How Do I Know If My Period Is Irregular?
Worried your cycle is off? This blog breaks down what counts as normal, when to worry, and what might be behind changes in your cycle.
Why Do I Have Pain During Sex?
Sex is supposed to be enjoyable and intimate, but it isn’t always painless. It’s natural to feel occasional discomfort after a long period of activity when you’re already sore, or if there isn’t enough natural lubrication. However, if you experience pain almost every time you have sex, it’s a sign that something needs attention. The cause may be simple and easily treated, or it may point to an underlying condition that requires urgent medical care.
There are many culprits for painful sex. Some are mechanical, like pelvic floor muscle tightening (vaginismus). Others involve the skin or tissue at the entrance to the vagina, hormonal changes that reduce lubrication, or conditions like endometriosis, fibroids, or infections. For some women, past trauma or hormonal changes may also play a role.
Getting to the root of the problem matters not only so sex can be comfortable again, but also to catch and treat any medical issues causing the pain. At Rose Women’s Medical Center, our team evaluates sexual pain and treats connected conditions every day. Here, we’ll take a closer look at why sex might hurt and when to get help.
Common causes of painful sex
Pain during sex can happen for many reasons. Understanding the most common causes can help you recognize when to reach out for help.
Vaginal dryness
One of the leading culprits is inadequate lubrication. Vaginal dryness often happens during menopause due to lower estrogen levels, but younger women can experience it too, from certain medications, breastfeeding, or hormonal changes. Without enough lubrication, friction can cause irritation and pain.
Vaginismus
This condition causes the muscles around the vagina to tighten reflexively, sometimes because of previous painful experiences, anxiety, childbirth trauma, or no apparent reason at all. That tightness makes penetration painful or impossible and can create a cycle: anticipating pain causes more clenching, which causes more pain. Pelvic floor physical therapy and gentle desensitization techniques are highly effective for treating this condition.
Endometriosis and other gynecological conditions
Painful sex is one of the hallmark symptoms of endometriosis, where tissue similar to the lining of the uterus grows outside of it. Other conditions like fibroids, pelvic inflammatory disease (PID), or ovarian cysts can also cause deep pelvic pain during sex. These conditions often need medical evaluation to confirm and treat properly.
Infections or irritation
Yeast infections, urinary tract infections, or sexually transmitted infections can all cause burning or pain with intercourse. Even irritation from scented products or harsh soaps can trigger discomfort.
Why you shouldn’t ignore it
Painful sex is easy to dismiss. Some women tell themselves it’s “just part of getting older,” or that they need to “push through it.” Others are embarrassed to bring it up, even with a doctor. But ignoring pain can make things worse.
For example, if an infection is causing the pain and goes untreated, it could lead to complications like infertility. If endometriosis is the cause, waiting to get help might mean worsening symptoms over time. And even if the root issue isn’t medically serious, pain itself can affect intimacy, increase stress, and affect your mental health.
The bottom line is sex should not hurt. If it does, your body is trying to tell you something.
Treatment options
Treatment depends entirely on what’s causing your pain. Here are some of the strategies we often recommend:
- Lubricants and moisturizers: For dryness, high-quality, unscented lubricants or vaginal moisturizers can make a big difference
- Pelvic floor therapy: If vaginismus or muscle tension is the cause, working with a physical therapist can help retrain and relax those muscles
- Medication or hormone therapy: In cases of infection, inflammation, or hormonal imbalance, medications may be prescribed. For post-menopausal dryness, localized estrogen therapy may help
- Minimally invasive surgery: If conditions like fibroids or endometriosis are behind the pain, surgery may be an option to address the root issue
- Counseling or sex therapy: When there are emotional or psychological factors at play, counseling provides a safe space to work through them while also addressing the physical aspects
Many women benefit from a combination of treatments, and at Rose Women’s Medical Center, your treatment plan is always customized to fit your needs.
Pain during sex may be common, but that doesn’t make it normal. If intimacy leaves you hurting instead of feeling connected and fulfilled, it’s time to get answers.
At Rose Women’s Medical Center, our team specializes in helping women understand what’s causing their pain and finding solutions that fit their lives. With the right care, you can get back to enjoying intimacy again. Call us at 331-233-1350 today or request an online appointment.
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