Painful Sex

What causes painful sex?

Painful sex could signify a gynecological disorder or a sexual response problem. Common causes include:

Skin disorders

Skin disorders like contact dermatitis cause itching, burning, and pain and may lead to ulcers or cracks in the vulval skin. Reactions to irritants like perfumed soaps are the most likely trigger.

Vulvodynia

Vulvodynia is a pain disorder affecting the vulva. Vulvar vestibulitis syndrome (VVS) is where the pain only affects the vestibule (the area around the vaginal opening).

Hormonal changes

Decreasing estrogen (female sex hormone) levels during perimenopause and menopause can cause vaginal dryness (urogenital atrophy).

Vaginitis

Vaginitis is inflammation caused by a yeast or bacterial infection.

Vaginismus

Vaginismus is an automatic tightening of the vaginal opening muscles that makes penetration difficult.

Childbirth injuries

Women who suffer from perineal tears or need an episiotomy (surgical cut) during childbirth may experience painful sex for several months afterward.

Pelvic inflammatory disease (PID)

PID is inflammation typically caused by an internal infection.

Endometriosis

Endometriosis develops when tissue resembling the uterine lining grows outside the uterus. It swells and bleeds during menstruation, but because the blood can’t escape, painful adhesions form.

Lack of arousal can also lead to painful sex. Medications and conditions like thyroid disorders and diabetes can sometimes affect desire. Relationship problems and feeling anxious, embarrassed, or guilty about sex can all affect your response and result in painful sex.

How common is painful sex?

Painful sex is very common, with almost 75% of women experiencing it at some time. For some, the pain is temporary or easy to resolve, but for others, it becomes a long-term issue.

To determine the cause, Dr. Amersi reviews your medical and sexual history, assesses your symptoms, and completes a physical exam. She asks about any medications you take and experiences like sexual abuse or rape that affect your feelings about sex.

Dr. Amersi may also order tests or procedures like an ultrasound or laparoscopy to view your internal organs.

What treatments help with painful sex?

With so many possible causes for painful sex, the treatment you need can vary considerably. Potential therapies include:

• Anti-inflammatory medication
• Antibiotics for infections
• Using lubricants during sex
• Physical therapy
• Weight loss
• Medication changes
• Dietary changes and supplements
• Bioidentical hormone replacement therapy (BHRT)
• Vaginal laser rejuvenation
• Counseling
• Sex therapy

Sometimes, women need more invasive procedures like endometrial ablation or surgery to resolve the underlying cause of painful sex.

Call Dr. Amersi's office to arrange a confidential discussion about painful sex or request a consultation online today.