I am having pain during intercourse. What are some possible reasons for this pain?


Painful sexual activity (dyspareunia) is common and has many different causes. There are many causes of painful sexual activity. Some of the most common diseases include:

  • Pelvic infections
  • Endometriosis
  • Interstitial cystitis
  • Vaginismus (muscle spasm)
  • Irritable bowel syndrome
  • Postmenopausal vaginal dryness or atrophy due to low hormone levels.

The vagina and surrounding tissues have the highest number of estrogen receptors. In low estrogen states, as seen after menopause or after surgical removal of the ovaries, the tissue can become very thin, fragile and dry which can result in actual tearing of the delicate tissue.

You should seek care with a provider who can ask specific questions and perform a physical exam to better elucidate the cause of your symptoms. For example, if you have had a long history of painful intercourse, painful periods and difficulty conceiving, then you may have endometriosis. If the pain is associated with urinary burning and frequency in the absence of an infection, then interstitial cystitis may be the cause of your pain. Vaginismus is a condition where the pelvic floor muscles involuntarily spasm and as a result, make vaginal penetration uncomfortable and this can be treated with physical therapy. Irritable bowel syndrome is characterized by abdominal pain associated with diarrhea or constipation but can also manifest as pelvic pain.

If you are experiencing vaginal dryness, using olive oil as lubrication may help. However, if the dryness and thinness is related to low estrogen states, then you will need to start treatment to promote healthy, vaginal tissue.

Developing good coping mechanisms to life stresses and treatment of any underlying mood disorders are important to any woman’s sexual function. This is by no means an exhaustive list of the causes of painful intercourse and I encourage you to seek care with your physician who can diagnose and ultimately provide targeted treatment options for your painful intercourse.

All My Best,
Nurse Mary

September 23, 2014 at 10:25am