What are some less serious, common causes of pain with sex?
If you’re trying to have intercourse when you’re not aroused, lack of lubrication can cause friction and lead to pain. Even if you are aroused, decreased lubrication caused by hormonal deficiencies (such as atrophic vaginitis, which can occur when estrogen levels are low after menopause or while breastfeeding) can lead to pain.
Other common causes of painful sex include gynecologic conditions such as vulvar vestibulitis (inflammation of the vestibular glands at the vaginal opening), vaginismus (involuntary contractions of the vaginal muscles that may make intercourse painful -- or even impossible), and vulvodynia (non-specific vulvar pain, which is often experienced as an intense burning feeling).
How do you know if pain during sex signals something seriously wrong?
If you’ve never had pain before, and all of a sudden sex hurts, it’s a good idea to get checked out by a doctor. New onset of pain can signal a sexually transmitted disease (like gonorrhea or chlamydia), endometriosis, an ovarian cyst, a bladder condition like interstitial cystitis, scar tissue, or in very rare cases -- a cancer.
Other medical conditions that can cause pain include vaginal dryness resulting from menopause or breastfeeding (atrophic vaginitis) or vulvar pain disorders such as vulvar vestibulitis, vulvodynia, and vaginismus. While these are not health-threatening, I speak from personal experience when I say that they’re definitely happiness-threatening and should be investigated.
What can women do to prevent/lessen the pain if sex hurts?
Inadequate lubrication can be remedied with sexual lubricants, such as Astroglide or KY Jelly. (My personal fave is the all-natural option -- coconut oil. But don’t blame me if you’re jonesing for a post-coital macaroon! Keep in mind that coconut oil can break down condoms so only use it if you’re in a committed monogamous relationship.)
If you lack lubrication because of hormonal reasons, when used properly, vaginal estrogen is life-saving and safe -- but you’ll need a prescription, so talk to your gynecologist. My personal fave is the bioidentical vaginal estrogen called estriol which is very safe and preferentially improves vaginal health without some of the downsides of the more common estradiol.
If you suspect that you might be suffering from other conditions, such as vulvar vestibulitis, vaginismus, or vulvodynia, see your doctor. These conditions can be treated with things like Xylocaine jelly, antihistamines, vaginal dilators, pelvic physical therapy, and other options. Just remember, nobody should have to suffer during sex. It’s supposed to be fun!
What can their significant others do to lessen the pain?
Make sure she’s adequately aroused before intercourse is attempted. Go down on her first! Then let the woman be in charge of penetration. Go slow. Let her try being on top so she can control the pace and depth of thrusting.
What are some non-medical steps that can be taken to prevent/soothe the pain?
What level of pain should prompt a visit to the gynecologist?
In my opinion, any recurring pain during sex should be investigated by a gynecologist. That doesn’t necessarily mean anything is wrong, but it’s clearly not as right as it should be. Sex is not supposed to hurt, and there’s almost always a way to improve things. So don’t be afraid to ask for help!
Have you ever had pain with intercourse? Do you have pain now? What helps you?
Rooting for happy, healthy, pain-free sex,
Lissa Rankin, MD: Founder of OwningPink.com, Pink Medicine Woman coach, motivational speaker, and author of What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend and Encaustic Art: The Complete Guide To Creating Fine Art With Wax.
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