Sexual intercourse should be a source of pleasure, not pain. If sex brings you pain, it’s a sign that something needs attention. Pain during intercourse is never OK, so don’t wait to talk to a provider if it’s happening to you.
In women, painful sex (called dyspareunia) has many possible causes that may stem from physical or psychological issues. To make sex pleasurable again, it’s important to address the underlying problem.
Because there are several possible reasons for pain during intercourse, it’s important to discuss your symptoms with a board-certified women’s health specialist like Daniel S. Kushner, MD.
At his private practice in White Plains and Queens, New York, Dr. Kushner provides different services and resources to help women experiencing painful sex. Here’s a look at some causes of painful intercourse and the treatments that can help.
Why is sex painful for me?
While painful sex isn’t normal, studies show that at least 75% of women experience pain during intercourse at one time or another during their lives. The most common cause for short-term pain during sex is a lack of sufficient lubrication.
But if you’ve been experiencing pain during sex over a longer period, or if you experience severe pain during sexual intercourse, chances are there’s an underlying problem that should be addressed.
Identifying this underlying issue isn’t always straightforward, however. Any number of gynecological problems can contribute to pain during intercourse, including:
- Genital herpes or other sexually transmitted diseases (STDs)
- Urinary tract infections
- Ovarian cysts
- Lichen sclerosus
- Pelvic inflammatory disease (PID)
- Gynecological cancers
Many women also struggle with issues related to sexual response, low arousal or low libido, and other psychological issues that can affect their sexual reaction and trigger painful sex.
Dr. Kushner reviews your medical history, discusses your symptoms with you, and conducts a physical exam. He also orders any imaging studies or blood work necessary to better understand your pain.
Painful sex: The estrogen connection
For many women, sex is only painful after they undergo significant hormonal changes, such as going through menopause or after having a baby. This is because of the link between low estrogen and painful intercourse.
Estrogen helps your vaginal tissues stay moist, thick, and elastic. When the levels of estrogen you produce change significantly, it affects your vagina and the way you experience sex.
This is especially true for women transitioning into or already in menopause. During this time, estrogen production declines dramatically. These lower estrogen levels cause vaginal dryness, thin vaginal skin, and reduced elasticity and tone inside the vagina.
The dryness, fragility, and laxity (looseness) in the vaginal tissues, combined with the natural loss of muscle tone that comes with menopause, can lead to painful sexual intercourse. Women who are pregnant or nursing may experience similar vaginal changes due to hormonal shifts.
Can anything end pain during sex?
Absolutely, but the right treatment for painful sex depends on the root cause. Once Dr. Kushner determines what’s behind your pain, he creates a customized treatment plan that may include:
- Water-based lubricants for dryness
- Antibiotics for bacterial infections and STDs
- Antifungal medications for yeast infections
- Topical corticosteroids for inflammation
- Hormone-based medications for low estrogen levels
Dr. Kushner may also recommend taking preventive steps before having sex to help avoid any pain. For example, it may be useful to see a specialist or therapist for ongoing psychological or emotional concerns. Or it could be helpful to talk to your partner about extended foreplay to boost lubrication.
Many treatment options exist, and the right one for you depends on the reason you’re experiencing pain during sex. For personalized help with painful sexual intercourse, schedule an appointment online or over the phone with Dr. Kushner at the New York office nearest you.