or STIs (sexually transmitted infections) such as gonorrhea or chlamydia.

Potential Solutions: Be careful with self-diagnosing and self-treating for yeast infections, especially if it’s the first one you have experienced. It’s best for you to see a doctor and get this issue diagnosed properly. If it’s a yeast infection, you may need antifungal medication; and for bacterial vaginosis or STI, you may need an antibiotic.

2. The Problem

You are in pain after penetration (when something long enough hits your cervix) in the pelvis and the lower abdomen.

Possible Causes: Pelvic Inflammatory Disease (PID) is an infection in the reproductive organs that causes such pain and discharge. There might also be fever, irregular bleeding, or painful urination. PID is caused by bacteria spreading to the reproductive organs through the cervix, often in result of gonorrhea or chlamydia infection. It might also be from an infection after childbirth or IUD insertion.

Potential Solutions: For proper diagnosis, see a doctor. If it is PID, the doctor will likely prescribe a set of antibiotics. If PID is caused by some STI, your partner should also see a doctor.

3. The Problem

You feel pain deep inside during thrusting by a penis, fingers, toys, but it goes away if you change the position.

Possible Causes: Your partner might have poked your cervix. It’s usually an issue of angle and position.

Potential Solutions: This isn’t harmful medically, but it makes sex much less fun. If this always happens in a single position, find a position that works better.

4. The Problem

The walls of the vagina feel like sandpaper each time you attempt penetration.

Possible Causes: Vaginal dryness is usually associated with menopause, but younger women may also have a dry, tearing feeling when something gets inside. Sometimes, birth control pills cause this. Decongestants, used to clear up moisture in other body parts, can also be the cause. Dryness can occur if you’re not in the mood, distracted, or just not into your partner.

Potential Solutions: In most cases, a lubricant can do the job. If dryness happens too often, you may want to see a doctor. If the doctor determines that it is caused by medication, ask if there are other drugs that don’t have this side effect. In chronic cases, it may be helpful to use long-acting vaginal moisturizers, as they relieve dryness for a couple of days by imitating natural lubrication.

5. The problem

Sharp, local pain on the outside area of the vagina.

Possible Causes: Look at your genitals in a mirror, because the pain might be coming from a skin irritation like a pimple or an ingrown hair. Rubbing against these little bumps during sex will only worsen the irritation.

Potential Solutions: Treat the bumps the same way as if they were in any other part of the body. If the problem doesn’t go away in a few days, ask a dermatologist if further steps must be taken. He can also determine if that bump is a deeper problem, like a wart, for example.

6. The Problem

Deep pelvic throbbing and/or cramping during intercourse.

Possible Cause: This might be a symptom of endometriosis, a disorder that makes uterus-lining tissue (endometrium) grow somewhere outside of the uterus, like ovaries, pelvis, or bowel. In addition to painful sex, endometriosis makes periods a lot stronger and with the same pain.

Potential Solutions: See a doctor who can prescribe hormone therapy medications and pain relievers. Extreme cases require surgery.

7. The Problem

The vagina painfully shuts (like a Venus flytrap) whenever penetration starts.

Possible Cause:  A complex condition called Vaginismus causes involuntary contractions of the pelvic floor muscles. The roots of the condition can be both mental and physical—it may happen after a sexual trauma or to women who have grown up in a background that forbids premarital sex. Vaginismus may also be an anxious response caused by fear of pain or intimacy.

Potential Solutions: Vaginismus is often psychological, so your doctor might prescribe psychotherapy. Recovery may also probably require retraining the vaginal muscles (for them to learn how to relax) with a therapist.

8. The Problem

A stabbing pain on the outside and on the opening of the vagina when it’s touched.

Possible Cause: Vulvodynia affects the tissues that surround the entrance of the vagina, and makes them very sensitive. It can be very short-lived or may last for years, and can make not only sex but also exercise or wearing tight pants a painful thing.

Potential Solutions: Doctors aren’t sure what causes vulvodynia, so treatment is complex. A combination of medications might be used, as well as local anesthetics, physical therapy, etc.

9. The Problem

You cannot insert anything into a vagina because of pain.

Possible Cause: Your hymen might be partially or wholly intact. In this situation, sex will typically be very painful since there’s a physical barrier for penetration. An imperforate hymen is completely intact (no holes), and a septate hymen is broken, but still has a membrane, making penetration impossible.

Potential Solutions: Visit a doctor. If the doctor decides that the hymen is causing the pain, you may need to have a minor surgery to remove it.

10. The Problem

Pain in your pelvis during sex and a constant feeling of a need to urinate.

Possible Cause: Painful bladder syndrome (or interstitial cystitis) is a chronic condition that makes pressure on the bladder painful.

Potential Solutions: There is no treatment to fully cure it, but the doctor can help you find relief with medication and pelvic physical therapy.

The Takeaway

The best solution is always to see a medical professional if your sex-life is painful or uncomfortable. It is worth the minor awkwardness to stop pain and discomfort.

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