A healthy sex life is important to women of all age groups, from late teens to the latter part of their lives. It is crucial that all of these sexual relationships are equal and enjoyable, something which may be affected by whether or not you experience any pain or discomfort during times of intimacy.
There are occasions when such issues can put great strain on a relationship and force some women to avoid intercourse altogether. But how is pain during sex defined and why does it occur?
Why Can Intercourse Become Painful?
Pain during intercourse can be categorised in two ways: superficial pain or deep pain. Superficial pain is normally associated with vulval concerns, whereas deep pain can be linked to either vaginal problems or issues relating to the pelvis, such as endometriosis, scarring from infection or diverticulitis.
Pain relating to intercourse is more common after the menopause. This is because the menopause is associated with low levels of oestrogen which can have a noticeable impact on both vaginal and pelvic health.
Because of this lack of oestrogen, the vagina can start to thin. Subsequent penetrative intercourse may then become more painful due to this natural physical change, with there also being more of a chance of abrasions or physical injury during sex.
Vaginal atrophy, the condition described above, can easily be treated with hormone replacement therapy. Alternative, non-hormonal methods of treatment may also be offered. These include MonaLisa Touch® laser therapy.
Possible causes of pain
- The menopause: Women who have gone through the menopause will often feel pain during sex because of the vaginal dryness that is often associated with this hormonal shift. As a result of the menopause, oestrogen levels will decline which can leave the vagina lacking in moisture.
- Not feeling ready or in the mood for sex: There may be times when you don’t feel prepared for sex or aren’t feeling particularly aroused. In instances such as this, the lack of vaginal lubrication will make the act of intercourse difficult and could lead to great pain and discomfort. This phenomenon can also be influenced by something that has happened during sex in the past, meaning that the cause of this might also be psychological. Vaginismus, which describes a natural bodily reaction to the prospect of penetration, is particularly relevant here. In these cases, the vaginal muscles will automatically tighten, making penetration more difficult and quite often impossible. It should be noted that this does not necessarily affect your sexual arousal.
- An infection: The most common cause of pain during intercourse is candidiasis, which is otherwise known as thrush. Bacterial vaginosis which, like candidiasis, may be the result of a hormonal imbalance, can also be responsible for pain during intercourse. Sexually transmitted infections (STIs) might be the source of such discomfort as well.
- Childbirth or breastfeeding: Women who have just given birth or are currently breastfeeding may have lower levels of oestrogen. Like the menopause, this change in hormones can lead to problems with vaginal lubrication, making sex difficult and uncomfortable. Any vaginal trauma sustained during childbirth can also lead to painful sex, so it is advisable to ensure that this has properly healed before engaging in intercourse. Failure to abstain from sex during this period can lead to problems in the future.
- Pre-existing health conditions: This pain can be caused by the likes of endometriosis and irritate bowel syndrome and, in these cases, is normally located in the pelvic area. It is common for women who have been diagnosed with these conditions to experience pelvic pain during sex. Endometriosis commonly affects the ligaments that can support the cervix, which means that penetration can make any pain in this area much worse.
- Vulval pain: Vulval pain is something that affects many women throughout their daily lives. The symptoms of this can worsen during sex. Some examples of conditions that can cause vulval pain are vulval candidiasis (thrush) and lichen sclerosus, both of which are associated with irritation and itchiness. Vulvodynia, which is characterised by burning and discomfort in the vulva, can also lead to pain during sex. This cannot always be ascribed to a specific cause and can be triggered by touch.
- Fibroids: In rare cases, the presence of fibroids (growths) in the uterus can be the cause of pain during intercourse. As this will only happen when a fibroid has grown to such an extent that it becomes an obstruction, many other routes of enquiry will be taken first to uncover the source of any sexual discomfort.
Someone you can trust
Mr Francis Gardner is an experienced gynaecologist and takes a holistic approach to the care of all of his patients. He is keen to support women of all ages in maintaining healthy sex lives and is willing to explore a wide range of treatment methods, particularly in regards to post-menopausal women. These can include simple moisturisers and lubricants and numerous topical oestrogen treatments. Mr Gardner also offers MonaLisa Touch® laser therapy and is one of only a handful of practitioners in his field trained in this type of procedure.
To book in for a consultation or One Stop See and Treat with Mr Gardner and identify the cause of your pain during intercourse, get in touch today.
It’s always advisable to seek medical advice so the underlying cause of your pain can be identified and the appropriate treatment initiated. This is important because recurrent episodes of painful intercourse can lead to psychological problems and the avoidance of sex in the long-term, which can have a significant impact on your sexual health and wellbeing.
Yes. No one wants to feel uncomfortable or experience pain during such an intimate activity and it’s completely normal to be put off sex if this is no longer enjoyable. There are several other intimate acts you can perform that do not involve penetrative sex, so it’s recommended to focus on these until you are able to manage the pain you feel during intercourse.
During your consultation, you will be asked a series of questions about your symptoms. The next course of action will be dependent on your answers to these questions. Pelvic and vaginal examinations will be necessary to identify the underlying cause of the pain. In some cases, both an infection screen and sexual health screen may be recommended as well as a transvaginal scan
This is dependent on the results of your tests and examinations. Treatments will be directed to the underlying cause and may include psychosexual counselling, use of non-hormonal lubricants and moisturizers, hormonal treatments, anti-fungal and antibacterial treatment and potential MonaLisa Touch® laser therapy. Very rarely a biopsy or surgical procedure may be required particularly after childbirth.