Pain with Sex: Not Something You Have to Live With

Published on October 27, 2020
pain with sex

Dyspareunia, or pain with sex, is defined as a medical condition characterized by pain that is experienced by a woman with penetration during a sexual intercourse or a sexual activity. According to data from WHO, an estimated 8–22% of women at some point in their lives experience it. It is a very common challenge experienced by women in primarily two age groups: 20-30 years of age and women 50-60 years old. The pain may be superficial or deep. It is often caused by dryness of the vagina. The pain can be felt in the area around the vaginal opening as well as within the pelvic area when the penis is thrust inside. Pain may be sharp, burning, or cramping. If you are experiencing pain with intercourse, you don’t have to suffer. There are options for relief.

Causes of Dyspareunia: Pain with Sex

Causes of dyspareunia include:

  • Atrophic vaginitis, caused by declining estrogen levels with menopause that cause thinning, drying and inflammation of the vaginal wall tissue
  • Urinary tract infections
  • Interstitial cystitis, a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain
  • Erosion of implantable mesh
  • Tissue damage from radiation
  • Organ prolapse
  • Urethral access or vaginal cysts
  • Sexually transmitted diseases (STDs)
  • Vaginismus, a muscle spasm in the pelvic floor

Diagnosing Dyspareunia

To confirm dyspareunia, pain with sex, and rule out other possible concerns, a doctor will take a detailed medical history and conduct an examination. Tests may include a urinalysis and urine culture, blood tests and vaginal swabs to screen for STDs and a cystourethroscopy, a procedure that allows your doctor to see inside of the bladder and urethra, using a cystoscope, a thin tube with a light and a lens or small video camera on the end. 

Treating Painful Intercourse

Treatment for dyspareunia will depend on the cause of the pain. For atrophic vaginitis-related pain, initially over-the-counter remedies such as vaginal moisturizing products and water-based lubricants may provide relief. The use of estrogen supplementation, if appropriate (topical cream, oral estrogen, vaginal estrogen tablet), may also be used. A laser treatment has also been shown to be effective for many women for pain related to intercourse due to atrophic vaginitis. If an STD is at the root of the problem, your doctor will discuss treatment options.

Relaxation techniques like yoga and stretching that promote physical relaxation may also be helpful. Regular yoga and stretching can help relieve tightness of muscles that can be associated with pain associated with dyspareunia.

Learn more about this condition on Dr. Tay’s urology website.

Dr. Howard Tay is a board-certified urologist in Arizona certified by the American Board of Urology. He is an active member in the American Urological Association. He has practiced urology in Arizona since 1996. Dr. Tay is recognized as a leading Arizona urologist, including several Phoenix Magazine “Top Doc” awards for urology. He is an active member in advancing urology in the state of Arizona and serves on several hospital committees as is past Department Chair of Surgery at Banner Thunderbird Hospital. In addition to his practice, he is an educator training medical student and physician assistants in urology at Midwestern University, Northern Arizona University and the University of Arizona Medical School-Phoenix Campus. Dr. Tay and his wife Christina met while still in college at UC Berkeley and have been together through Dr. Tay’s medical school and residency. They have two children, Kimberly and Kevin. In his spare time, Dr. Tay enjoys tennis, racquet ball and golf as well as target shooting, restoring classic cars and home improvement projects. He and Christina love to travel.

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