Painful Intercourse: Is Pain During Sex Normal For Women?

Today we are discussing a topic which is often kept in shadows. We will be talking about painful sex also known as dyspareunia. Now medically it is something which many women experience at some point in their lives but very few feel comfortable talking about it or even seeking help. 

So in this post I will be explaining the causes of painful sex from physical to emotional factors, and we will also discuss the treatments which can help you find relief. So if this is something you or your loved one is going through know that you're not alone and there are effective solutions which are available. 

What is painful sex? 

Medically this is called as dyspareunia, in medical terms dyspareunia means persistent or recurrent pain which occurs just before, during or after sex. For some women the pain is mild and occasional but for others it can be severe, long lasting, affecting their quality of life and intimate relationships, this condition can happen at any point in their lives. 

Pain during sex can affects women of all ages. It's important to remember that painful sex is not normal and it is not something which you should just live with. There are many underlying reasons that causes pain during sex and understanding them is the first step towards finding the right treatment. 

Is Pain During Sex Common?

So first let's talk about how common is the problem of painful sex in Nigeria and worldwide. Did you know that pain during sex is quite common affecting one in two women at some point in their lives and this number may be even low because many people do not seek help for painful sex because it's a sensitive topic. So before we go further let's first understand the types of painful sex. 

Types Of Pain During Sex

Painful sex can manifest in different ways depending on the underlying cause. 

1. Superficial Pain During Sex

First could be superficial pain. This type of pain occurs at the opening of the vagina or on the surface or when your partner is trying to penetrate inside you.

This often feels like burning, stinging or a feeling of rawness. Women who experience superficial pain may notice discomfort as soon as the penetration begins or even when attempting to insert tampons, menstrual cups or even undergo gynecological exams. 

Now this type of pain during sex occurs commonly due to:

• Tight hymen
• Vaginal infections
• Vaginal injuries
• Vaginal dryness, cuts, boils, blisters in that area and 
• Vaginismus

2. Deep Pain During Sex

The second type of painful sex could be when there is deep pain inside. Now the deep pain occurs during deeper penetration and it is usually felt in the pelvis or in the lower abdomen. This feels like cramping, pressure or a stabbing sensation, some women describe it as lower abdominal pain during sex.

This kind of a pain is often linked to conditions which affect the internal reproductive organs like the uterus and the ovaries. So conditions that can cause this includes but not limited to: 

• Endometriosis
• Fibroids
• Ovarian cyst 
• PID which is the pelvic inflammatory disease.

So it is very important to distinguish between these two types of pain during sex because the treatment will depend upon where the pain is located.

Painful sex can also be described as primary or secondary. Primary pain is the pain which you've had ever since you became sexually active right from the first time. While the secondary pain develops after experiencing pain-free sex earlier which means things were fine earlier and now suddenly the sex has become very painful. 

What Causes Pain During Sex?

Did you also know that painful sex could happen because of physical and emotional factors? First let's talk about the physical causes of painful sex.

Physical Causes Of Pain During Sex

1. Poor Vaginal Lubrication 

One of the most common causes of painful sex is vaginal dryness which occurs when natural lubrication isn't enough. Not enough natural lubrication can happen due to lesser time at foreplay, hormonal changes especially during menopause, breastfeeding or even after childbirth. This can also be linked to taking certain medications like antihistamines, antidepressants and even birth control pills. 

2. Vulvodynia

Second is what is known as vulvodynia, this is a little technical term it refers to chronic pain or discomfort around the opening of the vagina or at the vulva. The cause for vulvodynia isn't always clear but it can cause burning, stinging and throbbing pain during sex and the pain may be constant or come and go or it can even make even light touch or pressure very painful. 

3. Vaginismus

Vaginismus is a condition where the muscles of the pelvic floor contract involuntarily during attempts at penetration. This tightening can make the sex extremely painful or even impossible. 

Women who have vaginismus often describe this as a feeling of being completely blocked during the penetration and the pain can be both emotional and physical. We spoke about vaginismus in one of our post sometime back so please refer to the post on vaginismus.

4. Endometriosis

This is a condition where the tissue or the lining which normally lines the inside of the uterus starts to grow outside the inner lining of the uterus. Now this lining can attach to other organs such as ovaries and fallopian tubes leading to bleeding, inflammation and scarring. Endometriosis typically causes deep pelvic pain during sex especially with deeper penetration. 

5. Pelvic Inflammatory Disease

It's also commonly known as PID, this is the infection of the reproductive organs. It could be caused by sexually transmitted infections like chlamydia and gonorrhea. This can cause inflammation and scarring leading to once again deep pain during the intercourse. 

6. Fibroids and Ovarian Cyst 

Then of course the fibroids and ovarian cysts, these are the non-cancerous growths of the uterus and ovaries respectively. They can cause pressure or pain during sex. 

These growths especially if they are very big can distort the normal anatomy of the uterus and ovaries making intercourse uncomfortable especially during deep penetration. 

7. Childbirth and Surgery Scars

Scarring from the vaginal delivery particularly if you've had a big episiotomy or a tear can lead to painful sex. Similarly scarring from the surgeries like c-section and hysterectomies also can cause discomfort. 

8. Bowel Urinary Tract Infections

Very rarely bowel problems like irritable bowel syndrome, ulcerative colitis, Crohn's disease, bladder problems like chronic UTIs, interstitial cystitis also can make the sex very painful. 

Emotional Causes Of Pain During Sex

While physical causes are common, sometimes the emotional and psychological factors are also an important reason of painful sex.

The mind and the body are closely connected and emotional stress can manifest as physical pain. So here are some emotional and psychological causes which can cause painful sex. 

1. Anxiety and Stress

Anxiety especially related to sexual performance or body image can cause tension in the pelvic muscles leading to discomfort or pain. Stress about work, relationships or personal issues can also interfere with the arousal and natural lubrication making the sex painful. 

2. Past Traumatic Experience 

Now women who have experienced sexual trauma such as abuse or assault may develop a fear or anxiety around sex leading to involuntary muscle tightening or pain during intercourse and this pain can persist even after the trauma has passed. 

3. Depression

Depression can reduce sexual desire and make the body less responsive to arousal which can contribute to painful sex. Women who are depressed may also be taking medications which can affect sexual function and lubrication. 

Very important, relationship issues, tension or unresolved conflicts in a relationship can manifest as physical discomfort during intimacy. So if emotional connection or trust is lacking, the body may respond with pain during sexual activity. 

Treatment of Pain During Sex

So now what is to be done when you are having pain during sex? If you've been experiencing pain during sex, the first thing and the most important thing which you have to do is to visit a gynecologist. The gynecologist should be your first point of contact. 

Many women feel embarrassed or ashamed to bring this up but remember painful sex is a medical issue. It is not something to be ashamed of. 

Let's talk about what is the treatment for the painful sex. Actually, the right treatment depends obviously on the underlying cause but there are plenty of ways to address both the physical and the emotional aspects of painful sex. 

1. Lubrication with Moisturizers

For women dealing with vaginal dryness, using a water-based lubricant during sex can help reduce friction and discomfort. In case of menopausal dryness, the doctor may prescribe a vaginal moisturizer or low-dose estrogen cream to restore the natural moisture levels of the vagina.

2. Pelvic Floor Physical Therapy

In case muscle tension or vaginismus is causing the pain, working with a pelvic floor physical therapist can help. These specialists can teach you exercises to relax and strengthen your pelvic muscles, making the penetration less painful. 

3. Topical Numbing Agents 

Topical means this can be applied over the skin, for conditions like vulvodynia, the doctor can prescribe a topical numbing cream or ointment to reduce the sensitivity and pain around the vulva and they can be applied before sex to reduce the discomfort. 

4. Treatment of Underlying Condition 

Then of course we have medications for the underlying condition. So in case your pain is because of a condition like endometriosis or pelvic inflammatory disease, the doctor may recommend medications to treat the underlying issues, like hormonal treatments, antibiotics, anti-inflammatory drugs can help reduce the pain and improve the sexual function. 

5. Cognitive Behavioural Therapy 

Cognitive behavioral therapy, it's also called CBT, if emotional factors like anxiety, depression or trauma are contributing to painful sex, cognitive behavioral therapy by a psychologist or a psychiatrist can be an effective treatment for this. This helps you identify and change the negative thought patterns and behaviors which might be causing the pain. 

6. Sex Therapy 

For couples dealing with relationship issues or sexual discomfort, working with a counselor or sex therapist also can be incredibly helpful. They can help you address communication problems, build trust and explore ways to improve your sexual relationship. 

7. Surgeries 

In cases where you have big fibroids, big ovarian cysts or there is scarring which is causing the pain, surgery may be necessary to remove the growths or repair the damaged tissues inside. This is typically reserved for more severe cases when all other treatments haven't really worked or failed. 

Conclusion 

Lafiyata is a place where we speak the unspoken, painful sex is one of them. Remember you don't have to suffer in silence. There are effective treatments available and speaking with your doctor is the first step towards finding relief. 

So if you have any questions and want to learn more, feel free to leave a comment below. Do not forget to subscribe to our blog for more content on women's health and wellness. Take care and I will see you in the next post.