Pain during sex (dyspareunia) can be caused by vaginal dryness, infection, endometriosis, pelvic floor tension, or anxiety. See a doctor for diagnosis.
Terms
Dyspareunia is persistent or recurrent pain during sex. It affects up to 20 percent of women in the US (ACOG) and some men.
Causes in women
- Vaginal dryness (menopause, breastfeeding, low estrogen).
- Infections and STIs.
- Endometriosis.
- Pelvic floor tension or vaginismus.
- Fibroids, cysts and pelvic inflammatory disease.
- Anxiety or past trauma.
Causes in men
Infection, Peyronie’s disease, tight foreskin and prostatitis.
What helps
Lubricant, foreplay, communication and positions that give control.
See a doctor
Painful sex is treatable. See a gynecologist, urologist or pelvic floor therapist.
Support
Counseling can help.
Terms
Painful sex is called dyspareunia, defined as persistent or recurrent genital pain before, during or after intercourse. It affects about 10% to 28% of women at some time in their lives and also occurs in men. It is a medical symptom that can be treated and it is not something to just put up with.
Causes in women
- Insufficient lubrication, from not enough arousal, menopause (genitourinary syndrome of menopause), breastfeeding, some medications or hormonal birth control.
- Vaginismus: involuntary tightening of the vaginal muscles, often linked to anxiety, fear or past trauma.
- Vulvodynia: chronic vulvar pain with no clear cause.
- Infections: yeast infection, bacterial vaginosis, STIs and urinary tract infections.
- Endometriosis, uterine fibroids, ovarian cysts and pelvic inflammatory disease, which cause deep pain.
- Skin conditions such as lichen sclerosus.
- Pelvic floor muscle tension.
- Scarring after childbirth, episiotomy or surgery.
- Interstitial cystitis.
- Emotional factors: stress, anxiety, depression, relationship problems or a history of abuse.
Causes in men
- Infections such as prostatitis, urethritis and balanitis.
- Phimosis (tight foreskin), Peyronie’s disease (curved penis due to scar tissue) and tight frenulum.
- Skin irritation or allergy to latex or lubricants.
- Pelvic floor problems.
- Chronic pelvic pain syndrome.
- Psychological factors.
What helps
- Use water-based or silicone lubricants.
- Spend more time on foreplay and arousal.
- Communicate with your partner and try positions that give you control.
- Use vaginal estrogen or moisturizers for menopause-related dryness.
- Pelvic floor physical therapy is highly effective for muscle-related pain.
- Treat infections and medical conditions.
- Sex therapy or cognitive behavioral therapy.
- Avoid scented products and irritating soaps.
See a doctor
See a gynecologist, urologist or primary care doctor if pain is persistent, severe, comes with bleeding, discharge, fever or lasts after sex. An exam and tests can find causes.
Support
Painful sex can strain relationships and mood. Counselors and sex therapists can help, and the American Association of Sexuality Educators, Counselors and Therapists (AASECT) lists certified therapists.
Medical conditions behind painful sex
Painful intercourse, medically called dyspareunia, affects about 3 in 4 women at some point in life, according to ACOG. Common causes in women include vaginal dryness from menopause or breastfeeding, vaginismus, endometriosis, pelvic inflammatory disease, fibroids, ovarian cysts, interstitial cystitis and infections such as yeast infections or sexually transmitted infections. In men, causes include Peyronie disease, tight foreskin (phimosis), prostatitis, infections and penile skin conditions. Using water based or silicone lubricants, allowing more time for arousal, trying different positions and treating infections can help. Pelvic floor physical therapy is effective for many types of pain. Pain with sex is a medical issue and not something to endure, and a doctor can help without judgment. Seek care for new or persistent pain, bleeding after sex, fever, unusual discharge or pelvic pain.
Based on data from ACOG and the Mayo Clinic
