10 Most Common Causes Of Pain in the Bedroom

“Ouch! That hurts!” is one of the last things you want to say during sex and pain is definitely not what you want to feel during sex. Not only can it ruin the mood, but it can create significant anxiety around having sex. In addition, it can cause issues within your relationship. Sex is supposed to be pleasurable, not painful. So what happens when it is?

If you are experiencing pain during sex, the first step is to try and figure out what's causing the pain. There are a variety of reasons a woman may experience pain during sex.

The reasons could be physical and/or psychological. The pain could even be the result of something as simple as the products that you are using may be irritating the genital area.

Knowing what is causing pain is crucial to relieving the pain but also to experiencing pleasure. Here are 10 possible causes:

1. Sexually Transmitted Infection

Having a sexually transmitted infection (STI) can definitely have an impact on sexual pleasure. An STI can cause significant pain to your internal and external sex organs. This pain may intensify during intercourse. STIs can also be pretty tricky. Some STIs, particularly gonorrhea and chlamydia, may not show any symptoms until it is too late or until it causes scarring and major damage to an organ. Additionally, some STIs will cause vaginal itching and dryness which may also make sex pretty painful. If you suspect that you have an STI, it is important to be evaluated as soon as possible to relieve the pain and/or reduce the chances of infertility.

2. Dyspareunia

Dyspareunia is recurrent or persistent genital pain before, during or after sex. It can be acquired or congenital or generalized or situational. Dyspareunia is not a disease, but rather a symptom of an underlying physical, biological or psychological factor. The pain, which is often described as excruciating menstrual cramps, can be mild or severe. It may be superficial, felt in the area around the opening of the vagina and vulva. Or the pain may be deep, felt within the pelvic region or lower back. When the pain occurs, a woman experiencing dyspareunia may be distracted from feeling the pleasure and excitement of sex. Due to the persistent experience of pain during sex, a woman still may experience pain during sex even after the original source of pain has disappeared, simply because, in her mind, she expects to.

3. Uterine Fibroids

Certain medical conditions, such as uterine fibroids located near the cervix, are often the underlying cause of painful sex. Pressure placed on these fibroids during intercourse can cause anything from mild discomfort to severe pain. For some, friction can also be a factor. Positioning can affect your level of pain during sex with fibroids. It may be helpful to experiment with different sexual positions to see if there is one you might find more comfortable. Remember that communication is key; although it may feel awkward, we encourage you to talk openly with your partner. If you’ve been diagnosed with fibroids and are experiencing painful sex that is affecting your sex life, personal relationships, and self-esteem, we encourage you to seek treatment from a fibroid specialist. You may be surprised to learn that nonsurgical methods can quickly and effectively improve your symptoms.

4. Lichen Sclerosus

Lichen sclerous is an uncommon condition that creates patchy, white skin in the vulva that is thinner than normal. Lichen sclerous can make sex extremely painful for women due to the itching and scarring. Scarring may narrow the opening of the vagina, which can make penetration painfully difficult. In addition, blistering of the skin may make the vulva unbearable to touch. The exact cause of lichen sclerosis is unknown. However, the condition may be related to a lack of sex hormones. Although lichen sclerosus may involve the skin around the genitals, it is not contagious and cannot be spread through sex.

5. Vulvodynia

Vulvodynia is chronic vulvar discomfort or pain, characterized by burning, stinging, irritation or rawness of the female genitalia. In the simplest of terms, it means "pain of the vulva." There are two main subtypes of vulvodynia: 1) generalized vulvodynia and 2) vulvar vestibulitis. Generalized vulvodynia is pain that occurs spontaneously and is relatively constant, but there can be some periods of symptom relief. Vulvar vestibulitis syndrome is characterized by pain limited to the vestibule, the area surrounding the opening of the vagina. It occurs during or after pressure is applied to the vestibule. The type of vulvodynia and severity of symptoms experienced are highly individualized. Vulvodynia can have a huge impact on a woman's life. The pain can be so severe that it puts limitations on a woman's ability to function and engage in normal daily activities such as work, tampon insertion, gynecological exams, sexual relationships and/or physical activities. Most women with vulvodynia feel unable to have sexual intercourse and are unable to fully enjoy life.

6. Products

Many products contain chemicals that can cause irritation to the vagina and vulva, leading to pain during sex. Some of those products include contraceptive foams or jellies, latex condoms, vaginal sprays and deodorants, scented tampons, perfumed soaps, laundry detergents and excessive douching. These products can cause the vaginal lining to dry out, making the vagina more prone to rips and tearing during intercourse. In addition, the products can cause inflammation, intense itching and burning to the vulva. Only warm water and mild soap, if absolutely necessary, should be used to wash the genital area.

7. Vaginismus

Vaginismus is the physical or psychological condition that affects a woman's ability to tolerate vaginal penetration as a result of involuntary vaginal muscle spasms. A woman suffering from vaginismus cannot consciously control the spasm. The vaginismus reflex happens as a result of an object such as a penis, vibrator, tampon, etc. coming towards it. And in some cases, even the thought of the object can cause the vagina to spasm. The involuntary muscle spasm makes penetration painful or impossible. Vaginismus can be either primary or secondary.

A woman diagnosed with primary vaginismus has never been able to have penetrative sex or experience vaginal penetration without pain. Secondary vaginismus occurs when a woman who has previously been able to achieve penetration develops vaginismus. The exact cause of vaginismus is unknown, however, it may be due to physical causes such as an infection or trauma. Some cases of vaginismus may be due to psychological causes like fear or anxiety. It may also be linked to a combination of causes.

8. Sexual Positions

Certain sexual positions can cause pain during sex. Most positions that allow for deep, thrusting penetration can be painful for a woman, especially if her partner is well endowed or if she has an underlying medical condition. Generally, positions that allow the woman to control the pace and penetration, e.g., woman on top, tend to be more comfortable for a sufferer of painful sex. In order to find out what works, experiment with different positions, techniques and props (i.e., pillows) to find out the one(s) that offer the most stimulation with the least amount of pain.

9. Lack of Lubrication and Vaginal Dryness

Another frequent explanation for painful sex is thinning and drying of the vaginal tissue. Normally, the lining of the vagina stays lubricated with a thin layer of clear fluid, however, there are many things that can cause the lining to become dry. As the vagina's ability to make its own mucus declines, it becomes irritated, itchy and painful. Insufficient lubrication or vaginal dryness can cause mild to significant pain and interfere with sexual pleasure. Vaginal dryness is nothing to be embarrassed about. It affects many women, especially as they age. If vaginal dryness begins to affect your lifestyle, sex life and/or relationship with your partner, consider making an appointment with your physician. You do not have to live with uncomfortable vaginal dryness.

10. Negative Beliefs, Attitudes, Behaviors and Experiences with Sex

Sex is not only physical; it’s emotional, mental and social. The mind and the body work together to optimize the sexual experience. Any negative attitudes, thoughts or beliefs we have been taught regarding sexuality can contribute to unpleasurable sexual experiences. As a result, a woman may experience pain during sex because our bodies are responding to the negative intergenerational patterns, social messages, and misinformation that we have received about sex. In addition, past sexual abuse may subconsciously cause a woman to experience pain during sex. The body’s muscle memory may cause the vagina to tense up upon penetration. Even the thought of past sexual trauma, can be the source of pain. Psychological factors, emotional stressors, and dissatisfaction in a relationship can decrease sexual responsiveness, and therefore lead to painful intercourse as well.

When sex hurts, it can definitely damper the mood, and the relationship and cause feelings of inadequacy. Please keep in mind that there is a difference between pain and discomfort. Discomfort is a feeling that may not be pleasurable but is bearable. Pain is a feeling that is totally unbearable. Pain is an indication that something is wrong within your body and whatever it is that you are doing, you need to stop immediately before you do further damage.

If you are experiencing any pain during sex, consider contacting your physician and/or your local sex therapist to get to the root of the problem. Treatment is an option. You do not have to live with unbearable pain forever. Finally, sometimes you might have to get creative and think outside the box when it comes to reducing pain during sex.

Dr. TaMara loves nothing more than talking about sex! At the age of 13, she told her mother she wanted to be a Sex Therapist! Her passion is deeply rooted in spreading messages about healthy sexuality. Dr. TaMara is a sexologist, sex therapist, author and motivational speaker with more than 20 years of experience speaking, writing and teaching about sexuality. She travels the country helping individuals embrace and honor their sexuality. Dr. TaMara has published numerous books and articles. She is the owner of L.I.F.E. by Dr. TaMara Griffin Live Inspired Feel Empowered LLC-LIFE. She is the publisher and editor-in-chief for Our Sexuality! Magazine. Follow her on Twitter, Facebook or Instagram, www.drtamaragriffin.com.