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Painful Sex: Here's What Causes Pain During Penetration

Some of the "here's what you can do about it is really simple."Are you experiencing painful sex? You have lots of company. Pain is easily the most common sexual complaint for women in general, and midlife women in particular (especially with sex after menopause). Your pain may be superficial or deep. You may experience it upon initial penetration or only with deep thrusting. You may burn or ache. This may be something you've dealt with intermittently all your life, or it may be a completely new experience for you. But there are things you can do to bring back the intimate.

Dyspareunia: The Medical Term for Painful Sex

The medical name for this condition is dyspareunia ("dis-puh-ROO-nee-uh"). Women with dyspareunia can answer to any or many of these symptoms, because the causes of painful sex are many. Sometimes the solutions are easy to find. But sometimes, getting to the right condition and finding the right treatment can take patience. It's a process of trial and error you can begin on your own, but may be best explored with the guidance of a trusted doctor or menopause care provider.

Painful Intercourse Causes

The most common painful intercourse causes are: vaginal dryness, vaginal atrophy, vaginitis, vaginismusvulvodynia, post-treatment for pelvic conditions (intercourse after hysterectomy or intercourse after chemo), deep pelvic pain, and other physical limitations related to sex and aging. That's quite a long list, but you can explore each of them by clicking on the condition links to the right. You'll also find treatments for painful intercourse and its causes, which you can discuss with your doctor and/or try on your own.

Dig deeper by exploring the related conditions listed at right, or choose another statement that sounds like you.

Products That Can Help With Painful Sex

While no single product is a cure-all for painful sex, and the solution is directly related to the cause, there are some products that are easy to use and have been helpful to thousands of women. While you can investigate the entire MiddlesexMD recipe for sexual health, these are products many women find helpful, listed so the simplest to adopt are first:

  1. Lubricants make intimacy more comfortable by replacing natural lubrication that diminishes as estrogen levels decline.
  2. Vaginal moisturizers are used as part of your daily self-care. They work over time to moisturize, strengthen, and restore vaginal tissues, countering painful dryness.
  3. Specially formulated soothing products are for vulvar or vaginal tissues that are sensitive to the touch, itchy, or dry. 
  4. Vaginal dilators can be part of a routine to keep vaginal tissues elastic and intimacy comfortable. Dilators can be used to restore vaginal length and width--what's called patency--by gentle stretching.
  5. Ohnut, a donut-shaped wearable that lets you control penetration depth.

The whole MiddlesexMD website was developed to help midlife women understand how their bodies are changing and find products to compensate. Again, start with the recipe for sexual health to learn all the ways you can move back to comfort.

Learn More About the Conditions That Can Cause Discomfort During Sexual Intercourse

Vaginal Dryness
Vaginal dryness is a common obstacle to comfortable sex for midlife women. Most often, it's one of the changes we all experience with menopause.

A vaginal discharge that some people think is kind of smelly, itching that can be light or furious, and irritation or pain are the key symptoms of vaginitis.

"It's like hitting a wall," say our patients with vaginismus. This is a condition in which the involuntary muscles of the vagina go into vaginal spasm.

Vulvodynia (VVS)
Pain in any part of your vulva—the mons, outer or inner labia, the clitoris or vestibule—that cannot be attributed to any other cause, is called vulvodynia.

After Treatment
It might be hernia repair, a hysterectomy, endometriosis, or the removal of fibroids.

Deep Pelvic Pain
Deep pain with penetration, especially with thrusting, is often caused by pelvic problems, and should be explored with your doctor if it is persistent.

Physical Limitations
Midlife comes with aches, pains, limitations. We don't bounce the way we used to. Some of us have lost strength in our limbs.