Is it normal to feel pain during sex? Pain during and after sexual intercourse: what does it mean and what to do? Sharp pain in the lower abdomen during intimacy.

Sometimes sex brings partners not only pleasure, but also discomfort. This may be due not only to problems in intimate life. It happens that after sexual intercourse a woman is bothered by various pains localized in the lower abdomen. They interfere with having a full sex life.

Pain cannot just happen. Perhaps they only indicate that an unsuccessful position was chosen for sex, which led to muscle overstrain, but pain can also indicate the presence of certain diseases.

Pain in the lower abdomen after intercourse: causes

Inflammatory processes in the vagina and cervix

The simplest cause of inflammation in the vagina is candidiasis, or, in simple terms, “thrush”. A large number of women face this disease. Its symptoms are profuse curd-like discharge. Thrush dries out the vaginal mucosa, making it more vulnerable. This causes pain after intercourse.

Inflammation can also develop in the cervix, this disease is called endocervicitis. Usually it is accompanied by pathological discharge from the vagina, the woman feels nagging pain in the lower abdomen. To establish what exactly triggered the development of inflammation, it is necessary to be tested for infections transmitted through sexual intercourse.

Endometriosis

Endometriosis is a disease in which the epithelium of the mucous membranes grows and extends beyond the uterus. For example, foci of endometriosis can be found in the abdominal cavity.

Why is this happening? When women menstruate, part of the excreted blood with epithelial particles enters the abdominal cavity through the fallopian tubes. Adhesions that occur in the pelvis cause pain not only during sex, but also during bowel movements. Endometriosis manifests itself not only with pain, but also with spotting and spotting long before and after menstruation. Discharge may be “smeared” throughout the entire cycle. Also, throughout the entire cycle, the woman is bothered by nagging pain. Factors contributing to the development of endometriosis are a history of abortion, curettage, hormonal disorders.

Ovarian cysts or ovarian apoplexy

Functional ovarian cysts occur periodically in most women. They do not pose any particular danger; usually such cysts resolve on their own by the beginning of the next cycle. But during too vigorous sex, the cyst may rupture, which will cause intense pain. This situation does not require urgent medical intervention, but still the regular occurrence of functional cysts is a reason to check your hormonal status, and perhaps seek help from an endocrinologist.

Ovarian apoplexy, on the contrary, is a serious complication in which surgical intervention should be performed as soon as possible. Apoplexy of the ovary is called its rupture. The pain is strong and intense, radiating to the sacrum and anus. Nausea and vomiting, pale skin, and decreased blood pressure may also appear. Ovarian rupture can occur during rough sexual intercourse.

Cystitis

Cystitis is called inflammatory processes in the genitourinary tract. A common symptom of cystitis is pain and burning in the lower abdomen after sexual intercourse.

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.

Painful sensations during sexual intercourse are experienced by both young girls and experienced women. This problem has not left men aside either. If you experience this phenomenon, then you need to visit a doctor. The cause of pain during sex may be a serious disease of the pelvic organs.

Common myths about the causes of pain during sexual intercourse

As a rule, most men and women visit a gynecologist or urologist only when absolutely necessary. The need for preventive examinations is often forgotten. And, by the way, any disease is easier to cure at the initial stage than at the chronic stage. Let's look at the most common myths about the causes of pain during sexual intercourse:

1. This is the norm for women at the beginning of sexual intercourse.

This is wrong. If the degree of arousal is insufficient, the partner may indeed experience unpleasant sensations, sometimes painful, at the beginning of sexual intercourse. But this cannot be the norm. In this case, sexual intercourse can lead to unpleasant consequences, for example, the occurrence of colpitis, vaginal dysbiosis, since the vaginal mucosa suffers from a lack of lubrication.

2. Pain occurs due to incompatibility in the size of the partners’ genital organs.

In this case, pain can occur only in extremely rare cases, and then if the partner cannot control his actions. Otherwise, with sufficient arousal, a woman should not experience pain, since the entrance to the vagina, like it itself, becomes elastic.

3. Pain is present due to cervical erosion.

Due to the anatomical structure of the female body, pain during sexual intercourse cannot occur due to erosion. Erosion may indicate the presence of an infection that causes an inflammatory process characterized by pain during sex.

When is pain normal?

Minor pain is normal only during the first sexual intercourse, when defloration occurs - rupture of the hymen. But, more often than not, women experience only unpleasant sensations.

Pain during sex in women as a cause of serious dysfunction of the reproductive system

Pain during sexual intercourse in women may occur due to the presence of:

1. vaginismus (pain during sex does not arise from penetration of the penis, but from compression of one’s own muscles);

Vaginismus can appear when the first sexual intercourse is unsuccessful, for example, accompanied by violence (in the case of rape), ridicule. Vaginismus sometimes occurs during a gynecological examination. Fear causes muscles to tighten so much that sometimes modern plastic gynecological speculums break. If the woman trusts the gynecologist and is sufficiently relaxed, the examination is painless.

2. inflammation of the genital organs;

During sex, during inflammatory processes of the organs of the reproductive system, there may be not only pain, but also an unpleasant odor, uncharacteristic discharge, and a feeling of dryness. In this case, you should immediately consult a doctor and get tested for infections. During treatment, sexual activity will have to be postponed, and when it resumes, you must use a condom. If an infection is present, treatment is necessary for both partners, even if the other does not show symptoms, as he may be a carrier of the infection.

Inflammation can be caused not only by sexually transmitted diseases (STDs), but also by microorganisms that every organism has: fungi, E. coli, staphylococcus and others. When the protective functions of the immune system are weakened (for example, during colds, menstruation, pregnancy), the ratio of these microorganisms is disrupted, which also causes inflammation.

Inflammation often appears when microorganisms enter a “foreign” environment (into the female genital tract from the male or from the skin, from the intestines, or the oral cavity).

3. adhesions;

Most adult women have adhesions. Many people don't care about them. For some, they hurt when stretched during an examination on a gynecological chair and during proximity. Pain during adhesions is localized deep in the abdomen and depends on the position and “aggression” of sexual intercourse. If adhesions disrupt a normal lifestyle, then treatment is necessary.

4. postpartum sutures;

In this case, the pain will go away on its own within a year. If this does not happen, it is necessary to look for the cause, and, most likely, eliminate it surgically.

5. endometriosis;
The main symptom of endometriosis is pain that appears or intensifies before menstruation and goes away with it. Pain during sexual activity or during bowel movements on the eve of menstruation can be signs of endometriosis. Pain during sex with endometriosis is felt inside the vagina, making sexual activity impossible due to the high degree of pain.

6. venous stagnation;

Most often, it occurs due to irregular sex life, lack of satisfaction, abstinence, and dissatisfaction with relationships. If this condition is observed for a long time, treatment is necessary, as it is dangerous due to the occurrence and development of uterine fibroids, endometriosis, mastopathy, and ovarian dysfunction.

7. neuralgia of the pelvic nerves;

With neuralgia, pain is felt and intensified by touch (sexual intercourse, examination on a chair, ultrasound with a vaginal sensor). It is often sharp, shooting, and radiates to the leg. The nerve can become inflamed from hypothermia, in the presence of infection, or from stress.

8. insufficient lubricant release.

Lack of lubrication may be a consequence of a psychological state (reluctance to intimacy, subconscious rejection of a partner - sometimes a woman is not consciously aware of this, and then the body hints to her in this way; fear of becoming pregnant), removal of the Bartholin gland that secretes lubrication (its inflammation, bartholinitis, previous previously) or hormonal disorders (postpartum period, taking hormonal contraceptives, menopause). For hormonal disorders that require correction, taking female sex hormones helps, unless they are contraindicated.

If you experience pain during sexual intercourse, do not blame your partner for this; consult a gynecologist. An experienced doctor will identify the cause and prescribe treatment if there is a gynecological disease. You can make an appointment with a gynecologist by calling the numbers listed on our website.

As sad as it may be, instead of experiencing pleasure, you may experience pain during sexual intercourse. This condition, which doctors call dyspareunia, occurs in both men and women. Although women, regardless of age, experience pain during sexual intercourse much more often than men. Pain can appear at any stage of intercourse: during arousal, directly during intimacy, when reaching orgasm or after it.

Any pain that occurs in the body, especially in such a delicate situation, is a signal that something is wrong; it is necessary to find out the reasons and try to eliminate them. Otherwise, you can greatly complicate your sex life and your partner's. Because the problems of one of the sexual partners cause problems for the other.

Reasons why women may experience pain during intercourse.

During defloration, pain is a consequence of fear, under the influence of which the muscles of the body are strongly compressed, including the vaginal ones. The structure of the hymen is such that it can stretch, but does not tear, and therefore there should be no pain.

Vaginismus is a strong contraction of the vaginal muscles when touching the genitals. It can be the result of rape, lack of trust in a partner, or sexual trauma. This is rather a psychological problem that does not allow a woman to relax, because pain does not appear from the penetration of a foreign object, but from muscle spasm.

Inflammation. When unpleasant sensations appear during or after intercourse - burning, pain, friction, itching, dryness - the cause is most often an inflammatory process. You need to immediately find out the cause and undergo appropriate treatment. In this case, both partners must be treated at once, regardless of the man’s test results. It is better to stop sexual activity at this time, and if you continue, then only with condoms. You should not convict your partner of cheating, because the cause of inflammation can be microorganisms that live in a person in a normal state - staphylococci, E. coli, etc.

Adhesions appear after inflammatory processes in the ovaries, fallopian tubes or intestines. Their presence can cause pain during sexual intercourse in certain positions, and it is localized deep in the abdomen. When you change your position, the pain disappears, but if the painful sensations do not go away even after sex, then you need to start treating chronic inflammation.

Pain can be caused by various stitches after operations or childbirth, after injuries and ruptures. In this case, the use of lubricants and special exercises to develop the vaginal muscles help. In extreme cases, surgical intervention is indicated.

With endometriosis, women experience pain during sex in the period before menstruation, making this process very painful. Treatment of the cause, that is, endometriosis, is required.

In some cases, life develops in such a way that a woman does not have sex regularly, abstains, or does not receive release for a long time. All this leads to stagnation, since the blood fills and there is no outflow. When sex becomes regular, instead of improving the condition, the woman experiences severe pain in the vagina. In addition, blood stagnation can provoke various gynecological diseases - uterine fibroids, mastopathy, endometriosis.

Another cause of acute pain in the pelvic area during sex, radiating to the leg, may be neuralgia of the pelvic nerves. Inflammation of the pelvic nerve can be a consequence of stress, hypothermia or infection. Warming procedures and physiotherapy are used for treatment.

If a woman does not want intimacy or is afraid of it, if her hormonal balance is disturbed (taking contraceptives, after childbirth, menopause), then an insufficient amount of secretion is formed in the vagina, which makes sexual intercourse very painful. Hormonal imbalance needs to be corrected with the help of the necessary hormones, it must be resolved independently or with a psychologist, using lubricants at this time.

Causes of pain during sexual intercourse in men:

• tear of the frenulum of the penis;
• infections of the genitourinary system, including STDs;
• very tight foreskin;
• prostatitis, urethritis.

Headache during sexual intercourse can occur due to neck and jaw tension in people of both sexes. Migraine sufferers may experience pain during climax due to pressure changes. To eliminate it, you can change your position, sometimes the doctor may prescribe medications that are taken before sex.

A headache may be a sign of hemorrhage if there is nausea or loss of consciousness. In this case, consult a doctor immediately.

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 a crucial moment, 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!