Checkout When sex is painful Painful sex is more common in women. The cause may be physical or psychological, and is often a combination of the two. If anxiety is great, the vaginal muscles may go into spasm, blocking penile entry completely.
This is called vaginismus, and is fully discussed below. Painful sex in men usually has a physical cause — commonly a skin infection of some sort on the skin of the penis.
Other rarer causes are discussed below. It is one of the most common complaints women make when they consult a gynaecologist, or a doctor in a sexual health clinic.
Occasionally a woman may be too shy to mention it and hope the doctor brings it up which they may or may not do , or complain instead about another symptom, such as heavy periods. This is unfortunate, as the symptom of painful sex, if it occurs, can be helpful to doctors trying to reach a diagnosis.
If the pain occurs when the penis enters the vagina, and is concentrated around the entrance to the vagina, it is called superficial dyspareunia. Both may occur together. If penile entry is impossible because the vaginal muscles go into a painful spasm, it is called vaginismus. Infections superficial or deep: Thrush candida , trichomoniasis, genital herpes and low-grade bacterial infections are common causes of painful sex. The appropriate treatment can then be prescribed.
As a general rule it is best to avoid washing the genital area with anything other than water because soaps, shower gels, bubble baths and disinfectants strip the vagina of healthy bacteria and allow other forms of infection to take hold. Sex may be painful for a while even after the infection has cleared, because of remaining inflammation and reduced lubrication. Postnatal or postsurgical problems superficial or deep: The scar that forms may not stretch as much as the rest of the vagina, making sex painful.
In some cases it may be possible for the surgeon to refashion scarred areas to allow for easier intercourse. Problems with the cervix, uterus, tubes or ovaries deep: If symptoms also include bleeding between periods or after intercourse, or lower abdominal pain and weight loss, tumours of the cervix or pelvic organs need to be ruled out. Women should always be up to date with their cervical smears, and go to their GP for examination and investigation.
A referral for an ultrasound scan and a gynaecological opinion may be necessary. KY Jelly can help ease this problem, but it may be an idea to cut down on sex till it feels more comfortable.
Vaginal dryness and thinning of vaginal tissue is one effect of the menopause. Menopausal women should therefore use additional lubrication or consider hormone replacement therapy either locally to the vagina or for the whole body.
Women having sex for the first time can find the experience painful, especially if the hymen has not been previously broken by tampons or other instruments. Anxiety can be dealt with by the following: KY Jelly, from the pharmacist can be used safely with condoms. Most oils cooking oil, massage oil, Vaseline break condoms. It may help if penetration is attempted slowly, in stages, with the introduction of one finger, and then two, beforehand.
Problems with the structure of the vagina or hymen superficial: Or it may split on two sides, leaving a hard band in the middle, which again makes sex uncomfortable. A physical examination by a doctor will rule out these unusual shapes, and in most cases simple surgery will rectify the problem. Any anxiety about their own sexuality, pregnancy, the relationship, etc. The woman may also become tense in response to a physical cause of pain, or a remembered trauma, e.
In some cases the thigh muscles clench as well, so that the partner is unable to get near the vagina. Vaginismus may be caused by any of the reasons for painful sex listed above, if pain and anxiety are severe enough. It may occur after a traumatic experience of sex, such as rape or sexual abuse. Vaginismus is best treated with the help of an understanding GP or a sex therapist.
A gentle examination is required to rule out physical problems. Once this has been done, the woman is encouraged to express her fears or fantasies about her body, proceeding to an exploration of her own genitalia. Her partner may be present if she so wishes.
The couple may then proceed to exercises in which the woman controls penile penetration, before full intercourse. In mild cases, only a few visits may be necessary, but in severe cases more sessions may be needed. Common causes include the following. Infection will make these more inflamed and painful. Tight foreskin Some men have difficulty retracting their foreskins, and erection may lead to tightness and discomfort. It may also be difficult to clean the area behind the foreskin, and any resulting infection will add to the problem.
Circumcision should be considered if problems are frequent. The foreskin forms a tight band around the penis, which swells and becomes painful. Infections and skin reactions Herpes infection causes painful, itchy blisters on the penis, which burst after a few days and scab over.
Men can also get thrush, most commonly if their partners have it, and this causes irritation with redness and occasionally swelling at the head of the penis. If any of these infections are suspected, a full check-up at a sexual health clinic is necessary.
Some men are allergic to the rubber or lubricant used in ordinary condoms. Hypoallergenic condoms are now available from leading brands. It is also possible to react to massage oils, washing powders, shower gels or soaps. The condition may resolve by itself over months or years, but help should be sought if intercourse is impossible.
Surgery is the answer for some men. In both cases the opinion of a urologist may be helpful. Priapism is a condition in which the erection fails to subside and lasts for hours, becoming painful. Urgent treatment at an accident and emergency department should be sought, because permanent damage can result. KEY POINTS If sex is painful, mention it to the doctor For women, painful sex may be superficial, deep or both Causes of painful sex in women are physical or psychological Vaginismus preventing penile entry can be overcome with the help of a sex therapist In men, painful sex is usually caused by a skin problem.