The 14 Main Causes of Painful Intercourse (Dyspareunia)

According to the Centers for Disease Control and Prevention(CDC), painful intercourse is among the leading sexual health concerns. Pain during intercourse is fairly frequent, with approximately three out of four women experiencing it at some point in their life. The pain is merely a transient issue for some women, while it is a long-term issue for others.

Dyspareunia is a medical term that means painful intercourse.  Painful intercourse is genital pain that can be felt externally on the vulva or internally in the vagina, uterus, or pelvis during or after sexual intercourse.


Painful intercourse can be caused by vaginismus, vaginal dryness, trauma, congenital abnormalities, injuries, hormone changes, and skin disorders. Other causes include illnesses, surgeries, psychological conditions, sexual abuse from the past, stress, and depression.

This article is going to take you through who suffers from painful intercourse, the types, and causes of painful intercourse. It shall also talk about the diagnosis, symptoms, and treatments for painful intercourse.

Symptoms of painful intercourse

  • A throbbing ache that lasts for hours after a sexual encounter
  • Cramping in the pelvis.
  • Pain only at sexual penetration.
  • Muscle spasms or stiffness.
  • Every penetration, including inserting a tampon, causes pain.
  • There is a lot of pain during thrusting.
  • Burning and aching pain.

Who suffers from painful intercourse?

Anyone of any gender or age can suffer from painful intercourse. However, this condition is very common in women. It affects women and men of different ages/all ages. We shall handle a different article on this (men dyspareunia).

Types of painful intercourse

There are two main types of painful intercourse and they are characterized by the location of the pain you experience.

  1. Superficial dyspareunia (entry pain).
    2. Collision dyspareunia(Deep penetrative pain).


1. Superficial dyspareunia

This is the pain felt at the vaginal opening during initial penetration

2. Collision dyspareunia

This is the pain caused by deep penetration of the penis, fingers, or toys into the vagina. This kind of pain is felt in the cervix or lower abdomen and it becomes more extreme with certain sex styles.

Physical causes of Superficial dyspareunia (Entry Pain)

1. Vaginismus.

A reflex contraction (tightening) of the muscles near the opening of your vagina is known as vaginismus. The dread of being wounded or a previous trauma might produce a spasm of the vaginal muscles, resulting in pain during sexual intercourse. Penetration might be unpleasant due to these spontaneous spasms of the vaginal wall muscles. Vaginismus can be treated with a variety of methods.

2. Inadequate lubrication.

Vaginal lubrication is highly crucial when it comes to sexual intercourse. It aids in intercourse by reducing pain and allowing the penis to slip into the vagina without causing discomfort to the parties. Lack of lubrication is frequently caused by insufficient foreplay. Other factors include estrogen deficiency following menopause, childbirth, and breast-feeding.

Certain drugs have been shown to reduce lubrication and make sex painful by affecting sexual desire or arousal. Antidepressants, blood pressure drugs, sedatives, antihistamines, and several birth control pills are among them.


3.  Trauma.

Trauma might also result in painful intercourse. Trauma might be as a result of:

  • Injury or discomfort from an accident.
  • Pelvic surgery.
  • Female circumcision.
  • Cut made during labor to expand the birth canal.
  • Sexual abuse from the past.

4. Congenital abnormality.

A condition present at birth, such as the absence of a completely formed vaginal opening (vaginal agenesis) or the formation of a membrane that plugs the vaginal opening or hymen, can also cause painful intercourse.

5. Injuries.

Injuries around or in the female genitalia can result in painful intercourse. A tear from childbirth or a cut (episiotomy) in the perineum (the area of skin between the vagina and the anus) created during labor are examples of these injuries. An injury can also occur if you have intercourse too soon after surgery or childbirth.

7. Skin disorders.

Ulcers or cracks in the vulva’s skin can occur as a result of certain skin conditions. Eczema or contact dermatitis, which affects the vulva, is a frequent skin condition. It’s an allergic reaction to something irritating, like fragrant soaps, douches, or lubricants. Itching, burning, and soreness are all possible side effects. The type of skin condition determines how it is treated.

8. Hormone changes.

Reduced levels of the female hormone estrogen during perimenopause and menopause can cause vaginal dryness. Hormone therapy is one possibility for treatment. Using a lubricant or a vaginal moisturizer during intercourse might also assist.

9. Vaginitis

A yeast or bacterial infection can induce vaginal inflammation, which is known as vaginitis. The vaginal and vulval discharge, itching, and burning are symptoms. Medication can be used to treat vaginitis.


Physical Causes of Collision dyspareunia (Deep penetrative pain)

Deep penetration is frequently accompanied by severe pain. It may be worse in specific positions or as a result of specific conditions, illnesses, or treatments. Cysts, endometriosis, Pelvic inflammatory disease, and fibroids are just a few of the illnesses that may lead to deep pain painful intercourse.

1. Illnesses and conditions.

  • Pelvic inflammatory disease(PID) is a condition in which the tissues deep inside the vagina become inflamed, causing severe pain from the pressure of the intercourse.
  • Endometriosis is a disorder in which tissue that borders the uterus develops outside of it, leading a woman to experience pain during deep penetrative sex.
  • Fibroids are tumors that grow in the uterus and are made up of smooth muscle cells and fibrous connective tissue. They make intercourse painful.
  • Sexually Transmitted Diseases, such as genital warts, herpes sores, or the human papillomavirus, can make sexual intercourse painful.
  • Another cause of painful intercourse could be a condition such as ectopic pregnancy where a fertilized egg grows and develops outside the uterus. An ectopic pregnancy could lead to painful intercourse in case of deep penetration.

2. Surgeries or medical treatments

Surgeries and medical treatments can also lead to painful intercourse. For instance, Scarring from pelvic surgery, such as a hysterectomy, and cancer treatments, such as radiation and chemotherapy, can all result in alterations that make sex painful.

Vaginal atrophy is a condition in which the vaginal lining loses its typical moisture and thickness, becoming dry, thin, and inflammatory as a result of medication, menopause, or other hormonal changes.


Emotional Causes of Painful Intercause

1. Psychological conditions.

Psychological problems can sometimes cause painful intercourse. Low arousal and associated discomfort or suffering might be caused by anxiety, despair, concerns about your physical attractiveness, fear of intimacy, or relationship problems.

2. History of sexual harassment or abuse.

Women with a history of rape or sexual harassment tend to have problems with their sexual health. This is due to the trauma. Although not everyone with dyspareunia has a history of sexual abuse, it might play a role if you have.

3. Stress and depression.

painful intercourse

The human body is subjected to a variety of harmful impacts as a result of stress. Your pelvic floor muscles on the other hand tend to tense in response to stress in your life, which is bad for your sexual health. This can cause discomfort during intercourse.


Diagnosis for dyspareunia

1. Medical history.

A comprehensive medical history is required for the diagnosis of painful intercourse. Your doctor may ask you a series of questions to figure out what’s causing your painful intercourse. Please don’t let shame or embarrassment prevent you from answering honestly. These inquiries can help you figure out what’s causing your pain.

During your diagnosis, your doctor may ask you the following questions:

  • When the pain first started.
  • Where you feel pain.
  • How it feels.
  • How long the pain lasts.
  • If it happens with every sexual partner and in every sexual position.
  • Your doctor may also question about your sexual, surgical, and birthing histories.

2. Physical examinations.

painful intercourse
Doctor with patient

Physical exams such as pelvic examination is another approach to diagnose dyspareunia. The doctor will determine if they will perform an external or speculum exam. This may be recommended after the doctor has asked or reviewed your medical history. Your doctor checks for signs of skin irritation, infection, or anatomical issues during a pelvic exam. The doctor may also apply light pressure on your genitals and pelvic muscles to try to pinpoint the source of your pain.

A visual examination of your vaginal wall, using a speculum to separate the vaginal walls, may also be conducted. Some women who experience painful intercourse also experience pain during a pelvic check.

Note that because you might be experiencing painful intercourse, the exam could be painful or uncomfortable as well. KIndly, if the exam is excessively painful, tell your doctor and they will know what to do. You can as well ask to have it stopped.

3. Ultrasound.

Your doctor might also suggest that you have a pelvic ultrasound. That could be to determine what exactly is the issue with your genitalia or if he suspects a certain illness.


Treatment for painful intercourse

Treatment for painful intercourse is not necessarily medical. This is because painful intercourse is caused by different reasons. For instance, if your pain is associated with childbirth, give yourself time until you completely heal before doing it again.

1. Medication.

painful intercourse
Topical cream

If your pain is caused by an illness or a medical condition, treating the source of the problem may help. Dyspareunia is caused by insufficient lubrication produced by low estrogen levels in many postmenopausal women. This is frequently treated with topical estrogen administered to the vaginal area.

2. Desensitization therapy

It involves learning pain-relieving vaginal relaxation exercises.

3. Sex therapy.

If you and your spouse have avoided intimacy as a result of painful intercourse, you may require assistance in enhancing communication and reestablishing the sexual connection. A sex therapist can help you with that.

4. Couples’ counseling.

painful intercourse
couple counseling session

Couples counseling is also a very effective way to address painful intercourse issues. Your counselor will try to address the issue by asking questions and suggesting solutions. Kindly do not forget to go for those regular cancer screenings.

When to visit a doctor

  • If you experience regular or severe pain when having sex.
  • If you’re experiencing new or worsening sex pain.
  • Bleeding.
  • Genital lesions.
  • Irregular periods.
  • Vaginal discharge, or involuntary vaginal muscle spasms.

Is painful intercourse curable?

With adequate medical attention, painful intercourse can be cured. Solutions and treatments are accessible with qualified and professional healthcare personnel depending on the causes or type of dyspareunia you have. On the other hand, women with long-term dyspareunia or a history of sexual assault or trauma may require counseling to alleviate their symptoms.

Treatment is not only medicinal, but it also involves therapy, counseling, lifestyles changes, and home remedies to reduce the pain during sex. These lifestyle and home remedies include:


  • Incorporating lubricants in sexual activities. Do not just use any lubricant, choose the right one.
  • Be open-minded to changing sex positions to see which works best for you.
  • Exercising your pelvic floor muscles with kegel exercises.
  • Communicating with your partner. Here, you really need an understanding partner, if you don’t try to make him or her understand your situation.
  • Take your time in bed. I.e, having adequate foreplay till you are fully ready for penetration.
  • Create a bonding time with your partner.
painful intercourse
A couple bonding


This article has taken you through all that there is to know about painful intercourse in women. We have all gone through that at a certain point in life. The truth remains that some women experience painful intercourse temporarily while others go through it again and again. Nevertheless, there is treatment, and the earlier you address the issue the better.

Did we miss something? feel free to tell us what you know about painful intercourse in the comment section that you feel we have not mentioned.

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