5 Common Causes of Sexual Pain

Dyspareunia, or painful sexual intercourse among women, is an issue that is getting more attention. In a recent study, approximately 1 in 4 women reported pain during their last sexual experience. Most of the women (more than 80%) reported a little pain, lasting less than one hour. Pain was most often inside the vagina (35%), at the vaginal entrance (30%), or deep inside the vagina near the cervix (19%).

Here are five common conditions that are associated with painful sexual intercourse.

• Endometriosis occurs when the tissue that normally lines the uterus grows outside of the uterus. This tissue can be found on the ovaries or fallopian tubes. In addition to pain during sex, endometriosis may cause irregular and painful menstrual cycles, pain with bowel movements, and can lead to infertility.
• Pelvic inflammatory disease (PID) occurs when sexually transmitted bacteria (e.g., chlamydia or gonorrhea) spreads from the vagina to the uterus, fallopian tubes, or ovaries. PID is also associated with pelvic, lower back, and abdominal pain.
• Ovarian cysts are fluid-filled sacs inside or outside the ovaries. Ovarian cysts can go away on their own, but if they don’t, they can cause pelvic pain, irregular bowel movements and changes to the menstrual cycle.
• Vulvodynia is chronic pain of the vulva, including the labia (lips), clitoris, and vaginal opening. The cause remains unknown, and pain may occur in one or more areas of the vulva.
• Menopause is the natural biological process when menstruation ends and the ovaries stop making reproductive hormones. It is typically diagnosed 12 months after the last period has occurred. During menopause, the vaginal lining can lose its moisture and become dry, causing pain or irritation in the vagina or around the vaginal opening.

Women (or people with a vulva and vagina) can also experience pain during sexual intercourse when there is not enough vaginal lubrication, injuries have occurred to the vagina or vulva, or other conditions are present impacting the cervix, uterus, ovaries, vulva, or vagina.

If properly addressed, these conditions can be treated or cured. But more than two-thirds of women who reported painful sex said they did not or could not remember discussing it with their healthcare providers. About half of those women said they did not tell their partners. Women do not have to normalize or accept that sex is meant to be painful. It is important that women prioritize their sexual health and pleasure by discussing painful sex and other sexual difficulties with their partners and providers to improve their sexual lives.