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Painful Intercourse - Physical Causes You Must Be Aware Of!

Written and reviewed by
Dr. Saraschandrika P. V. 92% (10 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Obstetrics & Gynaecology
Gynaecologist, Hyderabad  •  56 years experience
Painful Intercourse - Physical Causes You Must Be Aware Of!

Love making is generally portrayed as a way to great pleasure. However, what most may not know is that intercouse can be painful, very painful, so much so that you at times  don’t want it. In fact, an alarming 75% of women have had pain during sex at some point in their lives. There are physical and psychological components to this, both of which can be managed easily if identified. While some may be frank and talk about it, a lot of them go unspoken and therefore endure the pain in silence.

Painful intercourse, which is a major deterrent for a happy intimate life, has a lot to do with the mindset and emotions than actual physical or physiological problems. Fear of being hurt, performance anxiety, sexual inhibitions, past history of abuse, etc. are major contributors for painful intercourse.

Physical causes for the pain include temporary reasons like the ones listed below.

  1. Vaginal Infections: Fungal infections of the vagina and surrounding organs are very common and there could be sores or lesions, which can turn painful with sex.
  2. Vaginismus: Another common condition leading to painful sex, these are involuntary contractions, which often happens as a defense mechanism. The woman has the fear of being hurt and so these spasms happen.
  3. Gynaecological Issues: Ectopic pregnancy, ovarian cysts, menstrual disorders, endometriosis, cervical problems and vulvar injuries are other causes which can lead to painful intercourse.

With any of these, the remedy lies in acknowledging the problem.
If there are no physical issues, talking about the past, discussing her fears and anxiety can help. Many times, the expectations are often unspoken and there is a lot of uncertainty, fear and anxiety between the couple, especially with respect to intimacy. A frank talk can help ease both of them, and that can often help in reducing pain during sex. If required, counselling can be sought,so that she opens up. In most cases, one or two sittings with both couples and a counsellor can help find the problem and work out a lasting solution.

Lubrication is often another problem that leads to pain. When there is not sufficient mental stimulation, the chances of a dry vaginal mucosa are high. Artificial lubricants can be used to help with easy penetration and reducing the pain. Infections can be managed with antibiotics, often topical, unless it is very severe and requires systemic antibiotics. Women who have delivered babies should refrain from sex for complete healing, as it can be painful. 

Menopause is another reason for painful sex and this is due to lower hormone level. Using hormones either topically or supplements like birth control pills can improve overall sexual urge and lead to painless sex.

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