Gynecological Conditions Related to Painful Intercourse
It is a tough topic to talk about, but many women experience pain during intercourse. It can vary from mild to unbearable, from sharp and stabbing to dull and widespread. Women who experience this kind of pain often have a difficult time talking about their symptoms with their partners. They might believe what they are experiencing is normal or that it is too taboo to even acknowledge. However, pain during intercourse, or dyspareunia, is not normal and could, in fact, be an early sign of endometriosis, uterine fibroids, or uterine prolapse. Leaving pain unchecked can lead to complications, a delay in diagnosis and treatment, as well as psychological distress.
What Kinds of Conditions Can Cause Pain During Intercourse?
Endometriosis is a condition in which the tissue of the uterine lining (the endometrium) begins to grow outside the uterus. If the endometriosis occurs behind the vagina and the lower part of the uterus and affects the uterine nerves, it can cause pain during intercourse because sexual activity pushes and pulls on the growths.
Uterine fibroids are non-cancerous growths within the muscle tissue of the uterus. Uterine fibroids can cause pain during intercourse because fibroids press on the cervix, hang through the cervical opening or when fibroids get irritated.
Uterine prolapse occurs when a woman's uterus moves out of its normal position. The uterus may even slip enough that it drops partway into the vagina causing pain during intercourse.
Where Can Pain Occur During Intercourse?
Pain can be felt in the vulva, in the area surrounding the opening of the vagina or within the vagina. The perineum, lower back, pelvic region, uterus and bladder are also areas where pain may be felt. In addition to gynecologic conditions, pain can also be caused by issues with sexual response: lack of arousal or a lack of desire, which may need to be addressed with a specialist.
Causes of Pain During Sex
Pain can be the first warning sign of an underlying gynecologic condition and may be more pronounced in certain positions. Pain during intercourse may be associated with a range of factors, including:
- Certain medication: antidepressants, high blood pressure medications, sedatives, antihistamines and certain birth control pills
- Congenital abnormality, inflammation, infection, skin disorder, injury, trauma, irritation
- Insufficient lubrication: drop in estrogen levels after menopause/childbirth/during breastfeeding
- Vaginismus: involuntary tightening of the vaginal muscles during penetration
- Past surgeries
Sexual activity is deeply intertwined with emotion, which can play a role in any type of experience, negative or positive. Psychological problems, stress, and a history of sexual abuse are known emotional factors that may also contribute to painful intercourse.
As a leading surgical hospital focused on women’s health, the physicians at Cedars sinai Marina del Rey Hospital are here to help - it is not necessary to live with pain and discomfort.