Are You Experiencing Painful Intercourse?

When it comes to our sexual health, many topics may have once been considered taboo or too embarrassing to discuss. Here at Honu Women’s Health, we encourage patients to bring up any and all sexual health concerns. One major sexual health problem is painful intercourse. If you are experiencing pain during sex, it’s important to talk to your doctor, as it may be an indicator of an underlying health problem.

Symptoms of Vaginal Pain

Painful intercourse, or dyspareunia, is described as persistent or recurrent genital pain that occurs just before, during or after intercourse. Most women will experience painful intercourse at some point in their lives that is short-lived. However, if you have recurrent or persistent pain during sex, you should talk to Dr. Sultan about it. The most common symptoms of painful intercourse are:

Pain on sexual entry (superficial penetration)
Pain with any penetration, such as use of a tampon
Deep pain (for example, during thrusting)
Burning or aching pain
Throbbing pain, lasting for hours after intercourse

Causes of Painful Intercourse

The cause of your painful intercourse could be something simple and easy to reverse, or it could be signaling more serious health concerns. Reasons for painful intercourse can range from menopause side effects to medical/anatomical problems to psychological concerns, and understanding the type of pain you are experiencing can help Dr. Sultan determine the cause of your pain and best treatment options. For women experiencing pain only at sexual entry, the reason could be as simple as not having enough lubrication. This is a common side effect of menopause or pregnancy-related hormonal imbalances resulting in low estrogen.

Your sexual discomfort could also be due to injury, trauma, irritation or infection. Eczema or other skin issues, such as lichen sclerosis, in your genital area could also be causing painful intercourse. Dr. Sultan has extensive training in diagnosing and treating skin issues of the genitalia, many of which can contribute to painful intercourse.

Involuntary spasms of the muscles of the vaginal wall, or vaginismus, could be causing pain with intercourse, especially on initial penetration. There are also structural abnormalities that could cause painful intercourse and a thorough examination can help determine if these are causing your painful intercourse.

For women experiencing deeper pain during intercourse, there could be underlying conditions or illnesses causing the pain such as endometriosis, pelvic inflammatory disease (PID), uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, hemorrhoids or ovarian cysts. Scarring from pelvic surgery, such as a hysterectomy, can also cause painful intercourse. Emotional factors such as anxiety, depression or a history of sexual abuse can also be contributors to painful intercourse due to a low level of arousal.

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Treatments for Painful Intercourse

We understand that if you are dealing with painful intercourse, the thought of an exam or bringing the topic up to your doctor can be frightening or embarrassing. At Honu Women’s Health, we want you to be comfortable discussing anything and will stop an exam at any time if it’s too painful. Most importantly will be determining the underlying issue(s) for your painful intercourse and then treating it appropriately.

For women who have hormonal imbalances (such as postmenopausal or postpartum women), low estrogen levels could be causing painful intercourse due to inadequate lubrication. Hormone therapy can help increase lubrication within the vaginal lining and also improve your mood, skin and energy levels. If your painful intercourse is due to an underlying condition, like endometriosis, PID or fibroids, treating these underlying conditions should also result in improvement of the pain experienced during sex.

Another treatment option for women experiencing painful intercourse due to side effects of menopause or childbirth is diVa® laser therapy. This type of laser therapy can reverse the thinning, drying and inflammation of the vaginal walls that happens as a result of reduced estrogen production. The diVa® laser works by triggering the production of collagen and replacing it with new, healthier tissue, as well as increasing the vascularity within the vagina resulting in increased lubrication.

If your painful intercourse is due to a psychological issue, there are many therapies we can recommend to help you learn how to relax your vaginal muscles to lead to decreased pain. We can also recommend counselors or sex therapists who can help you work through your negative emotional response to sexual stimulation.

Lastly, a thorough review of your prescription medications could help identify those medicines that may lead to decreased lubrication or libido, which can result in painful intercourse.

Your Comfort is Our Priority

We encourage you to schedule an appointment at Honu Women's Health to discuss your struggle with painful intercourse in a comfortable, judgment-free environment. At your appointment, be prepared to share sensitive information on when your pain started and under what conditions it occurs. Your medical and surgical history, current medications, and even current life events will be important to share. Here at Honu Women’s Health, your comfort during the exam is a top priority. We believe every woman should be able to enjoy her sexuality and embrace her uniqueness in body, mind and spirit.