8 Reasons You Might Be Having Painful Sex and What You Can Do About It

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Dyspareunia is defined as persistent or recurring pain during sex. It mostly affects women, and the pain can range from moderate to severe. While not all of us may be familiar with the term, unfortunately many women are all too familiar with the feeling.

In fact, according to statistics, between 10-20% of women suffer from dyspareunia, while the American College of Obstetricians and Gynecologysts states that 3 out of 4 women will experience pain during sex at some point in their lives.

So – what causes painful sex? Read on to learn some of the main causes of dyspareunia, along with how can it be prevented.

Here Are 8 Reasons You Could Be Having Painful Sex:

While it’s important to check in with your doctor who knows your personal health, these are some common causes of dyspareunia.

1. Provoked Vestibulodynia (PVD)

80% of pain during sex (premenopause) is caused by provoked vestibulodynia, according to Dr. Deborah Coady – author of Healing Painful Sex. PVD is pain at the entrance of the vagina when that area is touched.

What to do about it:
According to the International Society for Sexual Medicine, there are many issues that can cause PVD, including hormonal changes, infections, hypersensitivity, tight pelvic floor muscles, or stress responses. If you’re experiencing this type of pain, it’s important to get it checked out to determine the best solution.

2. Vaginismus

Vaginismus is common, yet often goes misdiagnosed and is when the vaginal wall muscles contract or spasm during penetration. This extreme muscle clenching or spasming can lead to painful sex. It is typically associated with anxiety or fear around sex or penetration, which is often due to past trauma.

What to do about it:
This condition can be caused by a range of factors including past emotional or physical trauma. Doctors recommend pelvic floor physical therapy or cognitive therapy. SELF.com offers an in-depth informative article on Vaginismus and what you can do about it.

3. Vaginal Dryness

One of the most common causes of painful sex is vaginal dryness. Sexual arousal typically leads to natural lubrication, but if you’re not properly lubricated (either naturally or with a lubricant), sex will most likely be uncomfortable.

What to do about it:
There’s absolutely no shame in the lube game! Try using lubricant – and better yet, try a CBD lubricant. CBD can help reduce physical discomfort or tension and help your muscles relax (see #2). Note that oil-based lubricants are not compatible with condoms.

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4. You May Have an Infection

UTIs (urinary tract infections) or yeast infections can add to – or cause – painful sex. STIs (sexually transmitted infections) like chlamydia or gonorrhea can also lead to painful sex.

What to do about it:
If you suspect you have an infection, hold off on having sex and seek medical help to get the necessary treatment.

5. Hormonal Changes

Depending on what phase of life you’re in, hormonal changes could be caused from a change in birth control (using a new type, or starting/stopping it), breastfeeding, or from menopause. These factors can result in decreased levels of estrogen which can in turn cause dryness and/or thinning of the vaginal walls.

What to do about it:
If you’re experiencing dryness as a result of these changes, try using a personal lubricant (CBD lubricant is helpful for dryness). If the hormonal changes are from your birth control, discuss your options with your doctor.

6. What About the Technique?

While it may sound obvious, it’s important to voice what you like – and what you don’t. Not all positions and angles feel good for everyone, so establishing clear communication with your partner – and what you like and don’t like – is key.

What to do about it:
Vanessa Marin, an LA-based sex therapist, recommends playing “this or that” to establish physical comfort and how you like to be touched (a massage or a stroke, this angle or that angle, etc).

She also states that it’s important to be fully aroused and take the time and steps to get there in order to avoid painful sex. Ask for – and enjoy – longer foreplay! (This is another area where a lubricant, especially something that feels and smells good, can really make things more pleasurable and relaxing.)

7. Endometriosis

Endometriosis is a condition where the tissue that normally lines the uterus begins growing outside of it, resulting in scar tissue that can build up and be especially painful during sex.

Endometriosis can also lead to cysts in your ovaries. According to UCSF Medical Center ob/gyn Tami Rowen, MD, sex can sometimes cause ovarian cysts to rupture, which results in sudden, sharp pain.

What to do about it:
Hormone therapy is typically recommended as a starting point for endometriosis and sometimes surgery can help.

8. Gastrointestinal Issues

Believe it or not, gastrointestinal issues like IBS or even being constipated or bloated can also contribute to painful sex. These issues can create pressure and pain in the pelvic region during sex.

What to do about it:
Constipation or bloating are typically temporary issues that will go away, but if the issue persists, then it’s important to let your doctor know about it.

Dyspareunia: The Takeaway on Painful Sex

While there are many causes of dyspareunia, the good news is there are many ways to help prevent or treat it. It’s important to know your body and honor what it’s telling you. If you’re experiencing pain during sex, pay attention to the symptoms and then seek the help you need.

You deserve to enjoy sex, pain-free!

All included information is not intended to treat or diagnose. The views expressed are those of the author and should be attributed solely to the author. For medical questions, please consult your healthcare provider.

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