There are lots of reasons to have sex: connection, pleasure, or fun, to name a few. But feeling pain? That’s everything sex isn’t supposed to be.
However, for many women, painful sex is the reality of getting intimate. According to experts, one in five young women says that intercourse consistently hurts.
Women with dyspareunia, the medical term for pain upon penetration, often fear to lose their partner, feel sexually inadequate, and experience a dip in sexual desire and satisfaction. Yet many women say nothing about their painful sex to their doctor or to their partner.
Identifying the underlying reason why it hurts when you have sex is the first step to resolving it. While you should definitely speak with your doctor about it, the reasons below may help you figure out why you’re having painful sex.
Endometriosis is a condition where endometrial tissue grows outside of the uterus. Women with endometriosis also suffer from pain during sex. Deep penetration can put pressure on areas where endometriosis occurs, such as the ligaments attaching your uterus to your pelvis or the lining of your pelvis, and make intercourse painful. “Anything that touches those areas, a penis, a tampon, can be extremely painful.
Overactive Pelvic Floor Muscles
Your pelvic floor (a group of sling-like muscles that support your uterus) is supposed to relax during sex. But in some women, these muscles constrict, often as a result of difficult childbirth, sitting too much of the day, or past sexual abuse.
Pelvic floor muscle spasm is far and away the number one most under-recognized cause of painful intercourse.
Signs to look for: a burning, throbbing sensation at the entrance of your vagina, which can last for hours or days after sex.
A History of Urinary Tract Infections
If your medicine cabinet is regularly stocked with antibiotics, you may be predisposed to penetration pain. Infection leads to nerve hypersensitivity. Normally, nerves calm down over time. But if you get another infection within a couple weeks or months, those nerves never have time to relax. That means the entrance to your vagina is incredibly sensitive, so much so that even attempting penetration can be intolerable. (Excessive use of antibiotics may lead to recurrent infections too, triggering severe inflammation and a greater risk of pain around your vulva, the study authors say.)
You’re Not Lubing Up
If you’re not sufficiently wet, you’ll likely feel pain during penetrative sex of any kind. A drop in estrogen (a common side effect of menopause, childbirth, or breastfeeding) could be to blame for a lack of lubrication, or you just may not be aroused enough. In this case, the fix is simple: first, take your time with foreplay. Second, try silicone-based lubricants, which tend to be slicker than water-based varieties.
Pain with fibroids tends to be a quick, fast, sharp pain. Women with fibroids are three times more likely to report severe pain during sex than those without the growths.
Fibroids can indent into the vagina, and the act of hitting them can be incredibly uncomfortable. Another cause of discomfort: As fibroids increase in size, they may die off, leaving your uterus inflamed and primed for pain.
A Tilted Uterus
Women with a tilted uterus have a higher risk of endometriosis. When the top of the uterus is tilted back, the penis can hit that, an expert explains. That can lead the supporting tissues to stretch, ultimately causing pressure and pain. Other signs of a tilted uterus: menstrual pain, back pain during sex, UTI’s, and trouble using tampons.
A New Baby
Nearly half of nursing women report pain six months after childbirth, compared to new moms who weren’t breastfeeding. Vaginal delivery can also cause tearing and nerve damage and breastfeeding may temporarily affect your body’s ability to lube up during sex which can definitely cause pain, says Levey.
Anxiety alone probably won’t make sex painful, but it can set you up for a number of conditions that trigger tension below the belt. Stress often causes changes in the pH of the vagina, which can lead to bacterial infections. A bad case of the nerves may also cause pelvic floor muscle spasms while reducing your overall tolerance for pain too.