Dyspareunia: What Actually Makes Me Pained and Uncomfortable During Sex?
CONTENT WARNING: This article contains dialogue on rape, sexual assault, and abuse. Reader discretion is advised.
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Why does it hurt to have sex? While the answer to this question might not be straightforward or simple — and could potentially have multiple causes — painful intercourse (medically referred to as ‘dyspareunia’) is not something you have to live with indefinitely. While there are plenty of ways to build intimacy without sex between couples, as well as stimulate the exterior of the genitals with sex toys for vaginas or sex toys for penises (providing orgasm itself is not sore or uncomfortable), intercourse itself should never have to be off the table.
Whether experiencing pain during sex, pelvic pain after sex, or general discomfort during sex, here are some potential reasons as to why intercourse hurts for you or your partner.
Lack of natural lubrication
When discomfort during sex occurs, it may stem from a lack of natural lubrication. This is a relatively common cause of dyspareunia and adding a bit of lube can go a long way! Maintaining passion in a relationship through sex is still possible; try practicing mindful sex and slow sex to gauge how you’re both feeling and communicate about pain or discomfort levels.
Keep in mind, too, that the anus does not naturally self-lubricate, meaning that during anal sex, using lube is always needed!
Trauma to the genitals or reproductive organs
Sometimes, intercourse hurts due to trauma to the genitals or reproductive organs. This can be anything from pregnancy and childbirth (affecting the uterus, cervix, and vagina), piercings (for example, on the vulva or the penis or testicles), a recent cut or blunt force trauma to the genitals, and surgery. Typically, this pain does not last forever and will heal as time goes on. Wait it out and leave the affected area alone, but seek medical advice should the problem persist.
Infection of the genitals
If you are experiencing an infection in your genitals, painful intercourse is often an unfortunate outcome. Whether it is the result of surgery or trauma to the area, or a sexually transmitted infection (STI), it’s best to refrain from sexual activities (including oral sex) until the area has healed.
When it comes to having sex with an STI, ensure that it is safe to do so (for example, between flare-ups) and that protection is constantly being used. Precautions to prevent STIs from spreading to non-positive partners should also be considered.
History of sexual abuse and violence
The reason why you experience pain after sex (or during) — and potentially why you have no sex drive — can be related to the experience of sexual assault or rape. There is no timeline as to when you will be ready to engage in sexual activities again, if at all.
To have a better relationship, open communication is crucial; tell your partner that you’re not yet ready to engage in a sexual relationship. There is no need to disclose the reason why until you feel ready.
Conditions that affect the uterus, cervix, and vagina
If intercourse hurts and you have a uterus, cervix, or vagina, you may be experiencing pain associated with endometriosis, fibroids, PCOS, adenomyosis, ovarian or vulval cysts, and any other number of conditions. Speak to your doctor about ways to manage your pain and discomfort levels.
Also, talking to your partner about your needs helps alleviate the stress of painful sex and keeps an open communication line between you both.
Sensations caused by the foreskin
Painful intercourse can sometimes be caused by phimosis, where a tight foreskin prevents it from retracting over the glans (head of the penis) during penetration. Balanitis, the swelling of the glans, can often be caused by phimosis (or allergic reactions to soaps and detergents or prolonged contact with urine) and result in painful sex.
Again, talking to your partner about sex makes the topic seem less frightening and more manageable. Working together, you can get through this frustrating and physically uncomfortable time.
Penile or prostate diseases
Chronic prostatitis or pelvic pain in folks with penises can result in pain during intercourse or other penetrative acts. Prostate and penile cancer or tumours can also result in tenderness, discomfort, or outright pain in the affected areas, making sex feel impossible. In these situations, it’s best to speak to a medical professional about your options.
If able to pinpoint and treat the source of your or your partner’s sex pain, stresses and physical repercussions associated with dyspareunia can be put to rest. By exploring these potential causes and treating them at their source, it’s possible to no longer experience discomfort or pain during and after sex.
Please remember, though, that healthy relationships do not have to include sex to be satisfying; if it’s currently not working for one or both partners, it’s not necessary. If painful sex does not stop, seek out the help of a medical professional.
How do you deal with discomfort during sex when it arises? Is becoming sore after sex something that happens commonly with either you or your partner? Let us know your thoughts in the comments below.
