Expert: Inna Apolikhina, Doctor of Medical Sciences, Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology of the I.M. Sechenov First Moscow State Medical University. Head of the gynecological department of rehabilitation treatment and day hospital of the Federal State Budgetary Institution "Scientific Center of Obstetrics, Gynecology and Perinatology named after Kulakov" under the leadership of Academician G. T. Sukhikh.
Women face this problem more often than men. According to statistics, every third person knows about this first-hand. There can be many reasons for such pain - both physiological and psychological. The manifestations are also varied - from sharp and stabbing to pulling. In any case, you should not endure it, and if unpleasant sensations appear, the first thing you need to do is run to a gynecologist in order to rule out dangerous diseases and, of course, get rid of discomfort. Let's look at the most common causes of pain during sexual intercourse.
Not ready, what's wrong?
Feel
During penetration, pain occurs, a feeling of tightness and unpleasant friction during friction. After sex, the vagina becomes inflamed or irritated.
Probable Cause
Insufficient lubricant release. Sometimes this happens simply because the woman is not aroused. Perhaps the foreplay is too short. In this case, the problem can be solved without a doctor. However, vaginal dryness can also be caused by taking oral contraceptives, breastfeeding and menopause. In this case, the reason is a decrease in the level of estrogen in the blood, this leads to a sharp thinning of the vaginal mucosa, it becomes susceptible to damage and painful sensations may occur during sexual intercourse. Inna Apolikhina notes that from the age of 30, women’s levels of sex hormones decrease by 1–3% annually; by the age of 50, the drop in hormones is 20%. But this is not scary, the doctor can prescribe suitable medications, estrogen-containing creams, suppositories, various moisturizing substances based on tea tree extracts and extracts, and PH-neutral lubricants. All this helps to moisturize the mucous membrane and reduce discomfort.
1.General information
It is difficult to imagine something more paradoxical and unpleasant than painful sensations during sexual intercourse. The paradox of this problem is that pain is exactly the opposite of what was intended by wise nature (more precisely, the evolution of higher primates) for the species Homo Sapiens Erectus. And yet, many women and men around the world suffer from so-called. dyspareunia - an unpleasant, uncomfortable or downright painful physiological background of sexual life.
Some of these people, sometimes quite healthy in other respects and living in the enlightened 21st century, believe that “this is how it should be”; others are prevented from seeking help from a doctor (or at least telling their partner) by cultural and religious traditions, various deficiencies and distortions in sex education in childhood, ridiculous prejudices and God knows what other complexes that force them to endure in silence or wait until “it goes away on its own” - instead of solving or at least studying the problem.
At the same time, the range of possible causes of pain during sexual intercourse is very wide, and it extends from psychosexual factors to latent diseases that do not manifest themselves in anything else for the time being, but are deadly.
A must read! Help with treatment and hospitalization!
Danger signal
Feel
Wandering pain in the perineum or lower abdomen, frequent urge to urinate, painful urination, and itching may also be observed.
Probable Cause
Urinary tract infections (UTI). Many of them can cause inflammation or neoplasms that provoke discomfort during sexual intercourse, for example, genital warts form on the external genitalia (a consequence of the human papillomavirus). Herpes and trichomoniasis can also cause pain. Such BMIs not only cause inconvenience in your personal life, but can also lead to infertility and even the development of malignant tumors. The sooner a diagnosis is made and treatment is prescribed, the greater the chances of a successful outcome. And of course, after therapy the pain should disappear.
You annoy me!
Researcher Michael Caroll from the University of Manchester, after long-term observations, discovered that itching, burning, pain, inflammation of the mucous membrane after sexual intercourse in 12% of cases is caused by a banal allergy to the sperm of the chosen one! The symptoms are similar to those of sexually transmitted diseases or thrush, but they occur about an hour after sex or immediately, rather than weeks later. In this case, it is enough to undergo a course of treatment with special drugs and you can forget about the problem.
Common causes of pain
Not enough lubrication
Most often, vaginal dryness is caused by insufficient foreplay. But there are other reasons: hormonal imbalance or medication. These include antidepressants, blood pressure lowering drugs, sedatives, antihistamines and some contraceptives.
A drop in estrogen levels after menopause, childbirth, or during breastfeeding may also be a cause.
If you are not taking the above medications and have had a blood test done to check your hormone levels, then try extending the foreplay.
Clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, Dr. Jane Minkin, says it takes at least 20 minutes to develop the required amount of lubrication.
This time is necessary for the labia, clitoris and vaginal canal to begin to erect. Perhaps a woman is naturally lacking in natural lubrication: one way to cope with the problem involves the use of water-soluble lubricants.
Surgery, injury, irritation
This may include injury from an accident, pelvic surgery, episiotomy (an incision in the vagina during childbirth to enlarge the birth canal), female circumcision, anatomical changes such as endometriosis, ovarian cysts, or surgical scars.
All of this can be very painful, especially if there is a wound that has not completely healed.
In this case, you will have to stop having vaginal sex, take time for proper treatment and resume sexual activity only when the doctor decides that the wound has truly healed or the injury will not bother you.
Inflammation, infection, irritation
An infection in the genital area or urinary tract can make intercourse painful. Eczema, an allergic reaction, irritation from new soaps, inflammation and irritation from thrush are all also reasons why vaginal penetration becomes painful.
If irritation appears after starting to use something new on a daily basis, it is worth removing the innovation and seeing if the irritation or allergic inflammation goes away. Here's what can cause these symptoms:
- perfumed soap;
- douching;
- vaginal perfume;
- baths with foam or bombs;
- scented toilet paper;
- thongs or other tight synthetic underwear.
Vaginismus
Vaginismus is painful spasms when the vagina opens. May be an involuntary response to stimuli such as painful previous sexual experiences, experiences of violence, unresolved conflicts regarding one’s own sexuality (for example, strong complexes), feelings of shame towards sex due to a conservative upbringing.
This is a condition in which involuntary contraction of the muscles of the vagina and pelvic floor can be so strong that even a tampon cannot be inserted into the vagina.
Dr. Shannon Chavez, a licensed clinical psychologist and certified sex therapist, says that because muscle contraction is involuntary, it can occur even when a person is aroused and wants to have sex. According to her, many women with vaginismus do not share it with doctors or loved ones.
Vaginismus can be caused by either physical or psychological factors, or a combination of both. A gynecologist can help you relax or retrain your muscles. And you will most likely need the help of a psychologist or psychotherapist to cope with the anxiety and stress that sexual intercourse causes.
Congenital anomalies
There is, for example, Mayer-Rokitansky-Custer-Hauser syndrome, a rare disorder of sexual development in which there is no fully formed vagina or vagina at all. Or a person is born with incomplete reproductive organs.
In these cases, attempting penetration can be very painful. Treatment will involve surgery or the use of vaginal dilators, Dr. Minkin said.
Vaginal muscle atrophy due to menopause
Pain caused by vaginal muscle atrophy (thinning of the vaginal walls) is common among postmenopausal women who are not taking estrogen replacement medications.
The secretion of natural lubrication is entirely dependent on changes in estrogen levels. The quickest solution to the problem is to use estrogen vaginal cream. But of course, you need to consult a doctor and choose the most appropriate solution together with him.
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 (a procedure to look inside 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.
Vulvodynia
This disease causes chronic pain in the vulva. Moreover, according to Dr. Minkin, pain is caused not only by penetration, but also by any other actions that put pressure on the vulva. For example, riding a bike or even just sitting.
Minkin says doctors don't know the exact medical cause, but think it may be inflammation of the nerves that causes hypersensitivity and pain.
There is no cure for vulvodynia, but relief from symptoms is possible. This is a fairly common phenomenon, with up to 9% of women experiencing it at some point in their lives.
Endometriosis
Endometriosis is also one of the most common causes of severe pain deep in the pelvic area during sex.
It takes an average of 9.28 years for a woman to finally receive this diagnosis and be prescribed treatment. This is data from a scientific study, Women's Sexual Pain and Its Management, which explains how women wait out those nine-plus years:
“Anyone who regularly experiences complaints of dyspareunia knows that women tend to continue intercourse if necessary by simply clenching their teeth.”
Endometriosis occurs when the tissue that makes up the uterus grows on other organs, and pain during sex with endometriosis is some of the worst.
There is no cure for endometriosis, but hormone therapy or surgery can be used to improve the condition.
In addition to endometriosis, chronic pelvic pain can be caused by tissue scarring due to infections, uterine prolapse, pelvic inflammatory disease, fibroids, ovarian cysts, and so on. Dr. Minkin says pain deep in your pelvis is definitely a reason to see a doctor because you may need to have fibroids or cysts removed.
Uncomfortable sex position and partner's big penis
It is possible that you feel comfortable and good in some positions, but others cause pain during penetration, especially deep penetration.
In this case, you need to tell your partner about this so that together you can look for new positions that are comfortable for both of you.
A large penis or dildo can also cause discomfort and pain. However, Dr Minkin says it is unlikely that the penis will be "too big" for the vagina or that it will damage the cervix. After all, the vagina can accommodate a child’s head with a diameter of 10 centimeters.
In this case, using more lube and avoiding positions where penetration is too deep and painful may help.
Psychological problems
Fear and anxiety related to penetration can create a mental barrier. This, in turn, can lead to unconscious tension in the pelvic floor muscles during sex, which also creates a physical barrier to penetration.
Perhaps you have had a negative sexual experience, you have experienced sexual violence, harassment, or violation of boundaries. In this case, the body expects pain and discomfort from sex, and the brain goes into combat mode.
Low self-esteem and issues with body acceptance can also reduce arousal and cause tension or nervousness during sex, Dr. Chavez says.
In this case, overcoming these psychological barriers will depend entirely 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.
No entry allowed
Feel
When excited, throbbing pain occurs in the labia. Sometimes it can be so strong that sexual intercourse is simply impossible. You can also feel lumps near the entrance to the vagina.
Probable Cause
Bartholinitis is an inflammation of the Bartholin glands (they are located on the inner labia and are responsible for the secretion of lubricant during sexual arousal), while the channels become clogged and swelling and discomfort appear. Similar symptoms are observed with glandular cysts; if they appear on both sides, then entry into the vagina will be extremely difficult. In this case, you need to contact a gynecologist as soon as possible.
Just not there
Feel
With deep penetration during sexual intercourse, sharp pain is observed on the right or left. During menstruation, a pulling sensation may also occur in this place.
Probable Cause
Ovarian cyst. This is a benign formation (a cavity with thin walls filled with liquid). It can be detected using ultrasound. The doctor will prescribe appropriate treatment and possibly laparoscopy. When having sex, until the problem is resolved, it is better to choose positions that allow you to control the depth of penetration - for example, “woman on top”.
Not true to size
There is an opinion that pain may occur due to a discrepancy between the sizes of the penis and vagina. This is very rare, since the vagina is very elastic and easily adapts to shape and length.
So differenti
Needless to say, men and women are inhabitants of different planets. This also applies to intimacy. It’s much easier for the stronger sex to get ready for sexual intercourse, it’s so cool! What is there to think? Sex – yes, please – always ready! Not so rude, of course, but, in general, the guys know what to do and you definitely won’t have to ask twice.
The reason for hypersexuality in men lies in hormones. The main purpose of the male is to fertilize as many females as possible. So to speak, leave a true mark on the history of mankind. Perhaps this is the reason for male inconstancy. Or maybe women themselves are a little to blame? Why be so beautiful and seductive? Not everyone will resist.
The male body works for the productivity of sexual intercourse, it should end with ejaculation with the expected conception of the offspring. And romantic relationships have nothing to do with it. Nature will always tell a man that it’s time to act and under no circumstances should he give in, so as not to become an outsider in the geological tree of homosapiens.
Regarding women, everything is much more complicated here. If the moon has entered the wrong phase or a revolution has occurred in a galaxy far, far away, then the female body will definitely find out about it and “block” access. Sometimes women themselves are unable to explain why the desire for intimacy does not arise. But there are a number of reasons for this, the main one being discomfort during sex.
By making characteristic movements, a man’s penis invariably causes changes in the condition of the woman’s vagina and uterus. The level of arousal of the lady before the start of intercourse is very important. Only if the vagina is sufficiently moisturized is there no risk of micro tears, and as a result of pain during sexual intercourse.
By-effect
Feel
Throbbing or spasmodic pain in the lower abdomen. Sharp, piercing and radiating into the leg.
Probable Cause
Any inflammation in the back, pelvis, muscles, tendons or nerves, diseases of the spine, intervertebral hernia can cause similar sensations.
In any case, even if this is precisely the problem, it is worth starting an examination with a gynecologist to rule out varicose veins in the pelvic area (the symptoms are similar). In addition, the doctor will tell you which specialist you should contact.
And men too
Like women, they may experience pain during sexual intercourse. There are many reasons for this, but most often it is due to infectious diseases. With inflammation of the glans penis, with balanoposthitis (the head does not open, the foreskin is motionless), sex turns into torture, as with the appearance of genital warts. But itching and burning can be caused by an allergy, for example, to latex.
The main causes of pain during sexual intercourse2
There are several factors that influence a woman's sensations during sex. Most representatives of the fairer sex have at least once encountered negative consequences during or after a passionate process. So why does it hurt when it goes deep?
The first reason for unpleasant or painful sensations during deep penetration lies in the lack of natural lubrication of the vagina. Natural hydration of the mucous membrane is disrupted if a woman takes hormonal contraceptives or antihistamines. Also, dryness of the intimate area can be caused by the use of vaginal suppositories to prevent pregnancy. In order to restore the sharpness of sensations and enjoy intimacy with your partner, it is enough to use lubricant. It is recommended to use special water-based moisturizers.
Note to men: the lack of foreplay is fraught with negative reviews. In other words, you should control your ardor before diving into the ocean of desires, otherwise you may find yourself in an arid desert! A woman needs to be introduced to the process smoothly and correctly. A gradual increase in excitement guarantees a comfortable act for both partners.
The next cause of pain during deep sex may be uninvited guests. It is very unpleasant to discover pathogens such as chlamydia. It is the pathogens that cause pain during sexual intercourse. If, when changing positions and using lubricant, the sensation continues to be painful, then you should immediately consult a doctor. Both partners need to be examined, since this kind of sharing can lead to very serious health problems.
Fungal infections, such as candidiasis, change the microflora of a woman’s vagina and steal wonderful moments of pleasure.
Another reason for poor quality sexual intercourse will be a heavy lunch or dinner. The golden rule is: “if you want to have good sex, eat a little.” It's all about the peculiarities of the structure of the human intestine; after eating, all organs begin to become active in processing it, and the intestines become full, which will not allow partners to fully enjoy intimacy, or even cause pain during deep penetration.
In addition, the cause of pain can be pregnancy, uncomfortable posture, uterine fibroids, cysts and other diseases. In most cases of discomfort, you just need to postpone the warm embrace for a while, for example, during ovulation, a woman may experience pain, and after seven days everything will be as fine as before.
Why does it hurt when it goes deep? As an option - hard sex the day before. Such outbursts of love will not remain without a trace, and pain in the lower abdomen can haunt the girl for several days.
In conclusion, we can say that the size of the penis does not in any way affect the pain experienced by the partner. The fact is that if a man’s dignity is within the normal size, then the female body will accept it without any negative consequences.
Victoria Fomina
Expert
Doctor sexologist of the highest category, psychiatrist, psychotherapist. I have been working as a sexologist for more than 10 years. I help couples resolve problems in their sex life.
Penetration during sex directly depends on the position. Even with a small penis, you can choose a comfortable position in which your manhood will reach the cervix. But not all girls like it, and pain during deep penetration is one of the norms. It’s not for nothing that they say that the size of the penis does not matter. And a large penis is not always a plus. There are not many women who can experience vaginal orgasm - only 20%. The rest need stimulation of the clitoris, and pain during deep penetration can only “knock down” the sensations.
Message from the Editor
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No need for feats
Do not forget that pain is, first of all, a warning signal about disorders in the body, and you should not “endure for the sake of love.” When a woman bravely endures unpleasant sensations, the mucous membrane becomes inflamed and only gets worse. This is reflected in everyday life. Gynecologists note that such troubles often provoke increased irritability and lead to psychological problems. In addition, if the cause is infection, such heroism can lead to infertility. Therefore, you cannot waste time and put off visiting a gynecologist and treatment. Self-medication in this case is unacceptable.
Author: Maria Veselova Published: September 14, 2016
