Ask the Loveologist: Pain With Sex

I have been experiencing pain with sex for months now. It has gotten to be so painful that I dread saying yes even though I love my partner and want to have good sex with him. Even with my own natural lubrication and when I am really aroused, I still get this intense cramping. I haven’t talked to my doctor about this because it felt so awkward. Any ideas about what I can do?

Questions and fears about pain during sex are very common because this condition affects two thirds of all women at some point in their lives. Generally diagnosed as dyspareunia, a medical term which comes from an ancient Greek word that means “difficulty mating,” this condition was described in ancient Egyptian medical literature. Probably all women suffer some form of dysparuenia at some time in their reproductive lives. It is hard to say, because like you, more than half the women with this condition don’t talk to their physicians and many physicians also fail to engage their patients about their sex lives.

The most common symptom is pain on entry. The second most common symptom is deep pain. Other common symptoms include feelings of muscle spasms, cramps, or muscle tightness. There are some solutions that you can try at home, but if the problem persists, a conversation and exam by a good gynecologist should be scheduled. The exam, not unlike an annual exam will give your doctor a chance to check for medical issues that are treatable that could be causing the pain. Ovarian cysts, urinary tract infections, and endometriosis are all commonly associated with painful intercourse. Other common culprits that interfere with sexual satisfaction are yeast infections and genital herpes.

Other diagnoses that cause pain with sex are vulvodynia and vaginismus. These disorders, which cause itching, burning and spasms of the vaginal muscles are not well understood, although they impact over 16 percent of all women. The interaction between mind and body reigns supreme when it comes to sexual health. The association of pain and sex can and often does create problems of its own, resulting in a stress and tension response that makes sexual arousal hard to find. Many women get caught in a cycle of experiencing pain and then expecting pain which makes the vulnerability of sexual intimacy difficult at best.

Painful sex is never just in your head. Yet there is a great deal of negative attitudes about sex and misinformation about sexual functioning that can contribute to the experience of pain with sex. Pain with sex can be a mental health issue which is just as valid and treatable as a physical one. As challenging as it may be to discuss sex, the alternative is sure to exacerbate the issues you are having. Talking to your partner and/or your health care provider is an important first step to solving the problem.

For many women with pain at entry problems, the fix can be as simple as using good quality lubricants and making sure you are aroused before penetration. Many women have sensitivity to the petrochemical based lubricants on the market and switching to a natural product can be enough to solve the problem. For deeper penetration issues or pain that happens in the midst of sexual activity, sometimes all it takes is a change of position so that your sexual organs are better aligned and the thrust doesn’t bump uncomfortably against the cervix or an ovary. Try being on top where you have more control over the depth and direction of the thrust.

Sometimes women will experience pain during or after intercourse if they haven’t climaxed also. Just like the classic “blue balls” that men will get, if the blood rush to the pelvic region does not dissipate with the release associated with orgasm, she can be left with pelvic congestion that can feel like cramps or a dull ache.

Dealing with the many forms of sexual dysfunction that both men and women experience in their lifetime is no different than taking care of other aches and pains that come and go in the body. Honoring your right to a sexually healthy lifestyle means that doing nothing when faced with painful intimacy is not an option.

Wendy Strgar is a loveologist who writes and lectures on Making Love Sustainable, a green philosophy of relationships which teaches the importance of valuing the renewable resources of love and family. Wendy helps couples tackle the questions and concerns of intimacy and relationships, providing honest answers and innovative advice. As her online presence continues to grow, Wendy has become a trusted and respected source of information on lasting and healthy relationships. I feel like I am inventing a language to give intimacy back to the people, take the fear away and open a space for physical love to serve as the glue that holds relationships together.” Wendy lives in Eugene, Oregon with her husband, a psychiatrist, and their four children ages 11-20.


Debrah Roemisch
Debrah R7 years ago

Annie D, Susan Weed is an herbalist in the Wise Woman tradition--on her web site is a forum also where you can discuss health issues with other women--you could look up your problem or post a question, others may have dealt with this issue. Weed has some great ideas for sexual health with herbs. I started using nettles and red clover infusions as mentioned by Weed and they have helped so much for menopause symptoms including dryness.

Donni Schick
Donni Schick7 years ago

Pain is how I finally figured out that I have an allergy to latex. Ow.

alicia h.
Alicia Hecht7 years ago

Another very painful sexual problem is vaginismus. When someone has this physical problem it can effect the pc muscles. Which then tighten making it very hard if not impossible for something to enter into the vagina. Even a tampon can become very painful. Vaginisimus since it can involve the PC muscles or also known as pubococcygeus can not only effect sex but can make it harder for a women to pee. Men do not always understand that a women is not purposely not allowing him in, it is like blinking your eyes. It is a involuntary response. However for those who have this problem it can be corrected through different means. One is through physical therapy.

Annie D.
Annie D.7 years ago

I forgot to tell an important detail in my last message. I told that my vestibulodynia has been caused by the medication for yeast infection. That is true, but it makes a half of a year that I do not have yeast infection anymore but the vestibulodynia is still there. It is typicaly a chronical problem and the solutions are rarely satisfying. I think I will be obligated to have a surgery for that. Is anybody succeeded with another solution ? I tryed a lot of things... I know that this is the third message that I live, but this problem is like a poison in my life. With all that I read on Internet, I know that I am not the only one who feel like that.

Annie D.
Annie D.7 years ago

Dear lovologist, you could look on Internet about vestibulodynia so you will learn new things about sexual pain. Thank you from all woman that are suffering about sexual pain and misunderstanding from professionnals almost as much as from people in general.

Annie D.
Annie D.7 years ago

I am so frustrated that even the professionnals do not know well this problem. First, the lovologist talked about different things that cause pain at the penetration, but there is also vestibulodynia that the author should know (it is not vulvodynia neither vaginismus) Also, I did not appreciated at all this sentence: "Yet there is a great deal of negative attitudes about sex and misinformation about sexual functioning" Sometimes it is true that the cause can be a psychological issue reliated to sex, but it is not for the majority. Before my vestibulodynia, I had a wonderful sexual life with no problems at all. The vestibulodynia has been caused by medication for yeast infection. I am hurted to feel so misunderstood by professionals that talking and thinking that they know what they are talking about. Is someone could imagine how sad I can be to be deprivated of sexuality and affection ? Why the lovologist do not propose a solution for vestibulodynia that in my case have no link at all with a lack of lubrification or a lack of desire (sorry for my langage mistakes, I am french)

Hilary Batzel
Hilary Batzel7 years ago saved my sanity

Jessica B.
Jessica B7 years ago

"Sometimes women will experience pain during or after intercourse if they haven’t climaxed also"

I like to call this "bluterus"

Ivy S.
Ivy S7 years ago

I started having pain (burning and cramping) durring intercourse a few years ago. After going to the doctor they told me it was due to ovarian cysts. The pain has continued for years and even now that I am pregnant. I am on a rare occasion able to enjoy sex. It is extremely sad thing for me and makes me feel guilty that I can not enjoy sex with my DH. It has also made him feel like he is doing something wrong. After so long you start to disassociate yourself from the deed and not longer feel the lust, since sex has a much more negative association.

Gabriela A.
Gabriela A7 years ago

I didn't see anything in this article addressing painful sex due to Fibromyalgia or Menopause. I would like to see more about that please.