Pinning down the root cause is the first step to a solution.
Unless you’re dipping your toes into the world of BDSM, sex should not be painful. But for many people with vaginas, it can be all too common. According to a 2014 study, anywhere from 10 to 20% of women in the United States experience dyspareunia—recurrent and persistent pain that comes along with sexual activity. As Women’s Healthcare of Princeton explains, this pain doesn’t necessarily have to be experienced in the vagina, but can also be felt in the pelvic region, uterus, or even the lower back. It might occur during sexual penetration or it might develop post-coitus. Dyspareunia is one name for pain that can be experienced in a wide range of ways.
Dyspareunia can have a drastic effect on a person, impacting mental and physical health, as well as relationships. But the good news is that it’s typically treatable, and not necessarily a condition that becomes chronic.
Some causes are themselves fairly common, according to Harvard Health Publishing. UTIs, yeast infections, and STIs can all make sex uncomfortable, but with a good antibiotic, these root causes can be managed. Vaginal dryness, which is often a side-effect of pre-menopause and menopause, and atrophic vaginitis, a thinning of the vaginal lining in postmenopausal patients, can also contribute to pain—but the use of lubrication can help, or, in the latter case, estrogen therapy may be recommended. Some causes are harder to solve, like endometriosis. According to Forbes, one in ten women globally experience endometriosis, but the disease remains hard to diagnose, likely because painful periods are normalized, and therefore can be dismissed as nothing out of the ordinary. Once it is honed in as the problem at play, surgery may be necessary to remove abnormal tissue growths from the pelvis.
These aren’t the only potential causes, either: medication, cysts, hormonal changes, chronic conditions like arthritis or fibromyalgia, skin disorders, bacterial infection, and perineum tears (from either anal sex or childbirth) can all cause pain. Simply put, if something hurts, it’s time to talk to a doctor—and there’s no shame about that.
In cases when no physical cause of dyspareunia can be pinned down, talking to a therapist can help. As the American College of Obstetricians and Gynecologists explains, the state of mind plays a big role in making sex painful. Relationship problems, anxiety, embarrassment, and other negative emotions make it harder to relax, and therefore make it harder to get aroused—which can then result in pain.
If you’re experiencing pain during sex, you’re far from alone—and the best thing you can do is speak up about it: to your partner and your doctor. No matter what the cause, some solutions can help, and get you on your way to feeling good again.