Sexual intercourse shouldn’t be painful. But for some women, it is.

For some, there may be pain during sexual entry or thrusting. For others, there is a burning, aching, or throbbing pain with every penetration, even pain that lasts several hours after intercourse.

What could be the reason for this?

Pain can be experienced before, during, or after vaginal sexual intercourse. Also called dyspareunia, painful intercourse occurs at the top of the vagina and intensifies with thrusting. It is characterized by a tearing, burning, or aching sensation.

The condition can happen at any age. It tends to occur in women who are still young, but you may also have the condition during or after menopause due to decreased elasticity of the vaginal walls, narrowing of the vaginal opening, or increased vaginal dryness. You may also experience painful intercourse after surgical menopause — the surgical removal of ovaries.

If you have painful intercourse, you might feel:

  1. Pain only at sexual entry (penetration)
  2. Pain with every penetration, including putting in a tampon
  3. Deep pain during thrusting
  4. Burning pain or aching pain with most intercourse
  5. Throbbing pain, lasting several hours after intercourse

An isolating, distressing condition

Painful intercourse not only causes you physical pain. It also restricts you from enjoying certain activities, such as sex, exercise, social outings, or work. It can render sexual intercourse uncomfortable, undesirable or impossible.

Beyond your sexual life, it can also make it challenging to sit for long periods, affect your mood, and make it impossible to wear pants. And with increased pain and numerous physical limitations, you may become depressed.

You don’t have to live with painful sexual intercourse. As soon as it begins, make sure to see a female pelvic medicine and reconstructive surgery (FPMRS) physician for help.

At Advanced Urology Institute, we have FPMRS physicians at our Fort Myers center so that you can get the best possible care at a location near you. You will find a urogynecologist with the requisite knowledge and experience to help you regain your pain-free, confident sex life.

What are the causes of painful intercourse?

  1. Inadequate lubrication
  2. Tight pelvic floor muscles
  3. Infections, such as Trichomonas vaginalis, Candida albicans, genital herpes or gonorrhea
  4. Ovarian cyst
  5. Uterine prolapse
  6. Uterine fibroids
  7. Hemorrhoids
  8. Adenomyosis
  9. Skin infection
  10. Vaginismus—spasm of the pelvic floor muscles that causes temporary narrowing of the vagina
  11. Sexual arousal disorders
  12. Illness, such as endometriosis, irritable bowel syndrome, pelvic inflammatory disease
  13. Surgery, such as hysterectomy, vaginal repair for prolapse, or episiotomy for childbirth
  14. Partner issues, fear, stress, and anxiety
  15. Trauma during surgery or childbirth
  16. Chemotherapy
  17. Radiation therapy

How is painful sexual intercourse diagnosed?

A timely diagnosis for painful intercourse can help you find the proper treatment. Your FPMRS physician will conduct a thorough medical history to determine when the pain began. The urogynecologist will also ask you when the pain started, where it hurts, and if it happens with every sexual position and every sexual partner.

You may also need to provide more information about your sexual history, surgical history, and childbirth. It is important that you try to overcome embarrassment and answer the questions truthfully.

The urogynecologist will conduct a pelvic exam to check for signs of infection, irritation, or anatomical problems. The doctor will gently touch the pelvic and genital area to locate the site of pain or insert a speculum into your vagina. Tests such as laparoscopy and ultrasound may also be ordered.

How is painful intercourse treated?

The treatment will depend on the cause. If vaginal dryness is the issue, your FPMRS physician will prescribe an over-the-counter lubricant.

However, if an infection is the cause, you may need antifungal medication for vaginal yeast infections, antibiotics for sexually transmitted diseases or urinary tract infections, or steroid creams for skin diseases affecting the vaginal area.

When vulvar vestibulitis is the cause, your doctor may recommend that you use a topical estrogen, low-dose pain medication, or physical therapy with biofeedback to lower muscular tension in your pelvic floor.

Your urogynecologist will prescribe estrogen therapy for atrophic vaginitis, either as a pill or as a vaginal formulation.

For painful intercourse due to endometriosis, your physician will prescribe medication or recommend surgery to remove or control your uterine tissue’s abnormal growths.

Why Advanced Urology Institute?

When experiencing recurrent painful sex, your comfort, self-confidence, relationship, or social life may be affected. That is why you should see a urogynecologist—a knowledgeable specialist with skills and experience in pelvic floor disorders, urology, and gynecology.

At Advanced Urology Institute, we offer female pelvic medicine and reconstructive surgery services at our Fort Myers center. The center boasts a team of knowledgeable and experienced urogynecologists who have treated many patients suffering from painful intercourse. At AUI’s Fort Myers clinic, you will find physicians who listen to your concerns and deliver personalized, effective care.

For more information on painful sexual intercourse, vulva pain, endometriosis, and vaginal dryness, visit the Advanced Urology Institute website.