It Hurts When I Have Sex
Pleasure and release through sexual intimacy is your right as a woman. Sexual intercourse — from initial penetration to completion — ought to feel good, exciting, and fulfilling. If it doesn’t, something is getting in the way of your right to sexual, sensual, and emotional satisfaction.
Up to 14% of women say they experience painful sex, also known as dyspareunia. If you’re one of them, our discreet and caring board-certified gynecologist, Sonia Enriquez, MD, can help.
At Lake Mary Gynecology in Lake Mary, Florida, Dr. Enriquez evaluates painful sex problems on a routine basis. By creating a customized treatment plan that allows you start enjoying intimate relations to the fullest, she can help you restore your sexual health and improve your overall well-being.
Here, Dr. Enriquez explores some of the top reasons behind painful sex, and what you can do to remedy them.
Your vagina doesn’t lubricate sufficiently
One of the most common reasons for pain during intercourse is lack of vaginal lubrication. When your vagina is healthy, its walls produce a slippery, mucus-like substance that reduces friction during penetration and thrusting. This slick excretion coats the entire canal, from its entrance to its inner depths.
If your vagina feels dry and irritated during or after sex, you may lack lubrication due to:
- Insufficient foreplay
- Hormonal imbalance
- Breastfeeding
- Douching
- Use of certain medications
- Cigarette smoking
As part of your work-up, Dr. Enriquez considers your complete medical history, including any medications you currently take. She may alter your dosage, change your prescription, or ask you to discontinue certain over-the-counter drugs if they interfere with lubrication.
She also takes a blood sample to evaluate your hormone levels. If your vaginal dryness is due to an age-related lack of estrogen, she may recommend bioidentical hormone replacement therapy (HRT) to restore balance and help counteract the symptoms of perimenopause and menopause.
If your hormone levels are normal, she may advise you to use a water-based lubricant during sex. You and your partner might also benefit from sex education and counseling that teaches you techniques for achieving proper lubrication before penetration.
You have a structural abnormality or a medical condition
If you recently went through childbirth, or had a sexual infection or reproductive surgery, your vulva and vagina may still be in the recovery stage. In such cases, refraining from sex as you heal may be enough to restore your sexual function and pleasure.
However, you may also have an abnormality in your cervix or uterus that could cause pain during deep thrusting. Structural abnormalities that can lessen sexual pleasure or make sex feel painful include:
- Endometriosis
- Adenomyosis
- Uterine fibroids
- Retroverted uterus
- Uterine prolapse
- Hemorrhoids
- Ovarian cysts
- Surgical scars
You may also have an inflammatory bowel disease (IBD) that makes your entire pelvic area sensitive to pressure. Cystitis and infections can also lead to painful sex.
Alleviating the underlying physical cause of painful sex through surgery, antibiotics, lifestyle changes, or medications may alleviate sexual pain and help restore your sexual well-being.
You’re living with significant stress or trauma
A common condition called vaginismus refers to spasms in your vaginal wall that take place when something enters or attempts to enter your vagina. Although vaginismus is typically triggered by sexual penetration, it can also be prompted by something as simple as inserting a tampon.
Although the cause of vaginismus is unclear, most women with vaginismus feel nervous or frightened during vaginal penetration. They may worry that the insertion is going to hurt.
Even though anxiety may be a result of vaginismus rather than its cause, painful sex is often rooted in psychological trauma or stress. Women who’ve been raped or sexually abused as children or adults may develop an aversion to sex. Similarly, excessive life stress may cause your pelvic floor muscles to tense up, which can make sex feel uncomfortable.
If deep-rooted distress, trauma, or anxiety contribute to your painful sex problem, Dr. Enriquez may refer you to a compassionate counselor. A counselor can give you the insight, skills, and tools you need to resolve or manage the issues that prevent you from enjoying intimacy.
She may also recommend a physical therapist who specializes in pelvic floor training. Doing Kegels and other exercises can help you learn how to strengthen and relax your entire pelvic floor, including your vaginal muscles.
Don’t give up on your sex life because of discomfort: Find out what’s causing your pain and replace it with pleasure by booking a painful sex consultation.
Call 407-706-6441 to speak with our understanding and knowledgeable team today, or use the easy online scheduling feature to make an appointment with Dr. Enriquez any time.