Pain in sex is a very uncomfortable thing that can sometimes be easy to understand and deal with. So says Shari Lawson, director of General Obstetrics and Gynecology at Johns Hopkins Hospital. «Painful sex can be caused by an infection or a hormonal imbalance,» she says. The good news is that these things are easy to deal with. We must start from the basis that it affects women more than men. They usually have one or more clear reasons for experiencing discomfort, Lawson says. Common reasons for painful sex include:
- Sexually Transmitted Diseases (STDs): Approximately 20 million STDs occur each year in the United States. Some, like chlamydia and gonorrhea, can cause vaginal irritation. This can cause pain during sex.
- Genital herpes: The blisters and sores caused by herpes can cause pain when penetrating.
- Vaginitis: Vaginitis refers to any vaginal inflammation. In particular, bacterial or yeast overgrowth (caused by a fungus called candida) in the vagina can cause irritation, discharge, sensitivity, and itching.
- Previous injuries: Women who have given birth to large babies may have tiny tears in the vagina, which will heal over time. This is more common if the baby was delivered with forceps.
- Lower Estrogen Levels: Postmenopausal women may experience a decrease in estrogen. This makes the vaginal lining thinner and less able to stretch. In this case, sex can often cause microscopic cuts, which can lead to burning and irritation.
- Lichen sclerosus: It is a condition in which the skin of the genitals becomes scaly and inflamed that can occur in postmenopausal women.
- Previous sexual abuse or injury: Women who have experienced sexual trauma may associate sex with pain, leading to muscle tension.
Feel less pain in sex
Your doctor will discuss your sexual history and perform an internal exam. If your doctor suspects a yeast infection or bacterial vaginosis (an infection of the vagina caused by bacteria), he or she will take a sample of your vaginal discharge and examine it under a microscope for signs of infection. Doctors also check the pH levels in your vagina. Too high a pH points to vaginosis, but a yeast infection usually has a normal vaginal pH. Your doctor will also examine your vagina and vulva, the outside of your genitals, for other lesions that may contribute to pain. You may also be screened for STDs through a urinalysis or vaginal swab.
Depending on the cause, common treatment options for painful sex include:
- Topical Estrogen Creams – If you have vaginal atrophy or vaginal thinning and inflammation, estrogen creams can help restore vaginal skin thickness and elasticity.
- Antibiotics: If you have an STD or bacterial vaginosis, antibiotics often clear up the infection within two weeks.
- Antifungal creams or tablets: If you have a yeast infection, your doctor may prescribe a cream or pill to get rid of the fungus.