Pain during sex is a common issue that affects up to 75% of women at some point in their lives. While it can be a sensitive topic, sexual pain can have a significant impact on your physical and emotional well-being.
If you’re dreading intimacy due to discomfort, Karen F. Brodman, MD, can help. With years of experience and expertise, Dr. Brodman is dedicated to providing compassionate and comprehensive gynecologic care to women of all ages from her practice on the Upper West Side of Manhattan, New York.
Painful sex isn’t an unavoidable part of getting older, and it’s not something you should ignore. Read on to learn more about the potential underlying cause of your pain and explore effective treatment options to feel like yourself again.
Dyspareunia, the medical term for pain during sex, affects both men and women. However, it’s significantly more common in women. You may experience external pain in your vulva or internal pain in your vaginal canal, pelvic floor, or lower abdomen.
Understanding the root of the problem is key to finding relief. Let’s take a closer look at the potential factors contributing to painful sex.
Hormonal fluctuations, particularly during menopause and perimenopause, can lead to vaginal dryness and thinning vaginal tissue. Without enough natural lubrication, even the gentlest touch can feel uncomfortable, not to mention the friction of penetration and intercourse.
Certain medical conditions can contribute to painful sex, such as endometriosis, pelvic inflammatory disease, and uterine fibroids. Vaginal infections like bacterial vaginosis or yeast infections may cause irritation and discomfort in your vaginal area, including during penetration and intercourse. Vulva skin conditions, such as lichen sclerosus, are often overlooked and underdiagnosed causes of pain. Dr Brodman is an expert in vulvar skin disorders and will address vulva skin disorders if present.
Chlamydia, gonorrhea, and other sexually transmitted infections (STIs) can also lead to pain during sex. If you suspect an STI is behind your discomfort, contact Dr. Brodman as soon as possible for testing.
Emotional factors, such as stress, anxiety, or past traumatic experiences, can influence physical sensations and make it difficult to relax and enjoy sex. In some cases, these issues may trigger vaginismus, a condition where your pelvic floor muscles spasm or contract involuntarily. These spasms can make penetration — or even using a tampon — painful or impossible.
Past injury or trauma to your vaginal area, such as childbirth, episiotomy, or pelvic surgery, can lead to scar tissue formation or nerve damage. This can lead to painful sex. These injuries can also affect your pelvic floor muscles, making it harder for them to relax during sex.
To accurately diagnose the underlying cause of the pain you’re experiencing, Dr. Brodman conducts a thorough physical examination. This includes a pelvic exam to check for any abnormalities or infections. In some cases, lab tests or imaging studies may be necessary to rule out certain medical conditions.
Once we identify the cause of your pain, Dr. Brodman will recommend appropriate treatment options. If hormonal changes are causing your discomfort, menopause hormone therapy (MHT) or local vaginal estrogen may be helpful. For conditions like endometriosis, fibroids, or pelvic inflammatory disease, specific treatments such as medication or surgery may be necessary. Pelvic physical floor therapy and home vaginal dilator use when needed are very helpful.
No matter the cause, Dr. Brodman can create a personalized treatment plan to help you reclaim your confidence and enjoy your sex life once again. To schedule a consultation with Dr. Brodman, request an appointment online today.
