Possible Reasons for Painful Intercourse

Painful intercourse is common in women, and can be structural or psychological in origin. But the problem should always be addressed promptly, because it can hurt your self-image and emotional intimacy, not to mention your interest in sex. Pain can lead to a fear of more pain, causing you to naturally want to avoid intercourse.

Types of pain include:

  • Pain with sexual or any kind of penetration, including inserting a tampon
  • Deep pain during thrusting
  • Burning, aching or throbbing pain

Often the problem is simply dryness. Medications that affect sexual desire or arousal–include antidepressants, high blood pressure medicines, sedatives, antihistamines and certain birth control pills–can decrease lubrication.

Dryness can usually be solved through additional foreplay and/or the use of a water-based sexual lubricant.

Physical Causes

Physical causes of painful intercourse include vaginismus; inflammation, infection or skin disorder; cervical, ovarian or uterine problems; endometriosis; pelvic inflammatory disease; ectopic pregnancy; sexually-transmitted diseases; congenital abnormality, surgery scarring; changes caused by radiation and chemotherapy; and vulvodynia.

Emotional Causes

Anxiety, depression, concerns about your appearance, fear of intimacy or relationship problems can contribute to low arousal and pain. Stress can cause pelvic floor muscles to tighten, adding to the discomfort.

A history of sexual abuse can cause ambivalent feelings about intercourse that increase the stress and pain.

Things To Try At Home

Beyond lubrication, there are some other home remedies that may resolve your problem. Relaxation is the number one recommendation here. Learn to relax first without any pressure of sex to follow. Make your everyday life have some form of relaxation in it. You can also try new positions, like woman-on-top, which allow you to control the depth of penetration; talking about what feels good and what doesn’t so your partner can make changes.

You can try other ways to be intimate: massage, kissing and mutual masturbation are great ways to mix up the routine.


If home remedies have not solved the problem, your doctor’s office is a good next stop, especially if you have bleeding, genital lesions, irregular periods, vaginal discharge, or involuntary vaginal muscle contractions.

Prepare for your appointment by writing down details about the pain, like when it started and when it occurs. Make a list of your other health conditions and medications you take, including vitamins and supplements. Note a few questions to ask your doctor, such as, “What could be causing my problem?” “What treatments are available?” and “What books or websites do you recommend for more information?”

A thorough medical and sexual/surgery/childbirth history can help your doctor determine what is causing the pain. Don’t be embarrassed to give honest, thorough answers.

Your doctor will probably also want to do a pelvic exam with a speculum.

Depending on what is found, your doctor may recommend a pelvic ultrasound as well.


While some problems, such as painful sex after pregnancy, can be cured with time and patience, others require a doctor or therapist’s care.

Some issues are helped with prescription drugs or vaginal relaxation exercises. When issues like guilt, inner conflicts about sex, or past are present, sex therapy can be quite effective. A pelvic therapist is also of great value.

If you have been avoiding intimacy, you might need help communicating with your partner. Cognitive behavioral therapy can also help change negative thought patterns and behaviors.