Sexual intercourse not only boosts physical and emotional intimacy with our partners, but it also releases powerful “feel-good hormones that keep us feeling upbeat. But this experience is often marred in women by pain - often unexplainable pain.
Most women have experienced painful intercourse at some point in their lives, and it can occur for so many reasons ranging from psychological to physical problems in the female genital area. Here we’ll explore some of the possible causes of painful intercourse and signs that show it may mean something much more.
Painful intercourse, medically termed dyspareunia, refers to persistent or recurrent pain in the genital just before, during, or after sexual intercourse. Some women experience this pain only at penetration, others experience it during penile thrusting, while some other women experience it during every penetration - including just inserting a tampon.
This often comes as a burning or aching pain that lasts several minutes to hours. But what could cause this feeling?
Painful intercourse may simply be localized to the vaginal area. In this case, it may be caused by the following:
1. Poor Lubrication: Normally, sexual arousal stimulates the secretion of fluid in the vagina to serve as a lubricant for easy penetration. Several factors could hinder the release of adequate lubricant for intercourse. These include inadequate foreplay, reduced estrogen levels after childbirth or during menopause, and use of certain medications such as antidepressants, certain blood pressure meds, and medicines for colds.
2. Vaginismus: This is often common in women who have never had sexual intercourse. Anxiety about the experience may stimulate involuntary contractions of muscles in the vaginal wall, making penetration difficult and painful.
3. Vaginal tears or injury: If you’ve sustained an injury in your genital area - may be as a result of irritation from an accident or surgery - penetration will be painful until the area heals up completely.
4. Vaginal infection: Vaginal infection also makes the vagina and cervix friable and easily irritated such as an activity as much as sexual intercourse causes serious pain.
Painful intercourse may also be caused by conditions not primarily localized to your vagina and may imply something sinister.
1. Endometriosis: Endometriosis occurs when the lining of the uterus that sheds during menstruation sheds backward - growing outside of the uterus. This means when it’s time to have your period, some of it flows backward into the tissues they have lined abnormally.
This triggers inflammation within and outside the uterus that causes extremely painful intercourse, painful menstruation, back pain, and severe cramps in your abdomen when you are urinating or having a bowel movement. These signs point to endometriosis, which is a common cause of infertility and chronic pelvic pain. An ultrasound scan could confirm this diagnosis.
2. Pelvic Inflammatory Disease: An infection of your genital area usually ascends if untreated to infect the uterus, the fallopian tubes, and even the ovaries. When this happens, it is called a pelvic inflammatory disease (PID) and if left untreated could lead to complications such as infertility. Your doctor may order a swab test and an ultrasound scan to confirm a PID.
3. Uterine fibroids: Uterine fibroids are abnormal growths of the uterine muscle. Depending on the size and number of uterine fibroids, you may experience heavy and painful menstruation, frequent lower abdominal cramps, frequent urination and bowel movements, as well as painful intercourse. Your doctor may recommend an ultrasound scan to check for this.
4. Adenomyosis: Adenomyosis is a condition in which the inner lining of the uterus breaks into the muscle layer of the uterus. Although the cause of adenomyosis is not exactly known, procedures that invade the inner lining of the womb, such as a cesarean section or fibroid surgery, may increase your risk of it.
Adenomyosis causes menstrual cramps, painful intercourse, heavy menstruation, and bloating just before your period. Your doctor may order a transvaginal ultrasound scan or Magnetic Resonance Imaging (MRI) scan to make a diagnosis of adenomyosis.
5. Pelvic floor dysfunction: There is a layer of muscles and tough tissue called the pelvic floor that holds your pelvic organs in place. The pelvic floor may be weakened by multiple childbirth, heavy lifting, pelvic surgery, injury to the pelvic region, and persistent straining from chronic constipation.
When this happens, you may begin to experience several symptoms including low back pain, painful intercourse, painful urination, and pain in the genitals. Much of these symptoms occur because the pelvic organs lose their support and drop into the vagina, causing these pressure symptoms.
To diagnose pelvic floor dysfunction, your doctor may perform a physical examination using a sensing device called a perineometer.
So, while painful intercourse is common and may resolve spontaneously, it may also signal something more debilitating. Contact your doctor if you observe any of these symptoms or if painful intercourse has become severe and prolonged.
