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Pain during intercourse this the problem faced by both sexually promoted girls and experienced women. They do not always guess to go to the doctor with this complaint: the first ones think that at the beginning this is the norm (but how long can the beginning last?), the second ones analyze that this was not the case with the previous partner, then it’s all about the man or the “incompatibility" who as a result experience their sensations literally inside themselves, not getting help.

After some time, the body gets used to the pain as a given and begins to wait for it in advance: fixed conditioned reflex: a woman begins to fear and avoid intimacy or experience pain even when the cause is eliminated, and doctors say she shouldn’t hurt anything. "But she remembers that in this situation it hurt, and the body produces the expected sensation from the archives of memory.


In men, pain during intercourse is more often caused by organic causes, for example, too tight foreskin, which does not bulge during erection and causes pain in the head area, or associated withPeyronie 's disease , in which there are sclerotic plaques on the penis, causing the curvature of the "genital organ." Temporary pain during intercourse occurs when the bridle of the penis is torn. Of course, it does not depend on the behavior of the partner.
In women, pain during intercourse may occur during defloration. In this case, the main reason lies in the fear of the woman herself. Fear makes all muscles of the body shrink, and especiallyvaginal muscles. There are cases when the hymen is thick and richly supplied with nerve endings, but more often it is elastic and stretchable, does not tear at first proximity, but stretches, and does not cause sharp pain (therefore, the absence of bleeding during defloration is rather the norm than the pathology). So the main pain comes from fear. Only you yourself can overcome it, if you know what is happening to you, trust your first man, firmly know that you are reliably protected from unwanted pregnancy and infections.

The first time you need to be protected is a condom, because alien microbes, normal for one organism (men), getting into a new organism (female), cause an inflammatory reaction in it andinflammation of the vagina ( colpitis ) and bladder (cystitis), the most frequent complication defloration .

Relaxing and helping to prevent a spasm will help a warm, familiar calm, a warm bubble bath, a glass of relaxing wine / champagne, trust in a partner (fear is often caused not only by uncertainty, but also by the fear of appearing different than he would like). foreplay and getting the girl pleasure before the beginning of the sexual act.


If sex (first in life or first with a specific partner or was rape) failed, the fear of him may be fixed in the subconscious and cause muscle spasm in advance, making it impossible sexual intercoursePain during intercourse does not arise from the penetration of the penis, but from the compression of one’s own muscles (the same pain sometimes occurs during a gynecological examination fear of the situation causes the muscles to contract so that modern plastic gynecological mirrors.

With the confidence of the woman to the gynecologist and relaxation, everything happens painlessly. The mechanism of one pain does not arise from a body that is foreign in this case, but from a spasm of your own muscles and in this case you have to treat yourself, change your attitude to the issue, find partners, trust in which will allow you to relax. Vaginismus, which the woman herself cannot handle, requires treatment from psychotherapist and sexologist. 

Uncorrupted hymen is also a common cause of pain. True, it passes in the process, but in the beginning it is always unpleasant. Usually, hymen at the beginning it is not torn, but only stretched or slightly screamed, but remains. Sometimes virginity in the anatomical sense is broken for the first time only during childbirth. And before that, some discomfort “at the entrance” at the beginning of sexual intercourse remains. When understanding the situation, a sufficient amount of lubricant and the gentle handling of a partner, this problem is easily solved.


If discomfort (pain, burning, itching, friction, feeling of dryness) occurs in the vagina during intercourse or immediately after it, the cause is most likely inflammatory process . We must go to the doctor and be examined at infections, sexually transmitted:

  • chlamydia;
  • gonorrhea;
  • trichomoniasis;
  • ureaplasmosis ;
  • candidiasis.

Sex life at this time should be limited and lead only under the protection of a condom. To be treated for what they find, it will be necessary to take two people at the same time with the same medications, being protected during condom treatment, regardless of the results of the man's analysis.

Routine tests in men rarely reveal an infection the main focus of which is in the prostate gland, so you need to either do backwater after provocation and prostate massage, either do not examine anything, but simply treat both, based on the rule that the microbes of the partners are always the same.

Inflammation is not necessarily caused by sexually transmitted pathogens, if you suspect inflammation, you should not immediately blame your partner for treason: most often, inflammation is caused by normal flora human body:

  • fungi;
  • E. coli;
  • staphylococcus.

When released into a foreign environment (in the female genital tract from the male or from the skin, from the intestine, oral cavity) and an insufficient level of protection (reduced immunity, menstruation, pregnancy), they begin to multiply and cause inflammation. They just need to properly treat, and not to look guilty.


The result of a previous inflammation of the appendages or intestines. If you have ever had occasional aching pain in the lower abdomen during hypothermia, or episodes of delayed or relieved stools or bowel disease in childhood - this means that you may have adhesions in the pelvis.

If you have never had such complaints, he also has the right to be, because the inflammation could be asymptomatic. Most adult females have spikes, many do not bother or harm. For some, they hurt during tension and when viewed on a gynecological chair and during intimacy, at the same time, pain, in contrast to the above cases, is deep in the abdomen and depends on the posture and “aggressiveness” of sex. In most cases, the selection of comfortable postures saves, if the pain persists and worries outside sex life need to treat chronic inflammation , including with the help of physiotherapy.


Endometriosis this a diagnosis that women often set themselves on the basis of spotting before or after menstruation. However, the main symptom of endometriosis is pain, which appears or intensifies before menstruation and passes along with it. If this discharge is painless, it is not endometriosis . If they are painful as well there is pain during intercourse and with bowel movements on the eve of menstruation, it may be a sign endometriosis . The pain during sex is also felt inside and is strong enough, making sex life impossible or painful at this time of the cycle. 

Venous congestion. Irregular sex life, lack of satisfaction, abstinence, dissatisfaction with the relationship as a result of blood rush to the organs, but there is no proper outflow. First, this feeling of heaviness, dissatisfaction, pulling pain after sex without sufficient discharge. Over time, the only cure - regular sex life with satisfaction becomes not deliverance, but on the contrary - an aggravating factor: the edematous walls of the vagina hurt from the sexual act itself, there is a sharp pain during intercourse. This condition is not just unpleasant - it is also dangerous: it is a predisposing factor for the development of many gynecological diseases: uterine fibroids, endometriosis , mastopathy, ovarian dysfunction, etc.

Try not to bring the outlined dissatisfaction to anatomical changes: learn to please yourself and teach this partner: you will bring joy to yourself and him, while maintaining a healthy body and healthy family relationships. The main treatment at the doctor is physiotherapy and gynecological massage. From venous stagnation is more pleasant to cure yourself at home with the help of a beloved man and toys from a sex shop . For such a reason, women in particular are predisposed to pain. varicose veins feet. 

Neuralgia of the pelvic nerves . Pain in the walls of the pelvis, aggravated by touch (sex, examination on the chair, ultrasound with a vaginal sensor), often acute, shooting, extending to the leg.Neuralgia occurs anywhere: facial, intercostal — there is pelvic neuralgia: a nerve can become inflamed from hypothermia, from an infection present, from stress. It is treated in the same way as other neuralgia: pepper plaster, warming ointments, physiotherapy .

Insufficient lubrication. May be due to psychological state (reluctance to have sex, subconscious rejection of a partner, sometimes a woman does not give herself a conscious account of this, and then the body hints at it in this way; fear of getting pregnant) removal Bartholin gland, releasing lubricant (or bartholinite , transferred earlier) or hormonal disorders:

  • postpartum period;
  • taking hormonal contraceptives;
  • menopause.

With hormonal disorders, requiring correction, it helps to receive drugs of female sex hormones, if they are not contraindicated. In other cases, in the process of fights with your I, you need to use artificial humidifiers ( lubricants ), special intimate gels sold in pharmacies and intimate shops . 

Anatomical incompatibility or size discrepancies can also cause pain. The vagina is extremely extensible, and if a man does not have a clinical case of gigantism, then it should not hurt from the size. Something prevents painless stretching : Think for yourself and consult a doctor. A gynecologist can cope with a similar problem (the urologist is for men). as well as a good psychologist.The gynecologist will deal with the consequences and physical trauma , and the psychologist will help avoid pain in the future due to the positive psychological mood and getting rid of old psychological trauma.

Pain that a woman may experience before, during and after sex is a common occurrence. In most cases, it requires medical intervention.

The reasons for the occurrence of pain during sex can be very, very much. For this phenomenon came up with a special medical term - dyspareunia. This concept includes persistent or repetitive genital pain, which occurs immediately before intercourse, during or after it.

It is said that by sexual intercourse it is vaginal penetration that is understood, so that pain can cause penetration of the penis, fingers, sex toys and even tampons.

How exactly does this pain feel

The pain itself can be felt in different ways.

  • Pain only with penetration of the penis or dildo .
  • Pain at any penetration, including the introduction of a tampon.
  • Pain deep in the pelvic region during penetration.
  • Burning or aching pain.
  • Throbbing pain that lasts long hours after intercourse.

Another pain shared in this way:

  • primary pain is a situation in which a woman feels pain throughout her sexual life;
  • secondary - develops chaotically at different periods of life;
  • full - the woman has pain throughout the sexual intercourse;
  • situational - arises from a specific partner or a certain type of stimulation;
  • superficial - it is felt only at penetration;
  • deep - the focus of pain is located in the cervix or lower abdomen, is felt during or after penetration;
  • pain during intercourse that occurs without direct physical exposure (may have a psychological origin).

How common is this phenomenon

According to various sources, dyspareunia in different moments of life affects a third of women. The difficulty with a more accurate assessment is that, firstly, many women do not consider pain as an abnormal part of sex and therefore do not seek medical attention. On the symptoms of others do not pay attention to the doctors themselves.

Alone research pain experienced and intercourse other-sex partners : findings representative probability study in the United States show that 30% women experience pain during vaginal sex, others - what 8–21% are affected by diagnosed dyspareunia , and 15% is chronic. AND finally 30% of womenexperien consultation about Sexual Health Issues in the Year after Childbirth : A Cohort Study constant pain during sex a year after childbirth.

In Russia, the situation is similar. Candidate of Medical Sciences, obstetrician-gynecologist Tatyana Rumyantseva told that about 30% women go to the doctor with complaints of discomfort during sex.

Frequent causes of pain

1. Not enough lubrication

Most often the dryness of the vagina is caused by insufficient prelude. But There are other reasons: hormonal imbalance or medication. TO These include antidepressants, pressure lowering drugs, sedatives, antihistamines, and some contraceptives.

A drop in estrogen levels after menopause, childbirth or during breastfeeding can also be the cause.

If you do not take the above medications, did a blood test for hormone levels, then try to prolong the prelude.

Clinical Professor of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, Doctor Jane minkin ( Jane  Minkin ) says at least 20 is required minutes to develop the required amount of lubricant.

This time is necessary for the labia, clitoris and vaginal canal to begin to erect. Perhaps the natural lubrication of a woman is not enough by nature: one of the ways to cope with the problem involves the use of water-soluble lubricants.

2. Surgery, injury, irritation

This could be an accident injury, pelvic surgery, episiotomy (a vaginal incision during labor to increase the birth canal), female circumcision, anatomical changes, such as endometriosis , an ovarian cyst, or surgical scars.

All this can cause very painful sensations, especially if there is a wound that has not fully healed.

In this case, you will have to stop practicing vaginal sex, spend time on proper treatment and resume sexual activity only when the doctor decides that the wound has really healed or the injury will not be disturbed.

3. Inflammation, infection, irritation

Infection in the genital or urinary tract can lead to painful intercourse. Eczema, allergic reaction, irritation from new soap, inflammation and irritation from thrush- All this is also the reason why penetration into the vagina becomes painful.

If the irritation appeared after the start of everyday use of something new, it is worth removing the innovation and see if irritation or allergic inflammation does not pass. These are the symptoms that can cause:

  • perfumed soap;
  • douching;
  • vaginal perfume;
  • bathtubs with foam or bombs ;
  • aromatic toilet paper;
  • Thong or other narrow synthetic underwear.

4. Vaginismus

Vaginismus is painful spasms when opening the vagina. There may be an involuntary response to stimuli such as a painful previous sexual experience, experienced violence, unresolved conflicts regarding one’s own sexuality (for example, strong complexes), feelings of shame towards sex because of conservative education.

This is a condition in which involuntary contraction of the muscles of the vagina and pelvic floor can be of such strength that it is impossible to insert even a tampon into the vagina.

Doctor Shannon Chavez ( Shannon  Chavez ), a licensed clinical psychologist and certified sex therapist, says that since the contraction of the muscles isinvoluntary, this can happen even in cases where a person is excited and wants to have sex. By According to her, many women with vaginism do not share this with doctors or with relatives.

Vaginismus can be caused by both physical and psychological factors or their combination. A gynecologist can help relax or retrain muscles . And most likely, you will need the help of a psychologist or psychotherapist to cope with the anxiety and stress that sexual intercourse causes.

5. Congenital anomalies

There is, for example, Mayer syndrome - Rokitansky - Caster - Hauser , a rare disorder of sexual development, in which there is no fully formed vagina or vagina in general. Or a person is born with incomplete reproductive organs.

In these cases, the penetration attempt can be very painful. By According to Dr. Minkin, treatment will be associated with surgery or the use of vaginal dilators.

6. Atrophy of vaginal muscles due to menopause

The pain caused by atrophy of the vaginal muscles (thinning of its walls) is common among postmenopausal women who do not take medication to replace estrogen.

The secretion of natural lubrication is completely dependent on changes in the level of estrogen. The quickest solution is to use an estrogen vaginal cream.  But Of course, you need to consult a doctor and choose the most appropriate solution with him.

7. Interstitial Cystitis

This condition refers to chronic inflammation of the bladder without any known cause. Painful intercourse is a common symptom.

The doctor may perform a cystoscopy (internal examination of the bladder) and stretch the bladder wall to try to improve the patient's condition. Other treatments include bladder flushing with dimethyl sulfoxide , as well as oral medications.

8. Vulvodynia

This disease causes chronic pain in the area of ​​the vulva. Moreover, according to Dr. Minkin, pain causes not only penetration, but also any other actions that put pressure on the vulva. For example, riding a bike or even just sitting.

Minkin says that doctors do not know the exact medical reason, but believe that this may be an inflammation of the nerves that causes hypersensitivity and pain.

There is no treatment for vulvodynia , but it is possible to get rid of symptoms. This is a fairly common phenomenon; up to 9% of women have come across it at some point in their lives. 

9. Endometriosis

Endometriosis is also one of the most frequent causes of severe pain deep in the pelvic region during sex.

The fact that a woman finally put this diagnosis and treatment, go Endometriosis Fact sheet in an average of 9.28 years. This is data from the study of Women's Sexual Pain and Its Management, which says how women have been waiting out these nine-plus years:

"Anyone who constantly faces complaints about dyspareunia knows that women tend to continue sexual contact, if necessary, just by clenching their teeth."

Endometriosis occurs when the tissue that makes up the uterus grows on other organs, and pain during sex with endometriosis is one of the strongest. 

Endometriosis cannot be cured , but hormone therapy or surgery can be used to improve the condition.

In addition to endometriosis , chronic pelvic pain can cause scarring of tissues due to infections, uterine prolapse, pelvic inflammatory disease, fibroids, ovarian cysts, and so on. Dr. Minkin believes that pain deep in the pelvic region is definitely a reason to see a doctor because you may need to remove fibroids or cysts.

10. Inconvenient posture in sex and a big member of the partner

It is possible that you are comfortable and well in some poses, but others cause pain during penetration, especially deep.   

In this case, you need to say about this partner in order to look for new, comfortable postures for both of you.

Big dick or dildo can also cause discomfort and pain. However, Dr. Minkin says that it is unlikely in this case that the penis is “too big” for the vagina or that it will damage the cervix. Still, the vagina can accommodate the head of a child with a diameter of 10 centimeters.

In this case, you can be helped by using more lubricant and avoiding poses in which penetration is too deep and painful.

11. Psychological problems

Fear and anxiety related to penetration can create a mental barrier. This, in turn, can lead to unconscious tension of the pelvic floor muscles during sex, which also creates a physical barrier to penetration.

You may have had a negative sexual experience, experienced sexual abuse, harassment, trespassing. AT In this case, the body expects sex and pain and discomfort, and the brain goes into combat mode.

According to Dr. Chavez , low self-esteem and problems in accepting your body can also reduce arousal and cause tension or nervous reaction during sex.   

In this case, overcoming these psychological barriers will completely depend on your readiness for this, because it will require work from you. Only you decide whether you are ready to turn to specialists and undergo, most likely, long-term therapy.

Why it is worth to consult a doctor for any discomfort

In Russia, according to the gynecologist Tatiana Rumyantseva, in the vast majority of cases of dissipation, the cause is inflammation of the vaginal mucosa, diseases of the pelvic organs and adjacent organs, atrophic changes of the mucous membranes. Vaginismus and vestibulodynia (a variety of vulvodynia . - Approx. Ed.) Are rare, but require special attention due to difficulties at the stages of diagnosis and treatment.    

According to Rumyantseva, there is no need to postpone the visit to the gynecologist:

"Any pain during sexual intercourse, which interferes with the enjoyment (especially if there were no such sensations before ), is a reason for going to the doctor."    

Also, the reason to make an appointment is bleeding or atypical discharge after intercourse. The gynecologist will help you to identify the main cause, but in the future you may need the help of a psychiatrist, psychologist or urologist , depending on the root cause of your condition. 

Usually, pain during penetration does not require emergency care, but it is worth resorting to it if the following symptoms occur: 

  • A new attack of pain or sensation is sharper than before, and it lasts longer than a few minutes;
  • bleeding with pain;
  • nausea, vomiting, or rectal pain;
  • changed selection.

It is also important to mention that on the Internet in such cases it is often advised to use anesthetics in order to be able to continue sexual intercourse.

Tatyana Rumyantseva commented on such recommendations: “Since there are a lot of causes of dyspareunia (and most of them require treatment), the long-term independent use of anesthetics is not recommended, as this can lead to progression of the underlying disease (for example, endometriosis , vaginitis, etc.), in which pain during sex is one of the symptoms. 

Anesthetics can mask a serious problem for a long time, and therefore their temporary use is possible only until the cause of the pain is ascertained.

If “true” dyspareunia is diagnosed , then anesthesia is not part of the standard of treatment and is not an effective remedy. ”