Pain During Intercourse

Women of any age may experience sexual discomfort. No matter your age, if you find sex painful, you should talk to you doctor. There may be a medical condition causing your discomfort that can be addressed and treated. Some causes of pain during intercourse include:

Vestibulodynia. This condition can affect women of any age but is the most common cause of sexual pain in women under 50. Vestibulodynia is associated with severe pain when any pressure is applied at the entrance of the vagina. It can be treated with topical anesthetics, estrogen cream, antidepressants, drugs used for nerve-related pain, and physical therapy.

Vulvodynia. This condition, which may be related to abnormal nerve firing, can cause irritation to the vulva even without sexual contact or any contact. It involves pain, stinging, burning, irritation, and rawness. Vulvodynia is treated similarly to vestibulodynia (described above).

Vaginismus or Pelvic Floor Muscle Dysfunction. This condition involves the voluntary spasm of the vaginal and perineal muscles when sexual contact is attempted, making intercourse difficult or impossible. It can be caused by trauma or underlying physical conditions. Vaginismus may be treated with dilator therapy (relaxation techniques are used while the vagina is dilated using progressive-sized dilators) or physical therapy.

For women who have gone through menopause, pain during intercourse can be the result of changes to the body during this transition. This is discussed in the previous section, “Menopause and Sex.”

Orgasm

It’s not entirely understood why women have orgasms. Regardless of the reason, however, orgasms may have health benefits. In addition to pleasure, orgasms also trigger a release of the “feel-good” hormones oxytocin and endorphins. These natural chemicals can aid relaxation, help couples bond more closely, and help reduce, stress, pain, and depression.

Not all women reach orgasm with every sexual encounter, and when a women does reach orgasm, it’s not always through intercourse. This is important to keep in mind because when orgasm becomes too much of a priority during intimacy, it can overshadow the other positive and pleasurable aspects of sexual contact—especially when orgasm isn’t reached. Several factors that may affect your ability to have an orgasm include:

  • Medical illness
  • Gynecologic surgeries (hysterectomy or cancer surgeries)
  • Medications (including blood pressure medicines, antihistamines, and antidepressants)
  • Drug use and excess alcohol consumption
  • The aging process (see “Menopause and Sex” for more information)
  • Psychological causes (including mental health problems, performance anxiety, and stress)
  • Relationship issues (conflicts or problems with trust and communication)

Some women who have trouble reaching an orgasm are able to learn techniques to help them reach climax. These methods aim to help women relax most of their body but tense the muscles in the lower pelvis, which can help induce an orgasm. A healthcare professional can suggest resources for learning more about ways to help you reach orgasm. Medical conditions as well as side effects of medications can interfere with your ability to orgasm—your healthcare provider can help you with this as well.

Resources

The National Institutes of Health

American Association of Sexuality Educators, Counselors, and Therapists

Sources

Sexual Health. The National Institutes of Health Web site. Available at: http://health.nih.gov/topic/SexualHealthGeneral. Accessed June 2010.

Sex and Relationships. HealthyWomen. Available at: http://www.healthywomen.org/ages-and-stages/healthy-living/sex-and-relationships. Accessed June 2010.