Abdominal pain during sex, what to do? Causes of pain during sex Why does your stomach hurt during intercourse?

According to statistics, every second woman sometimes experiences pain during sex. This problem makes sex life unpleasant and, in some cases, impossible.

A woman may experience pain during sex for various reasons. However, in any case, discomfort during intimacy is an indicator of problems. Therefore, when they appear, it is worth visiting a gynecologist and getting examined. The norm is pain at the first intimacy, when the hymen ruptures and blood appears. Although most often it does not tear during sexual intercourse, but only stretches. Then she can remind herself at the beginning of each sexual intercourse by the presence of unpleasant sensations. Often the first time pain during sex is associated with spasm of the vaginal muscles, which occurs due to fear and tension. You can reduce discomfort by relaxing and trusting your partner.

Sex is very good for health, but only if it is regular and ends in orgasm. However, in the presence of painful sensations, obtaining a discharge becomes almost impossible. And lack of satisfaction leads over time to venous stagnation, which is accompanied by pain during sex and can provoke a number of diseases.

Quite often, the cause of pain during intimacy is an insufficient amount of lubricant secreted. This can happen for various reasons:

• breast-feeding;
• taking hormones;
• menopause;
• psychological problems (disgust towards a partner, fear of getting pregnant);
• lack of excitement.

This problem can be solved with the help of artificial moisturizers - lubricants, which are sold in every pharmacy. However, if the problems are psychological, then it is necessary to deal with them. Some women experience pain during sex due to vaginismus, a spasm of the vaginal muscles. The reason for this is fear of intimacy due to psychological trauma. It may arise due to the first bad experience, rape. The muscles can contract so tightly that it is impossible to insert even the little finger into the vagina. Sometimes plastic speculums break due to fear of being examined by a gynecologist due to vaginismus. In this case, you need to relax, trust your partner and the gynecologist. If a woman is not able to cope with this problem herself, then she needs to visit a sex therapist and psychotherapist.

However, most often the patient’s question “Why does it hurt during sex?” you have to answer the gynecologist, since in most cases it is women’s diseases that contribute to this. In 25% of cases, the cause of pain during sexual intercourse is thrush. This is an inflammation of the vagina that is caused by a fungus. With timely treatment, the disease is diagnosed and treated quite easily. But getting rid of chronic thrush is much more difficult.

Vaginal inflammation can also be caused by other pathogens, including STDs. If colpitis is not treated, the infection may spread to the uterus, fallopian tubes and ovaries.

Adhesions can lead to pain during sex. They occur after operations and inflammation. Tears, stitches, injuries after operations and childbirth can spoil the pleasure of intimate life.

Another gynecological disease that causes pain during sex is endometriosis. This is the name for the growth of the uterine mucosa on other organs. These formations are subject to the same cyclical changes as the endometrium. The disease can affect the cervix, its muscular layer, fallopian tubes, ovaries, peritoneum, and bladder.

So, pain during sex is an indicator of health problems that requires consultation with a gynecologist. This cannot be tolerated as it will only make the problem worse.

Intimacy should give a loving couple happiness and positive emotions. But what if sexual contact is accompanied by unpleasant sensations? For example, after sex, the lower abdomen hurts and the pain does not go away for a long time. Such problems are not uncommon for women. Why might such a symptom occur? Doctors are ready to name several reasons at once.

First of all, it is necessary to determine whether pain actually occurs immediately after sexual intercourse or whether sex only intensifies the unpleasant symptom. In the second case, the cause of pain may be digestive problems or intestinal adhesions. Violation of the passage of feces leads to the formation of fairly hard lumps, which become the cause of pain.

Complaints that the lower abdomen hurts after sex may be symptoms of a dangerous disease such as endometriosis. Its development can lead to serious consequences, including severe uterine bleeding.

Some women know from their own experience that the cause of nagging pain after intercourse can be not only a disease, but also natural processes. Perhaps the cause of the pain was the fact that you did not receive sufficient release during sex, this tension became the impetus for the painful sensations.

Some congenital structural features of a woman’s genital organs can also cause pain in the vagina and lower abdomen after sex. In this case, discomfort occurs only in certain positions and such pain does not indicate any disease. Of course, not every woman will consult a doctor with such a problem. Although it can easily be solved by a sex therapist who will advise optimal positions for intimacy, and also relieve certain psychological discomfort.

The cause of painful sensations before and after sex is often an insufficient amount of natural lubrication. This problem occurs not only in postmenopausal women, but also in younger women. The reasons for this are varied: from hormonal changes to purely psychological complexes and fears.

If after sex there is pain in the lower abdomen and the pain radiates to the thigh, this is a sign of neuralgic inflammation, which, as a rule, goes away without additional treatment. But taking medications will significantly speed up the process.

If your lower abdomen hurts after sex, and the pain is so severe that it is difficult to bear, you should definitely get examined by a specialist. Most likely, we are talking about an inflammatory disease. In this case, long-term treatment, medication and physiotherapy, will be required. Advanced inflammation of the appendages often leads to infertility and the process may be irreversible.

According to the observations of practicing gynecologists, complaints that the lower abdomen hurts after sex are often associated with sexually transmitted diseases. Therefore, if pain is accompanied by burning and stinging, examination for the presence of sexually transmitted infections is necessary.

The cause of pain can be a benign tumor (cyst or fibroma), as well as postpartum sutures.

If in the first case treatment and even surgical intervention is necessary, then in the second option you just need to wait a while.

Pain in the lower abdomen, including that occurring after sexual intercourse, is often a sign of erosive lesions of the cervix, fibroids or cystitis.
No less often, such symptoms occur in women during pregnancy or during menstruation. These pains can be either natural or signal some kind of pathology. In any case, this should be decided by the doctor.

Judging by the fact that women's forums are filled with similar questions, many ladies prefer to solve the problem on their own and suffer pain, embarrassed to see a doctor. But in this case, we are talking not only about the pleasure of intimacy, but also about women’s health.

Many women complain of pain in the lower abdomen during sex. In medicine, this phenomenon is called dyspareunia. In some cases, it is due to physical reasons, and sometimes it may indicate the presence of serious health problems. Is there a treatment for lower abdominal pain in women during sex? For what reasons does this problem develop? What diagnostic methods do doctors use? You will learn about all this from the article.

Possible reasons

In order to find out for sure the cause of pain and discomfort in the lower abdomen during and after sexual intercourse, it is necessary to undergo examination by a nephrologist and gynecologist. The article describes supposed diseases and conditions that can cause pain in the lower abdomen in women after sex. You cannot diagnose yourself and choose treatment at random - you should visit a doctor.

The most common reasons:

• vaginitis - inflammation of the vaginal walls due to hypothermia, proliferation of infection, decreased immunity;
• premenstrual syndrome;
• urethritis - an inflammatory process in the urethra;
• chronic sluggish pyelonephritis - inflammation of the kidneys of a bacterial nature;
• vaginal candidiasis (or, as this disease is popularly called, thrush);
• problems with the muscle tissue of the pelvic floor - insufficient tone or partial atrophy;
• neuralgia of the pelvic nerves;
• neoplasms in the genital area.

Premenstrual pain during intercourse

There is an opinion that premenstrual syndrome in women manifests itself only at the psycho-emotional level. She becomes irritable, hot-tempered, and whiny. This is a misconception: physical manifestations are often much stronger and brighter.

One of the main manifestations of premenstrual syndrome is acute pain in the lower abdomen after sex. Why is this happening? The walls of the vagina are tense, and in some cases slight swelling may occur. As a result, friction causes pain not only during sexual intercourse, but also after it. Swollen vaginal walls receive microtraumas - this can cause inflammation and vaginitis.

How to solve this problem? The simplest solution is to not have sexual intercourse for about two to three days before the expected start of menstruation.

What is urethritis and how does it manifest itself during sexual intercourse?

Urethritis is the name in uronephrology for the inflammatory process in the urethra, which is accompanied by pain during emptying of the bladder. Depending on the stage of inflammation, symptoms may be as follows:

• temperature from 37 to 39 degrees;
• chills, fever;
• swelling of the genitals;
• pain in the lower abdomen during sex;
• sharp pain when urinating, burning.

You cannot treat urethritis on your own. You should undergo special tests that will also identify other infections. Symptoms of urethritis often coincide with sexually transmitted diseases. So pain during sexual intercourse in the lower abdomen and subsequent painful urination may be associated not only with inflammation of the urethra, but also with the presence of sexually transmitted infections.

Vaginitis in a woman: symptoms during sexual intercourse

This disease significantly affects a woman’s sexual life: it reduces libido, causes burning, itching and pain in the external genital area and inside the vagina. In some cases, the discomfort is so severe that it interferes with normal performance and forces the patient to take sick leave. Most often, there is an unpleasant odor (it is often compared to the smell of raw fish) from the genitals.

Vaginitis is the most common pathology of internal organs among women of reproductive age. According to statistics, every seventh woman has one or another number of pathogenic bacteria on her mucous membrane. The development of the inflammatory process may not occur immediately, but alternately develop and then subside for a while. This is due to the fact that when the immune system is in order, the body’s defenses can themselves prevent the development of such ailments. Failure to comply with the simplest rules of intimate hygiene aggravates the manifestations of vaginitis, and eating dishes with yeast contributes to the development of pathogenic microflora.

Vaginitis develops for the following reasons:

• non-compliance with the rules of sexual hygiene;
• lack of protection during sexual intercourse;
• injury to the genital organs;
• changes in hormonal status;
• abortions and miscarriages.

Sexual anxiety and its psychosomatic manifestations

Psychogenic sexual disorders are not a reality on the pages of textbooks on sexology. This is a very real diagnosis, the manifestations of which are observed in every eighth girl. The problem is often characteristic of inexperienced and young lovers. Their expectations from intimacy are particularly high, and as a result of some little thing that the partner does not even attach importance to, they will receive psychological trauma. This can affect the rest of your life.

Such girls may subsequently become cold or even completely frigid. Various sexual deviations may appear.

Another common problem that manifests itself on a physical level is the fear of pregnancy. Even with protection, these thoughts can become intrusive. A common fear for many girls is pregnancy. Pain in the lower abdomen after sex in this case is psychosomatic in nature, since there is no real reason for it. Attacks of nausea and weakness may also appear, although in reality there will be no reason for such feelings.

Diseases of the urinary system

It is very simple to distinguish them: in addition to sharp pain in the lower abdomen after sex, they are characterized by pain when urinating, nagging pain in the lumbar region, fever, chills, fever, and weakness.

Diagnoses such as pyelonephritis, glomerulonephritis, nephritis can cause inflammation and swelling of the organs not only of the urinary system, but also of the internal genitalia. The vaginal microflora may also be affected. As a result, the secretion of lubricant is disrupted and during sexual intercourse the girl receives many microtraumas. This is why pain occurs, in some cases it can be paroxysmal in nature. The severity of discomfort depends on the extent of inflammation.

Treatment methods for urethritis and pyelonephritis and women

The pharmacological market offers many active drugs. With constant use of certain medications, pain in the lower abdomen during sex and discomfort during urination will disappear after a few days.

1. "Canephron" is a homeopathic drug that gently relieves signs of inflammation. Normalizes urination and has a mild diuretic effect. The cost of packaging is about four hundred rubles. Duration of treatment is at least ten days, maximum two months. The exact dosage and conditions of administration will be reported by the treating gynecologist or urologist.
2. "Fitolysin" is a preparation based on plant extracts in the form of a paste. You should take one tablespoon on an empty stomach, several times a day. If, after a week of taking Phytolysin, pain during sexual intercourse remains the same intensity, then you should look for another cause of discomfort and a different drug for therapy.
3. "Monurel" is an excellent drug for the treatment of inflammatory processes not only in the kidneys, but also in the ureter. It can have a positive effect even with vaginitis and candidiasis. For maximum effect, it is recommended to take it in parallel with antibacterial drugs. after the bacteria are destroyed, pain in the lower abdomen during sex and burning during urination will go away. If the bacteria were not completely destroyed and the course of treatment was not long enough, unpleasant symptoms may return.

Alternative methods for treating lower abdominal pain in women

Simple tips to help minimize pain during and after sexual intercourse:

• do not take hot baths, do not visit steam rooms and baths - exposure to high temperatures is a suitable environment for the proliferation of pathogenic microflora;
• drink a course of nettle infusion - it thins the blood and has an anti-inflammatory effect;
• It is better to replace a sitz bath with a shower to avoid the spread of possible infection;
• change your underwear as often as possible; violation of this rule most often entails the development of chronic vaginitis and unpleasant odor;
• Avoid hypothermia of the legs and lower back.

How long after therapy does pain in the lower abdomen go away during sex?

When can I expect relief after starting therapy? it all depends on the individual state of the body, the degree of disease and immunity.

For sexually transmitted infections, one to two weeks of intensive therapy with antibiotics and anti-inflammatory drugs is sufficient.

If the reason is inflammatory processes in the organs of the urinary system, then you should be patient. Therapy may take several months until the pathogen is completely destroyed.

Therapy for vaginitis takes place quite quickly - it is enough to take a course of an antibacterial drug and observe intimate hygiene measures.

Prevention methods: how to prevent painful sex

Why does my lower abdomen hurt after sex? This question interests many girls. The most common causes and ways to eliminate them are listed above.

It is always easier to prevent the development of a disease than to treat it. Here are simple tips on how to do this:

• do not change sexual partners frequently, since even with protection, some infections can be transmitted through saliva and skin;
• observe the rules of hygiene - regularly wash the genitals with clean water and change underwear;
• avoid visiting steam rooms and saunas;
• Minimize the consumption of yeast products, as they often cause disruption of the vaginal microflora.

From 15 to 60% of women experience complaints of pain during sexual intercourse, but most of them do not consult a doctor due to the sensitivity of the problem. But pain during sex often accompanies a specific gynecological disease, which only a specialist can identify. Gynecologists at the Yauza Clinical Hospital will conduct a modern and in-depth examination (ultrasound, colposcopy, hysteroscopy) of the genital area, determine the cause of dyspareunia (painful sexual intercourse) and help get rid of the problem as quickly as possible.

Causes of pain during sexual intercourse

Inflammation of the genital organs

• Colpitis, vulvovaginitis. Pain during sexual intercourse is caused by an infectious and inflammatory process of the vulva (external genitalia) and vagina. Inflammation, pain/discomfort occurs at the beginning of coitus, when attempting to insert the penis, which is caused by irritation and swelling of the mucous membrane of the external genitalia. In addition to pain, the patient is bothered by copious vaginal discharge with an unpleasant odor, itching and burning of the vulva.
• Inflammation of the ovaries (oophoritis) or uterine appendages (salpingoophoritis or adnexitis). During sexual intercourse, a woman feels aching pain in the lower abdomen, on the right or left (depending on the side of the fallopian tubes and ovaries) or above the pubis (with bilateral inflammation). Other signs include fever, pain in the lower abdomen at rest and during exercise.
• Inflammation of the uterine mucosa (endometritis). Sexual intercourse causes pain in the lower abdomen, and sometimes bloody discharge may occur. The nature of the pain is aching, pulling. The development of endometritis is provoked by intrauterine interventions (curettage and abortion, insertion and removal of the IUD).

Gynecological pathology of non-inflammatory origin

• Endometriosis. With this disease, endometrial cells grow in unusual places (in the muscular layer of the uterus, in the ovaries, in the abdominal cavity or on the cervix). During the menstrual cycle, endometrioid lesions undergo the same changes as the uterine mucosa (bloody discharge during menstruation and pain before menstruation). In the case of cervical endometriosis, acute pain appears during sex, and in case of endometriosis of the ovaries or uterus, the pain is aching and localized above the pubis, in the lower abdomen.
• Malignant tumors of the cervix. Cervical cancer in advanced cases (stage 3 - 4) is also accompanied by dyspareunia. In addition to pain, a woman notices bloody or dark brown discharge from the genital tract after sexual intercourse.
• Atrophy of the vulvar and vaginal mucosa. Such changes sometimes make sexual activity impossible due to pain.
• Ovarian tumors and cysts. At rest and in the absence of complications, aching or nagging pain in the right or left iliac region is bothersome. During sexual intercourse, complications may develop - torsion of the leg of a tumor-like formation or rupture of a cyst, which is accompanied by sudden sharp pain in the lower abdomen. Later, nausea and vomiting, weakness and pale skin appear.

Other reasons

• Inflammation of the bladder (cystitis). Pain during sexual intercourse can be caused by cystitis, which is associated with the close location of the bladder and uterus. The inflamed bladder comes into contact with the uterine wall, which causes pain.
• Adhesive process of the small pelvis. Pelvic adhesions almost always provoke dyspareunia. The nature of the pain is dull, monotonous, the intensity of pain changes when changing body position.

Methods for diagnosing pain during sexual intercourse

Gynecologists at the Yauza Clinical Hospital carefully study the patient’s medical history and carefully examine the external genitalia, vagina and cervix, as well as bimanual palpation of the uterus and appendages. Additional diagnostic methods are prescribed:

• Testing for sexually transmitted infections. Taking smears from the vagina and cervix, determining hidden sexually transmitted infections using PCR (for colpitis, vulvovaginitis).
• Ultrasound of the pelvic organs. A safe and effective method for detecting many gynecological diseases.
• Colposcopy and vulvoscopy. Examination of the cervix, vulvar mucosa and vagina under magnification helps to identify various pathologies of the mucous membranes of the genital organs.
• Hysteroscopy. Hardware examination is carried out if uterine endometriosis is suspected.
• Laparoscopy. Performed to diagnose adhesive disease and dissect adhesions through punctures in the abdominal wall.

Advantages of examination at the Yauza Clinical Hospital

• conducting a comprehensive survey;
• modern diagnostic equipment (video colposcope, three-dimensional and four-dimensional ultrasound);
• extensive experience as gynecologists;
• quick and accurate determination of the cause of pain during sexual intercourse;
• consultations with related specialists if necessary.

Prices for services You can look at or check by calling the phone number listed on the website.

The pain can be continuous or intermittent, and sometimes it continues after sexual intercourse has ended. The main question to ask the patient is: does this pain interfere with sexual intercourse? It is divided as follows.

• Primary dyspareunia, in which sexual intercourse is always painful, often with a psychological background, may require specialist advice.
• Secondary dyspareunia, in which symptoms occur after a period of pain-free sex; underlying pathology, such as endometriosis, is possible.

Dyspareunia leads to vaginismus, an involuntary spasm of the pubococcygeus muscle that makes penetration difficult or impossible. It occurs after a single episode of pain, but persistent dyspareunia can occur. Anticipation of pain leads to muscle contraction and, in addition, the amount of lubrication decreases, which makes sexual intercourse more painful.

Superficial dyspareunia

Superficial dyspareunia is classified according to anatomical principles.

Vulvar causes

• Infectious vulvitis with herpetic or candida infection. It is necessary to examine smears and use antibiotics or antiviral drugs.
• At atrophic changes, especially in postmenopausal women, carry out hormone replacement therapy or recommend local use of estrogens. If there are contraindications to the use of estrogens, a lubricant with KY-gel or topical moisturizers (replens) can be used.
• Bartholinitis occurs when there is an infection in the area of ​​the Bartholin gland, but can also be the site of gonorrhea. Marsupialization is the standard treatment for draining the cyst and creating a new glandular duct.
• Skin diseases affecting the vulva including lichen sclerosus, cause pain due to cracks in the skin.
• These symptoms cause malignant tumors or precancerous diseases. Accurate diagnosis and adequate treatment are necessary.

Urethral causes

These are mostly anatomical problems and are rarely seen in a gynecology clinic.

• At urethritis And cystitis It may be necessary to study smears or midstream urine with microflora culture and sensitivity to antibiotics.
• Caruncle clearly visible upon examination and usually occurs in postmenopausal women. It becomes inflamed and painful.
• Urethral diverticulum- a rare disease in gynecological practice.

Vaginal reasons

• Vaginismus.
• Insufficient lubrication for psychosexual reasons, including sexual inexperience.
• Atrophic vaginitis, treatment is the same as for vulvar atrophy.
• Infectious vaginitis, the causative agents of which can be Candida, Trichomonas, herpes virus and gonococcus. Routine smears should be taken and appropriate treatment initiated.
• Anatomical problems- vaginal atresia or imperforate hymen. An ultrasound is needed to assess any associated problems in the pelvic area, and an examination under anesthesia is needed to determine the extent of the problem.
• Scars after surgery. especially after episiotomy and repair of perineal tears that lead to narrowing of the vaginal opening. Insertion of the penis into the vagina can be very difficult and surgery may be required to relieve local tissue tension.
• Post-radiation. It can be largely prevented by using vaginal dilators during treatment.

Size discrepancy in itself is rarely a big deal, since the vagina can stretch very much, but any damage increases the pain. An anal fissure and thrombosed and inflamed hemorrhoids are identified by careful examination of the anus and rectum with a finger or a mirror. Arthritis of the hips and lumbar spine can cause dyspareunia, although it is not as well localized.

Deep dyspareunia

Deep dyspareunia occurs when there is deep stretching of the pelvic tissues—the uterus fixed in a retroversion position, the uterosacral ligaments, or the rectovaginal septum—or pressure on the enlarged ovaries during sexual intercourse. There may be no pain or difficulty during insertion of the penis, but intercourse with deep penetration causes sharp pain or leads to dull pain after sexual intercourse is completed. A vaginal examination may mimic clinical symptoms. Common causes of deep dyspaurenia are as follows.

• Pelvic inflammatory disease. In case of inflammation of the pelvic organs, adhesions fix the tissue. In the acute period, antibiotics can be used and simultaneous treatment of the partner is important. In case of chronic disease, the final choice is possible surgical intervention with removal of the pelvic organs.
• ■ Endometriosis- a common cause of deep dyspareunia, especially with damage to the uterosacral ligaments. Symptoms do not always reflect the extent of endometriosis; the diagnosis is confirmed by diagnostic laparoscopy. The choice of treatment method depends on the degree of endometriosis; surgical intervention is possible.
• Ectopic pregnancy causes irritation of the peritoneum, which, in turn, leads to dyspareunia. This is a rare manifestation of ectopic pregnancy.
• Diagnosed by laparoscopy chronic pelvic pain syndrome with congestion in the pelvis, treatment is progesterone.
• Ovarian tumor- a rare cause of dyspareunia.
• Any pelvic pathology, causing irritation of the peritoneum.

In many women, severe constipation leads to dyspareunia, and this is noted during a vaginal examination. Laparoscopy is used to identify gynecological causes. However, if no cause is found during laparoscopy, it is necessary to reassure the woman that there is no pathology and break the stereotype of expecting and experiencing pain.

Pain during sexual intercourse, in medical terms - dyspareunia, occurs regardless of experience, age and gender. It is very difficult to diagnose and does not require delay in examination and subsequent treatment. In addition, pain during sexual intercourse can form a negative attitude towards sex and develop frigidity, which is absolutely unnatural for a psychologically healthy person.

Causes of pain during sexual intercourse

Pain during sexual intercourse is correctly divided by gender, since symptoms in men and women indicate completely different problems.

If a man experiences pain during sexual intercourse, this may be due to:

• Organic reasons (too tight foreskin or Peyronie's disease - curvature of the penis).
• Infections and inflammations of the genital organ.
• Prostatitis.

The situation in women is much more complicated in the case of pain during sexual intercourse. The range of possible reasons is wider:

• Psychological problems (fear, aversion to sex).
• Inflammatory processes and infections (vaginitis, cystitis, endometriosis, adhesions, cervicitis, inflammation of the hymen, uterine fibroids, cysts, etc.).
• Changes in hormonal levels, during which the vaginal mucosa becomes thinner.
• Varicose veins in the pelvic area.
• Bend of the uterus.
• Previous surgical interventions.

Symptoms of pain during sexual intercourse

Pain of any kind during sexual intercourse, whether acute or aching, is the most important sign that it is time to seek medical help.

In addition to the main reason, you should think about your health if:

• The pain is not one-time, but occurs every time you have sex.
• In women, pain is accompanied by associated symptoms such as burning, itching and redness of the genitals, and general weakness.
• In men - involuntary and painful urination, pain in the canal and radiating to the anus.

Pain during first intercourse

Pain during the first sexual intercourse is the norm, not a pathology. Very rarely, defloration is painless. When the partner's penis enters, the vaginal walls contract, which creates discomfort. In addition, often the hymen does not break after the first sexual intercourse, but only stretches due to its elasticity. Therefore, in the future during sex, the girl may feel discomfort.

There are no medications for pain during first intercourse. The most important thing is to be mentally prepared, and at the critical moment to relax as much as possible in a warm, comfortable environment.

Pain before and after intercourse

Often, pain that occurs at the beginning of sexual intercourse is not paid attention to, believing that this is the norm. In fact, this may indicate incompatibility of partners or diseases such as vaginismus, venous congestion, and adhesions.

If the pain does not go away even after intercourse, then most likely you are faced with a problem such as sexually transmitted diseases, a cyst or inflammation of the cervix.

The nature of pain during sexual intercourse and disease

Pain of any nature during sexual intercourse, radiating to the anus in men, is a sign of prostatitis. In addition, sharp pain in the scrotum during sex can be the cause of varicocele (dilated veins) and infectious diseases. If the pain bothers you for some time after intercourse, then this may be a sign of unemptied testicles.

In women, the list of diseases associated with this kind of pain is much wider.

Drawing and sharp pain in the lower abdomen during sexual intercourse is a sign of cystitis. The disease is accompanied by frequent urination.

Sharp pain and burning indicate fungal diseases or thrush.

If you feel a sharp pain as soon as your sexual partner enters you, then you are most likely dealing with vaginal dryness. This problem usually arises due to hormonal imbalance, previous drug treatment, or - most often - due to the inattention of the partner and neglect of foreplay.

A dull aching pain during sexual intercourse on the right or left side of the lower abdomen indicates a cyst.

Severe unbearable pain during sexual intercourse, which is accompanied by a burning sensation and vaginal discharge, means that the woman has vaginitis.

Pain in the external genitalia indicates a gynecological disease such as vulvodynia.

Dull but annoying pain is a symptom of diseases of the genitourinary organs.

Acute shooting pain radiating to the leg during sexual intercourse indicates neuralgia of the pelvic nerves.

The cause of pain can also be a psychological factor (unsuccessful first sexual experience, fear of sex, dissatisfaction with oneself and one’s partner).

Women feel severe pain during sexual intercourse after childbirth. This may be due to inflammation that has not yet passed or in the case when the stitches and cracks of the new mother have not yet healed. But this does not mean that you need to wait until the pain goes away on its own. You need to go to the doctor, because sometimes in such cases surgical intervention is required.

But pain during intercourse during pregnancy is partly a myth. More precisely, pain may be present, but it is in no way connected with the “interesting” position; rather, it is a sign of one of the above problems or the woman’s excessive suspiciousness.

Diagnosis of pain during sexual intercourse

It is almost impossible to independently determine the cause of discomfort. A gynecologist (for women) and a urologist (for men) can diagnose problems that cause a person to experience pain during sexual intercourse.

In any case, diagnosis is based on history. When you visit a doctor, you need to be prepared to clearly answer the question of how long you experience pain during sex.

It is important for a doctor to know:

• The pain is permanent or occurs for the first time.
• Are there any surgical interventions or problems of a similar nature that have already bothered the patient?

If tests and examination show that you are healthy, then you may be referred to a psychotherapist; perhaps the problem is psychological in nature and only this specialist will help you cope with it.

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If the pain is caused by a psychological factor, a woman needs to undergo psychotherapy (preferably with a partner).

For inflammatory and infectious processes, antibacterial therapy is prescribed, after which the vaginal microflora is restored.

• Vagikal suppositories – one suppository 3 times a day for 10 days.
• As a pain reliever (for men and women), you can take Ibuprofen - no more than 3 tablets per day.
• Antibiotics – Tetracycline (one tablet 0.25 mg no more than six times a day).

As a natural “folk” treatment, it is recommended to take baths with essential oils of lemon balm, juniper, myrtle, rosemary, yarrow, tea tree and thyme. For a bath, usually take 5-10 drops.

If the pain does not go away after intercourse (this applies to the external genitalia in women and the scrotum in men), you can try a cold compress - hold ice wrapped in a soft towel (but no more than 15 minutes!)

If the doctor determines that the pain is associated with a lack of natural lubrication, then the problem can be solved simply - select lubricants.

Be attentive to your health and let such a delicate problem as pain during sexual intercourse never bother you!

Sexual life is an integral and very important part of a relationship. After all, regular sexual intercourse is not only an opportunity to obtain physical satisfaction, but also a prerequisite for psychological comfort. However, in order for both partners to be satisfied, it is important that during sexual intercourse neither of them feels discomfort or pain.

In fact, pain during sexual intercourse is a typical phenomenon for women. If pain is a woman’s constant companion during sexual intercourse, then she, of course, will not be able to receive full pleasure. As a result, this will affect both her state of mind and her relationship with a loved one.

Dyspareunia is a medical term used to describe a condition where women experience pain during sexual intercourse. This condition can develop at any age, and pain or discomfort during sexual intercourse is possible at almost any stage of intimate contact. The nature of this symptom can also be different, as well as its localization and severity.

Only a specialist can answer the question of why it hurts during sexual intercourse, having previously carried out all the necessary examinations. It often happens that the cause of such troubles lies in absolutely simple things - for example, incorrect body position during sex. Also, this may be due to no less “banal” reasons - vaginal dryness, the presence of psychological discomfort due to the inexperience of the partner.

But if dyspareunia manifests itself systematically, then it is likely that it is associated with more serious causes. This phenomenon can be caused by diseases of the genitourinary or reproductive systems, associated with infections and those of a non-infectious nature. The causes of dyspareunia will be discussed in this article.

How does a doctor determine the causes of pain?

In the process of collecting anamnesis, the doctor asks a number of questions about the characteristics of the person’s health condition and more. During your consultation with a specialist, you may be asked the following questions:

• Are there other disorders associated with sexual activity, in particular poor hydration during arousal, lack of orgasm? Have there been any attempts to cure this condition?
• Do the uncharacteristic ones appear in a strange color or with an unpleasant odor? Did you experience pain in the lower abdomen?
• Has the woman had any illnesses caused by sexually transmitted infections (incl. , )?
• Is there an aggravated obstetric history: were there any injuries during childbirth, incisions of the perineal tissue, use of forceps during childbirth?
• Has the woman previously been diagnosed with chronic pelvic pain? salpingitis , and etc.?
• Have any surgical interventions been performed on the abdominal cavity or genitourinary organs? Did a woman pass by?
• What methods of contraception were used previously, and what contraceptives does the woman currently use? Have any intrauterine devices been used for protection?
• Has the woman been diagnosed or Behcet's syndrome ?
• Do you worry about skin diseases, etc.?
• Have there been any problems with the urinary system? Was the patient sick or bothered by colon diseases?
• Is there high sensitivity to cosmetics and medications – ointments, creams, lotions? Does sensitivity occur when using colored or scented toilet paper or intimate hygiene products?

The specialist also asks about the nature of the pain that manifests itself:

• When exactly do pain sensations appear - before the start of the act at the entrance, immediately during movement, after contact?
• If the pain is deep, where exactly is it located? Which side exactly did the pain start on?
• The nature of the pain – sharp, aching, strong, burning?
• Are you bothered by unpleasant sensations - burning, itching?
• Are the pains generalized (that is, independent of the situation or partner) or situational (related to circumstances, partner, dependent on the monthly cycle)?
• Does pain depend on position during sex?
• Is there a connection between the manifestation of pain and the use of alcohol or drugs?
• Was the pain bothering you from the very beginning of sexual activity or did this symptom appear recently?

Psychosocial aspects are also discussed:

• Has the woman discussed this issue with her partner?
• Have similar manifestations been observed in intimate relationships with another partner?
• Has any concerted action been taken to overcome these manifestations?
• Has the woman experienced rape or assault before?
• Does the patient suffer from symptoms anxiety disorders ?
• Are there any stress factors in her life?

Why does dyspareunia occur?

The reasons why painful sexual intercourse and discomfort during intimate contacts are noted are clearly divided into two groups by experts:

• Diseases of the genitourinary system associated with infections and having a non-infectious origin.
• The presence of psychological problems associated with the fear of experiencing pain again after an unsuccessful intimate experience.

If a specialist seeks to determine the reason why vaginal pain occurs during sexual intercourse, he initially needs to find out whether the patient’s arousal is sufficient before intimate intercourse.

Vaginal dryness associated with insufficient arousal is observed in unstable relationships in a couple and constant conflicts. A woman does not have time to become sufficiently aroused if her partners do not master the technique of foreplay or simply do not pay enough attention to them. As a result, a certain vicious circle gradually appears when initially a woman experiences insufficient hydration associated with psychological aspects or inexperience, and later this phenomenon repeats, and before each sexual intercourse the woman already expects the appearance of pain.

Diseases that cause pain during sexual intercourse

Pain during sexual intercourse can be a symptom of various diseases. They can develop anywhere in the intimate area and have different origins. There are a number of the most common infectious and non-infectious diseases that may cause pain during sexual intercourse.

Infectious diseases:

• Endometriosis – pathological changes in the endometrium, in which particles of this tissue appear in various atypical places – ovaries, serous and muscular layers of the uterus, peritoneum, etc.
• – acute or chronic inflammation in the vagina, which appears as a result of exposure to Trichomonas , chlamydia , gonococci , fungi, mycoplasma , nonspecific pathogenic microorganisms. Sometimes vaginitis is associated with hormonal disorders.
• Cystitis – an inflamed process in the bladder.
• Urethritis – inflammation of the tissues of the urethra.
• Spikes in the pelvis, manifested as a result of inflammation of the abdominal cavity, acute or chronic – develop after a previous acute or chronic inflammatory process in the abdominal cavity.
• Salpingitis , cervicitis in a chronic form.

Non-communicable diseases:

• Postpartum sutures, injuries, ruptures, as well as sutures after operations.
• Insufficient hydration - inactivity of the arousal phase in young women, lack of moisture during the period.
• Vaginal atrophy – a similar condition is characteristic of the menopause period, it is manifested by dryness of the vaginal mucous membranes due to a lack of estrogen in the body.
• Venous stagnation - this condition is observed when abstaining from intimate life or during irregular sexual intercourse, as a result of which stagnation of blood develops in the vessels of the small pelvis.
• Decreased tone of the pelvic floor - leads to .
• Myomas , cysts – neoplasms that appear in the pelvic organs.
• Retroversion of the uterus – anomalies in the position of this organ (bending, deviation) in relation to other pelvic organs.
• Incompatibility of sizes, anatomical discrepancy is a rare phenomenon, since the female vagina is stretchable, and if there is sufficient hydration, then there are no problems. This is possible with gigantism in a man.

Dyspareunia: what is it and how does it manifest?

Dyspareunia is a condition in which pain occurs during sexual intercourse. Symptoms of dyspareunia in women may appear before sexual intercourse, when the penis first penetrates the vagina. Dyspareunia can also occur with movement. Pain after sexual intercourse is also possible.

Each woman perceives such manifestations individually, feeling burning, pressure, discomfort or sharp pain.

If the pain is not severe or of moderate intensity, then most likely we are talking about an inflammatory disease.

Sharp pain may be a sign of acute inflammation of the ovaries, uterus, and appendages.

Psychological factors lead to pain of varying localization and intensity. They may disappear completely after a change of partner or environment.

Superficial pain

It appears at the entrance when the partner inserts the penis. They are often associated with diseases of the vestibule and lips, insufficient hydration, vaginismus . The probable cause of such sensations may be vaginitis of fungal or bacterial origin, as well as vulvodynia , vulvar dystrophy, mucosal atrophy. Superficial pain is also possible.

When a woman consults a doctor with such complaints, he may note the presence of ulcers or cracks in the vestibule of the vagina.

If pain appears during palpation along the urethra and bladder, then the cause is likely due to urethritis.

Herpeptic rashes indicate genital herpes, in which case the discomfort disappears after the course of treatment for the infection.

Deep pain

If sexual intercourse between a woman and a man causes deep pain, most often the reasons for this phenomenon are associated with adhesions, endometriosis . They can also be provoked by stagnation in the pelvis in women. Less common causes are endometritis, inflammation of the appendages, abnormal location of the uterus, weakened pelvic floor tone. A number of unpleasant symptoms, including dyspareunia, appear in diseases of the urinary system. The same thing happens with intestinal diseases. Therefore, dyspareunia can be caused by both colon inflammation and irritable bowel syndrome.

During menopause deep pain manifests itself as a result of atrophic changes, insufficient arousal phase and associated dryness in the vagina. As a result, friction becomes difficult, and pain appears both at the entrance and inside the vagina. With certain positions, the pain intensifies, because the vagina does not lengthen or expand. Often a woman is interested, for example, in why pain appears in a position where the woman is on top, but not in other positions.

In this way, we can summarize what pain can occur in certain diseases.

Superficial

• Vulvodynia .
• Urethritis .
• Vaginismus .
• Vulvar vestibulitis .
• Vaginitis .
• Lack of arousal and, as a result, hydration.

Deep

• Spikes in the small pelvis.
• Inflammation in the pelvis.
• Endometritis .
• Endometriosis .
• Pathology of the appendages, urethra.
• Venous stagnation in the small pelvis.
• Retroversion of the uterus .
• Cervicitis in a chronic form.

Both superficial and deep

• Vaginal atrophy and associated vaginal dryness.
• Insufficient hydration
• Investigation, operations, injuries.

Pain after pregnancy

The problem of pain during sex after childbirth very often worries young mothers. There is research data that after childbirth, about 40% of young mothers report non-localized pain, approximately 45% of women experience pain at the entrance. Directly during intimate contact, significant discomfort appears in 25% of patients who have undergone breastfeeding and in approximately 40% of nursing mothers. However, the reasons for this phenomenon remain completely unclear to doctors to this day.

In most cases, the pain stops within six months after birth, but sometimes this condition can persist for a whole year.

Reasons related to psychological factors

Not only physiological reasons can provoke the development dyspareunia . This condition is often associated with psychological reasons, which is why a woman may refuse sexual intercourse.

Fear of sexual intercourse

Most girls are afraid of their first sexual contact due to the upcoming defloration and pain associated with this process. During defloration, pain occurs due to tearing hymen . Many girls feel fear precisely because of this.

This disorder may be due to fear of the partner if he behaves cruelly. Also, a woman often fears an unwanted pregnancy, and this prevents her from relaxing. If you cannot overcome such fears on your own, a specialist psychologist or sexologist will help.

Pain during intercourse during pregnancy

When having sex during pregnancy, some women feel discomfort and pain at these moments. This condition develops at the level of the subcortical centers of the brain due to the risk of harming the fetus due to penetration of the penis into the vagina. However, some experts argue that dyspareunia cannot be associated with pregnancy, but is a consequence of gynecological diseases.

Vaginismus

Vaginismus is a condition that is often associated with complications of defloration. In this case, a woman for a long time cannot overcome the fears that are associated with sexual relations with a previous partner. Vaginismus is characterized by uncontrollable sharp spasms of the vaginal muscles, which causes pain and makes it impossible to fully complete sexual intercourse.

The presence of complexes and self-doubt

Often women believe that their body is imperfect, and this makes them doubt their own attractiveness and prevents them from focusing on sexual play. As a result, there is not enough arousal, and the partner feels pain during intercourse. This often happens to women who are overweight or have certain physical disabilities. Psychological complexes often become a serious problem, and only a specialist can help overcome them.

You can determine the causes of this condition by visiting a specialist - a urologist, gynecologist, psychotherapist, sexologist. First, the doctor carefully collects anamnesis, conducting a careful questioning of the patient about the characteristics of the symptoms and the circumstances under which pain appears. If the doctor suspects that the cause of unpleasant symptoms is gynecological diseases, he may prescribe a number of diagnostic and laboratory tests:

• Extensive or general clinical examinations of urine and blood.
• Ultrasound examination of the pelvic organs.
• Detection of infections, including those that are sexually transmitted.

Having received a complete picture thanks to the listed studies, the doctor will be able to confirm or deny that pain during sexual intercourse in a woman is associated with a certain disease. If it is not possible to identify clear reasons for the development of such a condition, then the psychological nature of dyspareunia is considered.

The table below shows the differentiation of those conditions in which dyspareunia manifests itself in a woman.

Disease	Signs	Causes	Research results	Following actions
Dyspareunia unknown origin	Pain at the entrance or deep pain.	Unidentified.	There are no signs of disease.	A psychological diagnosis should be carried out.
Vulvodynia	Complaints of burning; signs of irritation at the entrance; pain when sitting and while cycling; ineffectiveness of treatment.	Irritants; infections, pain due to unknown causes.	Pain on palpation; erythema on the skin or its absence; if ulcers, pigmentation, or nodules are present, then it is necessary to identify another pathology.	A thorough examination, biopsy, and colposcopy are performed;
Vaginismus	Pain at the entrance; muscle spasm at the entrance; difficulties when inserting a tampon, finger, penis.	Unidentified; reflex reaction or psychological reasons.	Vaginal spasm during palpation; difficulties when inserting a speculum.	Careful history taking; physical and psychological examination.
Vulvar vestibulitis	Aching pain at the entrance; burning, itching, inflammation of the vulva in the vestibular area.	Unidentified.	Flat erythema with clear or blurred edges; the appearance of sharp pain when touched by a cotton swab.	Thorough examination, biopsy, colposcopy; Apply an application of acetic acid to exposed areas.
Disturbed natural hydration, tissue atrophy	Difficulty in inserting the penis and the appearance of pain; dryness, irritation.	Postponed surgeries; problems during the arousal phase; decreased amount of natural lubrication and worsening vaginal stretching; deficit estrogen .	During the examination, special attention is paid to the fullness of the labia, the presence of pubic baldness and cracks, and violation of the integrity of the mucous membrane; it is determined how easily the mucous membrane is injured.	Discussion with a specialist about the role of foreplay and sensations during the arousal phase.
Diseases of the uterine appendages	Deep pain that often appears on either the right or left side.	STD; ovarian cyst.	The appendages are enlarged; inactive, painful.	Laparoscopy.
Endometriosis of the uterus, adhesions	Pain during menstruation; deep pain.	In case of adhesions – previous operations, infections; with endometriosis - the causes are unknown.	The uterus and appendages are inactive, the presence of nodules.	Laparoscopy.
Uterine fibroids, its abnormal location, weakened pelvic floor tone	Deep pain.	The uterus is located in a special way.	Prolapse or enlargement of the uterus.	It is recommended to change your position during intercourse.
Venous stagnation	Deep pain; pain after sexual intercourse.	Unidentified; With varicose veins, the likelihood of stagnation increases.	There are no special features.	Depending on the characteristics of the pain.
Endometritis, pelvic inflammatory diseases, cervicitis in chronic form	Deep pain.	Infections.	The cervix is ​​easily injured, there is discharge; pain is felt when the cervix is ​​displaced.	Bacterial culture, colposcopy, tests, laparoscopy are performed.
Urethritis, cystitis, interstitial cystitis	Feeling of pressure above the pubis; frequent urge to urinate.	Unclear origin; infections.	Pain on palpation of the urethra and bladder.	Bacterial culture of urine; its general analysis.

Therapy for this condition is carried out depending on the reasons for discomfort and pain during sexual intercourse.

If dyspareunia is caused by inflammatory processes, the patient is prescribed a medication regimen to eliminate the inflammation.

When it comes to pain caused by fibroids , endometriosis or ovarian cyst , surgery is often prescribed.

Provided that dyspareunia was provoked by the presence of psychological problems, the woman needs to consult a specialist sexologist or psychologist.

It is important for every woman to realize: if pain during sexual intercourse occurs constantly, this problem should never be ignored. Moreover, you cannot practice any self-medication.

Only a doctor can conduct a thorough diagnosis and, using the necessary examination methods, determine why such a problem occurs, and then completely eliminate it.

Since the factors causing dyspareunia , in fact, there are a lot, and some of them are very serious, you cannot expect that such an unpleasant symptom will disappear on its own over time. And the sooner a woman sounds the alarm and tells a specialist about her problem, the greater her chances of eliminating these symptoms as soon as possible, with a minimum of effort.