What Causes Painful Sex? — A Doctor’s Guide

If you're experiencing pain during or after sexual intercourse, don't hesitate to speak to a medical professional. The most common causes of painful sex and how to get assistance. Don't be embarrassed to talk to your doctor; there may be a quick fix.

Various physical or psychological issues can cause pain during sex. It is essential to seek help if you are experiencing painful sex, as it is often a sign of an underlying health issue.

‘Pain during or after sex is known as dyspareunia, and there’s a variety of reasons why both men and women may experience it, including infections, illness, a physical or psychological problem.

Don't be afraid to talk to a medical professional about your symptoms. They are accustomed to handling situations like this, and your body might be trying to tell you that it needs medical attention.

1. An Infection Down There

Sexually transmitted infections (STIs) are not the only cause of painful sex. Other non-STI infections can also cause pain during intercourse.

Thrush

The fungus Candida albicans can cause infection in both men and women. Women are more likely to be affected by this infection, with an estimated 75% experiencing thrush at some point in their lifetime.

Women with thrush may experience itching and tenderness around the entrance to the vagina, a thick and creamy vaginal discharge, and possibly some discomfort during sexual intercourse. In men, thrush can present as irritation and redness of the penile skin.

If symptoms of thrush do not improve after treatment with antifungal pessaries or cream, it is recommended that you speak to a doctor for further advice.

To avoid thrush reoccurring, you should not use soap or shower gels on the genital area, wear cotton underwear, and opt for looser clothing. Additionally, it is best to abstain from sexual activity until the thrush has been cleared up, as it can still be passed to another person, even though it is not considered a sexually transmitted infection (STI).

Cystitis

Women may be more prone to UTIs, such as cystitis, with up to 60% suffering from one at some point. Men, however, should seek medical help if they think they may be affected, as it is not as common in them.

When urinating, both men and women may experience a burning sensation, and often, the urine can appear cloudy or smell bad. Additionally, sex may be painful. In most cases, women can take over-the-counter medications to address the issue. However, if the symptoms persist or there is a fever over 38C and pain in the lower back or side, it is essential to seek medical help as this could indicate a kidney infection.

An STI

If you suspect you have contracted an infection transmitted through sexual contact, such as chlamydia or gonorrhoea, it is essential to seek medical attention. Common symptoms of these STIs include pain during sexual intercourse, bleeding after sex, genital discharge, pain while urinating, and unexpected bleeding between periods for women. However, it is possible to have an STI without any symptoms, and therefore, it is essential to get tested and treated if you suspect you may have an infection.

2. The Effects Of Menopause

As women approach or go through menopause, a common issue that may arise is painful sex. This is due to decreased oestrogen levels, leading to dryness in the vagina. This can cause discomfort or even pain during sexual intercourse. Additionally, some women may experience these symptoms in the years leading up to menopause, known as perimenopause.

If you are experiencing dryness, lubricants can help to reduce this, and they can be purchased from a pharmacy. If the dryness continues, you should consult your doctor about other possible treatments, such as hormone replacement therapy (HRT).

3. Not Being Aroused Enough

When a woman is not sufficiently aroused, she may not produce enough natural vaginal lubrication, making penetrative sex uncomfortable or even painful. To reduce this discomfort, it is important to ensure both partners are sufficiently aroused before engaging in sexual activity.

If you're not aroused during sex, it could be because you haven't produced enough natural lubrication. You can purchase a vaginal lubricant from a pharmacy to help with this, but it's also important to talk to your partner about any sexual issues or lack of arousal. Furthermore, if other stressors or problems affect your libido, you should seek help from a doctor or counsellor.

4. Irritated Or Inflamed Skin

Skin inflammation can result from allergies or irritants, such as latex condoms, soaps, and specific types of spermicide. Additionally, if a person has a skin condition like eczema or dermatitis in the genital area, it can cause dry, cracked, and fissured genital skin, resulting in painful sex.

Using a silicone-based lubricant is a temporary solution to dry skin. Still, it is important to seek medical advice from a doctor to address the root cause of the skin condition.

5. An Underlying Medical Cause

It's essential to have any symptoms of painful sex checked by a doctor, as several medical conditions can be the cause. Here are some of those conditions and why a doctor should be consulted.

Vaginismus

It's essential to have any symptoms of painful sex checked by a doctor, as several medical conditions can be the cause. Here are some of those conditions and why a doctor should be consulted.

Vaginismus is an involuntary reaction frequently caused by fear of being penetrated. Treatment for Vaginismus typically involves psychological aid, relaxation methods, and exercises to help individuals get comfortable with penetration.

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection in the pelvis seen more often in women under 24. Symptoms include pain during intercourse, pelvic or abdominal pain, a fever, increased vaginal discharge, or vaginal bleeding. It is essential to seek treatment from a doctor, typically with antibiotics, if any of these symptoms are present.

Endometriosis

Endometriosis is a widespread condition affecting an estimated 176 million women worldwide. This condition is characterized by cells like those in the uterus growing in other body areas, such as the ovaries. Women with endometriosis may experience painful intercourse, periods, and abdominal pain.

Although there is no cure for the condition, various treatments can help to alleviate symptoms, including surgical procedures, hormone therapy, and medications to reduce pain.

Fibroids

Fibroids are generally harmless growths in the uterus; however, they may cause painful intercourse if they are large and situated near the cervix.

Surgery is a standard treatment for those suffering from severe fibroids. However, for milder cases, medication prescribed by a doctor can help reduce fibroids' symptoms, such as heavy menstrual periods, pain in the lower back, and frequent urination.

Phimosis

Phimosis is a rare condition that affects about 1% of boys. It is characterised by a tight foreskin that cannot retract around the tip of the penis. If left untreated, it may cause pain during intercourse in adulthood. To reduce discomfort, individuals may use condoms or lubricant. However, if the issue persists, it is recommended that a person speak with their doctor.

As the name implies, prostatitis is an inflammation of the prostate gland and causes pain throughout the body, such as the penis, testicles, anus and lower back. It is a condition which can affect individuals of any age, and it is estimated that up to 10%-15% of the population experience this at some point. Symptoms of this condition include pain when passing urine, urinary frequency or urgency. To effectively address acute prostatitis, antibiotics are necessary.

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