Painful Sex in Women (Dyspareunia)

Medically Reviewed by Traci C. Johnson, MD on August 23, 2022
3 min read

Intercourse pain, or dyspareunia, can cause problems in a couple's sexual relationship. In addition to the physically painful sex, there is also the possibility of negative emotional effects. So the problem should be addressed as soon as it arises.

In many cases, a woman can experience painful sex if there is not sufficient vaginal lubrication. When this occurs, the pain can be resolved if the female becomes more relaxed, if the amount of foreplay is increased, or if the couple uses a sexual lubricant.

In some cases, a woman can experience painful sex if one of the following conditions is present:

  • Vaginismus. This is a common condition. It involves an involuntary spasm in the vaginal muscles, sometimes caused by fear of being hurt.
  • Vaginal infections. These conditions are common and include yeast infections.
  • Problems with the cervix (opening to the uterus). In this case, the penis can reach the cervix at maximum penetration. So problems with the cervix (such as infections) can cause pain during deep penetration.
  • Problems with the uterus. These problems may include fibroids that can cause deep intercourse pain.
  • Endometriosis. This is a condition in which the tissue similar to that which lines the uterus grows outside the uterus.
  • Problems with the ovaries. Problems might include cysts on the ovaries.
  • Pelvic inflammatory disease (PID). With PID, the tissues deep inside become badly inflamed and the pressure of intercourse causes deep pain.
  • Ectopic pregnancy. This is a pregnancy in which a fertilized egg develops outside the uterus.
  • Menopause. With menopause, the vaginal lining can lose its normal moisture and become dry.
  • Intercourse too soon after surgery or childbirth.
  • Sexually transmitted diseases. These may include genital warts, herpes sores, or other STDs.
  • Injury to the vulva or vagina. These injuries may include a tear from childbirth or from a cut (episiotomy) made in the area of skin between the vagina and anus during labor.
  • VulvodyniaThis refers to chronic pain that affects a woman's external sexual organs -- collectively called the vulva -- including the labia, clitoris, and vaginal opening. It may occur in just one spot, or affect different areas from one time to the next. Doctors don't know what causes it, and there is no known cure. But self-care combined with medical treatments can help bring relief.

 

Some treatments for painful sex in women do not require medical treatment. For example, painful sex after pregnancy can be addressed by waiting at least six weeks after childbirth before having intercourse. Make sure to practice gentleness and patience. In cases in which there is vaginal dryness or a lack of lubrication, try water-based lubricants.

Some treatments for female sexual pain do require a doctor's care. If vaginal dryness is due to menopause, ask a health care professional about estrogen creams or other prescription medications. Other causes of painful intercourse may also require prescription drugs.

For cases of sexual pain in which there is no underlying medical cause, sexual therapy might be helpful. Some individuals may need to resolve issues such as guilt, inner conflicts regarding sex, or feelings regarding past abuse.

Call a doctor if there are symptoms such as bleeding, genital lesions, irregular periods, vaginal discharge, or involuntary vaginal muscle contractions. Ask for a referral to a certified sex counselor if there are other concerns that need to be addressed.