Sexual Health: Female Pain During Sex (Dyspareunia)

Overview

What is female pain during sex (dyspareunia) and how can it impact me?

Pain during sex, or dyspareunia, can cause problems in a couple's sexual relationship. Painful intercourse can have negative emotional effects in addition to the physical pain. There are many effective treatment options available so patients should discuss their symptoms with a physician.

Symptoms and Causes

What causes female pain during sex (dyspareunia)?

In many cases, a woman can experience pain during sex if there is not sufficient vaginal lubrication. In these cases, 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 intercourse if one of the following conditions is present:

  • Vaginismus: This is a common condition in which there is a spasm in the vaginal muscles, mainly caused by the fear of being hurt or prior trauma.
  • Vaginal infections: These conditions are common and include yeast infections.
  • Problems with the cervix (opening to the uterus): The penis can reach the cervix at maximum penetration. Therefore, problems with the cervix (such as infections) can cause pain during deep penetration.
  • Problems with the uterus: These may include fibroids that can cause deep intercourse pain.
  • Endometriosis: A condition in which the endometrium (tissue lining the uterus) grows outside the uterus.
  • Problems with the ovaries: Such problems might include ovarian cysts.
  • Pelvic inflammatory disease: The tissues deep inside become badly inflamed, and the pressure of intercourse causes deep pain.
  • Ectopic pregnancy: A pregnancy in which a fertilized egg develops outside of the uterus.
  • Vaginal atrophy secondary to Menopause: The vaginal lining can lose its normal moisture and thickness and become dry, thin and inflamed.
  • Intercourse too soon after surgery or childbirth
  • Sexually transmitted infections (STIs): These may include genital warts, herpes sores, or other STIs.
  • Injury to the vulva or vagina: These injuries may include a tear from childbirth or from a cut (episiotomy) in the perineum (area of skin between the vagina and the anus) that is made during labor.
  • Skin disorders affecting the genitalia

Diagnosis and Tests

How is pain during sex (dyspareunia) diagnosed?

Your healthcare provider can diagnose the underlying cause of pain during sex (dyspareunia) by a thorough history, pelvic exam, additional testing to rule out infections and occasionally a pelvic ultrasound.

Management and Treatment

How can pain during sex (dyspareunia) in women be treated?

Some treatments for female sexual pain do not require medical intervention. For example, in the case of painful intercourse after pregnancy, wait at least six weeks after childbirth before attempting 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 sexual pain do require a doctor's care. If vaginal dryness is due to menopause, ask a healthcare professional about estrogen creams, tablets, rings or other prescription medications. Other causes of painful intercourse also may require prescription medications.

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.

Living With

When does female pain during sex (dyspareunia) require a doctor's care?

Contact your doctor if there are symptoms such as bleeding, genital lesions, irregular periods, vaginal discharge or involuntary vaginal muscle contractions. For pain with no underlying medical cause, ask the doctor for a referral to a certified sex counselor.

Last reviewed by a Cleveland Clinic medical professional on 11/06/2018.

References

  • The American College of Obstetricians and Gynecologists. When Sex is Painful. Accessed 11/7/2018.
  • The North American Menopause Society. Pain with Penetration. Accessed 11/7/2018.
  • Seehusen D, Baird D, Bode D. Dyspareunia in Women. American Family Physician. Oct 2014;90(7):465-470. Accessed 11/7/2018.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy