intercourse, known as dyspareunia, can occur for many reasons and can be persistent or recurrent. Dyspareunia can occur before, during or after intercourse. Sexual pain is treatable and can occur as a result of:
• Cancer treatment, medical and surgical conditions
• Vulvodynia, vaginitis, vaginismus
• Difficulty with sexual response, such as lack of desire or arousal
• Structural problems, such as pelvic floor disorders
• Hormonal changes, including perimenopause and menopause
• Ovarian cysts or endometriosis
• Emotional and relationship factors
Women can experience different sensations of pain during intercourse. Some may only feel pain during penetration – and also feel pain when inserting a tampon. Pain can also present itself as burning or aching and can be felt as a deep pain sensation during sexual activity or throbbing pain that last hours after intercourse. During intercourse, pain may be felt in different areas of the body including:
• Vulva – the area surrounding the opening of your vagina
• Lower back or bladder
If you experience pain during sexual activity, talk to your primary care physician, obstetrician or gynecologist. We understand that it may not be a comfortable conversation to initiate, but your provider will listen to your concerns with understanding, compassion and confidentiality. It’s important that you are honest with your provider to rule out gynecological conditions that may be causing the pain. Often your provider will refer you to a sexual health expert who will conduct a full medical and sexual health history and then to evaluate your symptoms more completely, may perform a pelvic exam or recommend additional testing such as an ultrasound.
Treating sexual pain depends on the cause. There are a number of self-help things you can do to try and resolve sexual pain on your own. Some women can find relief by increasing lubricant use, participating in stress relief activities, such as meditation or yoga, or setting aside quiet time with their partner to discuss how sexual activity makes them feel. When these self-help efforts don’t provide relief, medical intervention may improve symptoms.
Your sexual health expert can discuss medications such as antibiotics for UTIs or topical estrogen cream for vulvar vestibulitis, post-menopausal relief, vaginal exercises, laser therapy, or if endometriosis is diagnosed, you may need surgical intervention. Sometimes, dyspareunia occurs with no apparent physical cause. When this occurs counseling, or cognitive behavioral therapy can help to address stress or anxiety regarding sexual activity.
Don’t live with sexual pain – talk to your health care professional as soon as symptoms begin.
To find a specialist experienced in treating sexual pain and sexual health conditions, visit the Cincinnati Sexual Health Consortium provider page.
The following national organizations provide additional information on sexual pain and sexual health conditions.
International Society for the Study of Women’s Sexual Health
Urology Care Foundation
American Urological Association
International Society for Sexual Medicine
The North American Menopause Society
The American College of Obstetricians and Gynecologists