Possible causes of pain during sexual intercourse in women. Why can women experience lower abdominal pain during sex? Stomach hurts during intercourse

Painful sensations during sexual intercourse is a fairly common problem that worries the female half in most cases, affecting any age range of the life cycle. Many people do not pay due attention to warning signs, determining their insignificance and hoping for a quick and favorable outcome of the anxiety that has arisen.

The mechanism for the formation of pain during sexual intercourse is the development of a characteristic symptom when the penis is inserted into the lumen of the vagina at the initial stages or with deeper penetration and subsequent jerking movements. Various factors can contribute to the occurrence of pain, which include not only organic manifestations in changes in the physiological parameters of the female body, but also psychological disorders.

Pain during sexual intercourse: causes

Photo: Pain during sexual intercourse

Identifying the true cause of the development of a pain symptom requires a more in-depth study of the problem and establishing the degree of arousal of the female body before sexual intercourse. Insufficient preparation for the rapprochement process can occur in the following situations:

• instability of relationships with one partner;
• existing conflict of reciprocity;
• not using pre-stimulation techniques and techniques.

In such a situation, the psychological factors of pain formation are very quickly triggered in the absence of sufficient hydration of the vaginal mucosa, and with the constant repetition of the use of inadequate techniques of mutual caress and play, this is an expected factor in sexual intimacy.

Characteristics of pathological changes

During sexual intercourse, it can be a sign of various forms of pathological disorders affecting any anatomical area of ​​the female genital area, and having various causes underlying the disease. The main group of infectious pathological conditions that cause the development of pain symptoms include:

• Endometriosis. It represents a pathological proliferation of the mucous tissue of the uterus with their possible appearance in its internal tissues, affecting the muscular or serous layer, as well as nearby organs, namely in the ovaries, abdominal surface, walls of internal structures.
• An adhesive process that affects organs located in the retroperitoneal space. Pathology is formed after suffering a form of acute inflammatory process, manifested by the occurrence of pain in women during sexual intercourse.
• Vaginitis. Refers to the inflammatory process that develops when a pathogenic pathogen is introduced into the body, which includes the entire group of infections transmitted through sexual intercourse. In addition, the disease can develop due to hormonal instability of the female body.
• Cystitis, . The pathological process of inflammation affects the urinary organ and the channel for removing fluid from the body.
• Chronic form of salpingitis, cervicitis, endometritis. Characterizes a sluggish process of inflammation with the periodic manifestation of stages of its exacerbation, which are determined by the typical symptoms of the disease.

Organ disorders

The following conditions that provoke the development of pain during sexual intercourse in women are classified as non-infectious characteristics of the disorder:

It should be pointed out that there is a common assumption of size incompatibility between partners, which can cause pain during intercourse. This is a very rare condition, since the walls of the vagina are extremely elastic and, with a sufficient phase of female arousal, can accommodate the existing size of the partner. The only exception to this rule can be the manifestation of clinical signs of gigantism in a man.

Pain symptom manifestation parameters

The formation of a disturbing symptom during sexual intimacy can manifest itself in the following cases:

• directly when the penis is immersed in the vaginal space;
• at the first sexual intercourse;
• during physical activity;
• after the process is completed.

Why is there pain after intercourse? The sensations that arise are perceived differently by each woman, taking into account the intensity of their expression. Signs may have the following types of manifestation, characterizing the presence of pain symptoms:

• tingling;
• discomfort;
• acute attack of pain or nagging sensation.

The presence of constant pain of low intensity is typical for non-infectious disorders. Development severe pain after intercourse indicates a pathology of the structures of the genital area of ​​an acute inflammatory form, requiring a comprehensive diagnostic examination. If the cause of the development of pain discomfort is psychological factors, then the symptom may have a different distribution and disappears spontaneously when the partner or environment changes.

The structure of localization of sensations

Most often, the manifestation of pain at the beginning of sexual intercourse is associated with the development of complications of various pathological disorders, such as infection of the vestibule and lips, drying of the mucous membrane, vaginismus, etc. During the diagnostic process, a specialist visually determines the presence of deformation lesions of the tissues of the genital area. Palpation of the urinary organ and the presence of pain during urination after sexual intercourse indicates the development of urethritis, to establish the specifics of the course of which additional laboratory examination is carried out.

Internal pain in the lower abdomen during sexual intercourse is a consequence of current pathological disorders, namely:

• adhesions, endometriosis, congestion;
• less often inflammatory process and weak muscle tone;
• pathologies of the urinary system, when, against the background of frequent emptying of the urinary organ, burning and pain in the urethra, pain symptoms are observed during sex;
• diseases of the intestinal tract, identifying a localized inflammatory process, which may be accompanied by abdominal pain during sexual intercourse.

Psychological aspects of pain

The occurrence of painful discomfort during sexual intercourse can also develop on a subconscious level, affecting the psychological sphere of perception of the female body. Depending on the level of intensity of their manifestation, a woman may intuitively refuse sexual contact. These parameters include the following characteristics:

• Feeling of fear before sexual intimacy. It occurs at the beginning of sexual life, creating a feeling of pain during the first sexual intercourse, which is provoked by a rupture of the virgin septum of the vagina.

The reasons for the development of fear may be the partner’s incompetence in the technique of sexual intercourse, fear of unplanned conception, lack of mutual love and other factors that do not allow a woman to mentally relax and receive the required level of pleasure. It is necessary to overcome the threshold of fear on your own; if there is no effect and signs of pain recur, it is recommended to seek advice from a specialized specialist.

Photo: Pain during intercourse

• A sharp, spontaneous spastic contraction of the muscular layer of the vagina, which is called vaginismus, is based on existing fears of past sexual experience. The development of the condition causes pain and does not allow the process to be fully completed.
• Uncertainty and failure, when a woman, concentrating on her own shortcomings, spontaneously develops a fear of sexual intimacy. This condition does not allow one to achieve the required level of arousal and contributes to a more intense perception of pain.

Methods for identifying the causes of pathology and the principle of treatment

Consultation with specialized specialists such as a gynecologist, urologist, psychotherapist, and sexologist will help identify the basis for the development of pain in the lower abdomen after sexual intercourse. As an additional examination to confirm the established diagnosis, the following methods are used:

• laboratory diagnostics;
• ultrasound and tomography examination of the genital organs;
• identification of infectious carriers with identification of the nature of the existing pathogen or confirmation of the level of microflora purity.
• The natural remedy Urethramol, based on natural ingredients, juniper and oak bark, copes well with all male problems, we recommend it for use.

Treatment of abdominal pain that occurs after sexual intercourse or during its process depends on the established causes that contribute to its occurrence. In the current process of acute or chronic inflammation, a spectrum of medicinal effects is prescribed, which completely eliminates the source of the pathological disorder. In some cases, such as endometriosis, fibroids or cystic tissue growth, surgery is also used.

Interesting video about the psychological factors of pain during sexual intercourse

Psychological adjustment of the patient’s condition is carried out independently or in the process of consulting with a psychotherapist. In any case, the pain that occurs after sexual intercourse should not be left to chance. Only a competent examination with the establishment of the true causes of its development will help to quickly and effectively eliminate disturbing manifestations, which will naturally restore the fullness and comfort of sexual intercourse.

Considering the multiplicity and multidirectionality of the causes of pain discomfort, it is necessary to remember and value your own health, without expecting the process to resolve itself successfully. The earlier the cause of the development of pain is identified, the faster it will be eliminated along with the provoking factor that caused the development of the pathological disorder.

Sexual relationships are a normal and natural part of life, but sometimes various problems arise that interfere with or even prevent these relationships.

Dyspareunia is pain and discomfort during sexual intercourse that occurs in the external or internal genital area. The sensations can be of varying intensity and duration, accompany the entire sexual intercourse, or be present only at the beginning. Painful sensations can be expressed cyclically or be present regardless of the menstrual cycle. The causes of dyspareunia are varied and do not always involve a physical illness; a certain proportion of patients with similar complaints have psychological reasons for their condition.

Possible causes of pain during intercourse

Often the cause of pain during sexual intercourse turns out to be very simple - for example, uncomfortable body position. If an attack of pain is associated only with a change in body position, do not worry. Sometimes the occurrence of pain during sexual intercourse is due to purely mechanical reasons. This is dryness of the vaginal mucosa or tension in the vaginal walls. It is also important to take into account your emotional state. If sex takes on a frankly rough form or is aimed mainly at obtaining physiological pleasure, then it can lead to the release of an insufficient amount of secretion in the vagina and pain during intercourse.

Normally, sexual intercourse should not cause any pain.

Using an intrauterine device (IUD) as a contraceptive device may pose a risk of painful sex and prolonged painful menstruation. This risk is minimized when using a hormonal IUD and is quite high when inserting copper-containing IUDs. The action of the IUD is based on the activation of aseptic inflammation of the inner lining of the uterus and thickening of mucus in the cervical canal (cervical canal). Persistent inflammation provokes pain, especially with active sexual activity.

Starting to use combined oral contraceptives is often associated with a decrease in libido (this depends on the progestin component of the drug) and a decrease in the production of vaginal secretions (lubrication). Due to these factors, sex in the first stages of taking COCs may not change for the better. However, these phenomena are usually temporary and harmless.

A discrepancy in the size of the partners' genitals can also cause pain and discomfort during sexual intercourse. If the vestibule of the vagina is very narrow, and the size of the partner’s penis is large, then mechanical stretching and damage to the skin and mucous membranes occurs. This cannot but create unpleasant sensations.

A hypersensitivity reaction to the contraceptive or auxiliary elements is possible. An allergic reaction is theoretically possible to anything. The latex from which the condom is made, the lubricant on the condom, the lubricants used in sex are all multi-component substances and hypersensitivity reactions are not uncommon. But in this case, it is enough to take a short break and change the brand or type of contraception. Usually the situation is resolved quite painlessly and does not entail consequences.

Diseases accompanied by pain during sexual intercourse

Endometriosis is a disease unique in its structure, which has a tendency to invasion, that is, pathological tissue is able to invade neighboring organs and tissues and cause a specific non-inflammatory process in them.
Imagine what is normally rejected during menstruation - this is blood and particles of the inner lining of the uterus (endometrium). Normally, this mass comes out of the cavity in 3 to 7 days and then the discharge does not bother you until the next menstruation. With endometriosis, endometrial particles invade the walls of the uterus (uterine endometriosis or adenomyosis), then spread to the fallopian tubes and ovaries, to the peritoneum, intestines (first to the rectum, then further) and less often to other organs. According to the cycle, the same changes occur in these lesions as in the uterus, the lesions swell, may bleed (spotting brown discharge during the intermenstrual period), endometrioid cysts may form in the ovaries. All these pathological processes disrupt the quality of life in general (since pain above the womb, and sometimes throughout the abdomen, turns a woman off from her usual schedule) and the quality of sexual life in particular. Sometimes sexual intercourse is so painful that a woman deliberately refuses it. These pains, as a rule, are cyclical at first for a long time (in the middle of the cycle and a few days before menstruation), and then, as the process spreads, they become almost constant. We are now talking about the course of the disease without treatment. With specific treatment, pain decreases significantly and may disappear completely. You can help the patient even if the process is advanced, since many come late, believing that painful menstruation and sexual relations are the norm, and a woman’s lot is to endure. Such women, as a rule, turn only when the pain becomes unbearable and other symptoms are present (for example, a decrease in hemoglobin due to regular heavy menstrual blood loss).

- Inflammatory diseases. Chronic or acute endometritis is an inflammation of the inner lining of the uterus of various natures, often a complication after intrauterine interventions (abortions, diagnostic curettages) and childbirth.
Candidiasis or thrush cause damage to the mucous membrane, accompanied by itching, burning and pathological discharge. The loosening and vulnerability of the mucous membrane makes sex during an exacerbation of thrush an extremely unpleasant process throughout its entire duration.
Infections transmitted primarily through sexual contact (chlamydia, gonorrhea, trichomoniasis and others) also affect the mucous membrane, and the painful sensations during sexual intercourse are caused by friction.
Bartholinitis is an inflammation of the Bartholin gland (gland of the vestibule of the vagina), which can be caused by a variety of infectious agents. At the entrance to the vagina there is a swollen and painful round formation. When attempting penetration, the woman experiences severe pain and sexual intercourse is usually impossible until healing.

- Adhesive process– this, as a rule, is not an independent pathological process, but a consequence of other diseases, conditions and procedures. Adhesions are formed after suffering from inflammatory diseases, ruptures and torsion of ovarian cysts and curettage of the uterine cavity (instrumental abortion, curettage after an unsuccessful medical abortion or frozen pregnancy, separate therapeutic and diagnostic curettage for bleeding, hysteroscopy).
Adhesions are the adhesion of different anatomical structures to each other (the walls of the uterus to each other, the adhesion of intestinal loops to each other and to neighboring organs, the soldering of the peritoneum to the abdominal organs).
Sexual intercourse, especially active intercourse, causes a temporary displacement of organ structures, which entails tension on the adhesions and is accompanied by pain. The pain can be localized above the womb or in various parts of the abdomen. As a rule, partners adapt to certain positions in which pain is not so pronounced.

- Condylomas acuminata– these are outgrowths of the vaginal mucosa of an elongated shape (as a rule, they begin to form from the area of ​​the vestibule of the vagina, and then spread to the cervix and external genitalia), which are of a viral nature (human papillomavirus). During sex, friction is felt, condylomas can be damaged and even bleed. After treatment, sexual relations return to normal.

Uterine fibroids are now very common. In this case, the nodes that matter are large enough, which can cause compression of other organs, or are located in the cervical-isthmus region, or are located on a pedicle and the process of feeding the node is disrupted. Constant severe pain during sexual intercourse due to fibroids is not typical, but this does not mean that you do not need to see a gynecologist.

- Atrophic colpitis. Atrophy, that is, thinning and dryness of the mucous membranes, is a companion for ladies of elegant age. The postmenopausal period is often accompanied by the so-called genitourinary syndrome. This includes all disorders associated with age-related changes in the pelvic floor. Lack of estrogen leads to atrophic changes in the mucous membranes; while maintaining regular sexual activity, this can create discomfort (itching, burning) and pain during and after sex.

- Varicose veins of the pelvis– a rather rare cause of both chronic pelvic pain in general and pain during sexual intercourse in particular. This shows joint management of the patient by a gynecologist and phlebologist.

- Somatic diseases. Some diseases, seemingly unrelated to sexual activity, can have a significant impact on sexual activity and its comfort.

Diabetes mellitus causes dry mucous membranes, reduces local immunity, and as a result, the woman suffers from endless relapses of candidiasis or nonspecific colpitis.

Diseases of the rectum and anus, such as hemorrhoids or anal fissure and other, rarer diseases (ulcerative colitis or Crohn's disease), create indirect pain. There is no pain directly in the vagina, but the close proximity of the organs (bladder, uterus and rectum) causes sexual intercourse to provoke pain.

Chronic cystitis for the same reason can cause discomfort during sex.

Diffuse skin diseases, such as scleroderma, dermatitis, eczema, affect the skin, including the skin of the perineum. In this case, not only and not so much the sexual act itself will be unpleasant, but rather the touching and rubbing of the skin.

- Condition after surgical treatment. Changes in the architectonics of the pelvic organs and pelvic floor muscles after surgical treatment (vaginoplasty for prolapse, perineal surgery after complicated childbirth) can provoke pain during sexual intercourse. Sometimes this is an initial phenomenon that disappears over time, but it happens that after that the healing process occurs with peculiarities and the vestibule of the vagina becomes very narrow, which creates certain difficulties in sexual activity with the previous partner.
If we are talking about abdominal surgery (it does not matter whether it was a laparotomy or laparoscopic intervention), then the development of adhesions in the pelvis and abdominal cavity is likely. The adhesive process affects various adjacent organs, so intense sexual activity can cause severe pain, which persists for some time after the cessation of sexual intercourse and even requires taking medications.

Mild pain during intercourse and bleeding after it can be due to diseases of the cervix, including cervical erosion, and pain may be its only symptom.

Mild to severe pain during sex can be observed in the presence of adhesions in the pelvis; in this case, pain occurs systematically during the same manipulations during sexual intercourse, often in the ovarian area.

If pain is felt mainly after insertion of the penis, then the most common causes are inflammation of the vulva or labia majora or an infectious process in them. If pain occurs with deeper thrusting movements of the penis, it may be due to an infection in the vagina. Such pain is usually accompanied by leucorrhoea (vaginal discharge) with a different appearance or smell from the norm, and itching in the external genital area. In this case, only a doctor can make a diagnosis based on the results of the analysis and smear using the PCR method.

Pain during sexual intercourse, radiating to the lower back (right and left) occurs with inflammation of the uterine appendages, pain in the lower abdomen, sometimes accompanied by bleeding during sexual intercourse - with inflammation of the endometrium.

Other causes of pain during sexual intercourse include infectious diseases of the bladder and urinary tract.

Sometimes pain during sexual intercourse occurs with PCOS (polycystic ovary syndrome), in which the ovaries are enlarged and slightly painful, with ovarian cysts and other neoplasms of the pelvic organs, both benign and malignant (cancer).

Sexual intercourse can provoke symptoms of an acute abdomen with corresponding disorders (rupture of an ovarian cyst, ectopic pregnancy, nascent myomatous node, torsion of the pedicle of an ovarian tumor, etc.), which is accompanied by severe pain and requires emergency surgical intervention. In these cases, you need to seek medical help urgently!

Hormonal disorders of the female reproductive system can provoke uterine spasms, which is also accompanied by pain in the lower abdomen.

Psychological causes of pain

- Lack of psychological readiness for sexual relations. Often, young girls follow the wishes of their boyfriend, without having their own opinion on this issue, or, even worse, they have concerns and fear, but the fear of losing the relationship is stronger. Thus, sex for a young girl is initially associated with coercion and overstepping oneself. In the future, a lot depends on the partner; if a girl feels confident in the relationship, does not experience fears and is not under pressure, then the first negative sensations are smoothed out and may not affect her subsequent life. But it often happens that once a woman has chosen a inferior position, she continues to build unequal and inharmonious relationships in the future. Sex is not perceived as part of a healthy adult relationship, but only as a service or a sacrifice. Over time, this role cannot but affect the body; sexual intercourse may be accompanied by pain of varying intensity, thus the body tries to bring the existing problem to the attention.
Dyspareunia is in some cases one of the psychosomatic diseases (if physiological causes are excluded). Psychosomatic diseases are diseases of the body (soma in Greek means “body”) that are caused by mental and psychological causes.

- Consequences of a traumatic situation. A psychotraumatic situation in many cases is different, everyone has a different threshold of psychological stability, but situations such as rape by acquaintances or strangers, sexual harassment from relatives or other persons whom the victim previously trusted (friends of parents, colleagues and others) cannot but leave a trace . The trauma becomes especially severe if pregnancy occurs as a result of rape. Few people decide to preserve and carry the pregnancy in this case, and termination of pregnancy leaves a painful mark on a woman’s soul. Subsequent potential sexual partners are perceived as hostile, and if the relationship does move to a new level, the body’s defensive reaction can manifest itself in the form of convulsive contraction of the vaginal muscles, and then pain during penetration and sexual intercourse itself.

- Mismatch of partners' temperaments. If a woman is naturally endowed with a gentle and calm disposition, and her partner demands different behavior in bed and more frequent sex, then a feeling of guilt and inadequacy may arise, which leads to a defensive reaction in the form of pain during sexual intercourse. In addition to pain during sex, a woman often does not experience not only an orgasm, but also any positive sensations at all.

- Subconscious fears. Sometimes a woman is terrified of becoming pregnant or contracting some kind of infection. In this case, sexual intercourse is a direct threat to her peace of mind. Such consequences are not uncommon after termination of an unwanted pregnancy in the past, especially if the pregnancy occurred while using contraception. So the woman feels the lack of control over the situation, and sees abstinence as the only possible way to protect herself from unwanted consequences. When fear exists for a long time and cannot be resolved, it takes root in the mind and can affect sexual life even when a girl independently decides to have sexual relations.
There may also be a situation where there was a risk of contracting a serious disease (HIV infection, hepatitis B and C, gonorrhea and others) from a partner, and the woman found out about this after sexual intercourse or during the relationship. This situation contributes to a loss of trust in the opposite sex and a decrease in sexual desire. Dyspareunia in these cases is a subconscious defense against dangerous consequences for the patient.

Consequences

The consequences of dyspareunia are usually psychological. A woman avoids sex with her husband or partner, which can provoke misunderstandings and distance. Especially if talking about intimate problems is not acceptable in a relationship. The woman withdraws and feels inferior.

Untreated gynecological diseases, the first symptom of which was pain during sex, progress and subsequently lead to even greater problems (chronic pelvic pain, infertility, menstrual irregularities).

Diagnostics

Half of the diagnosis is a correctly and thoroughly collected medical history and life history. It matters when the pain appeared, what its nature is, whether it depends on the menstrual cycle, what diseases the patient suffered and how it was/was treated, whether there were any traumatic situations in the past. It is necessary to find out how the patient menstruates, whether the nature of menstruation has changed (duration, abundance, pain, the appearance of clots and intermenstrual spotting). Reproductive history, number of births, abortions, miscarriages, complications. The operation and method of contraception also plays an important role.

For a full examination, the patient must be undressed, so the condition of the skin and mucous membranes, the presence of enlarged lymph nodes and much more can be assessed. When examined in a chair, you can sometimes immediately find out the cause of the pain (colpitis, bartholinitis, condylomas are visible to the naked eye). The pain of a gynecological examination already indicates some deviation from the norm. If you feel pain during the examination, be sure to tell your gynecologist and specify the location of the pain (back wall, side wall, etc.), this will help in diagnosis.

Laboratory research:
- a smear on the flora and a cytological examination of scrapings from the cervical canal are mandatory routine studies that are carried out during the initial examination;
- examination for STIs is indicated if a specific type of inflammation in the vagina is suspected.

Instrumental studies:
- ultrasound examination of the pelvic organs is the basic level of diagnosis. A good ultrasound specialist will see fibroids, signs of endometriosis, varicose veins of the small pelvis and much more, which will help the clinician in diagnosis.
- MRI and CT of the pelvis are indicated if a mass formation or a common pathological process is suspected.
- laparoscopy is a therapeutic and diagnostic procedure that is performed only in a hospital and according to strict indications.

You may need to consult a surgeon, coloproctologist, endocrinologist, dermatologist, allergist, psychologist or psychiatrist.

Treatment of pain during sexual intercourse

Treatment of the underlying disease will be the specific treatment of dyspareunia, which is only one of the symptoms, although often the most striking and disturbing for the patient.

By removing condylomas or an inflamed Bartholin gland, carrying out specific treatment for endometriosis or infectious colpitis, we will help a woman regain her quality of life, including sexual life.

If the cause is psychological, then competent psychotherapy and drug correction will be the best etiological (that is, affecting the cause) treatment.

Which doctor should I contact if I have pain during sexual intercourse?

If pain during sexual intercourse is not an isolated incident and it recurs day after day or is accompanied by other unpleasant symptoms, contact your doctor immediately. gynecologist for advice and treatment.

Dyspareunia is a symptom of a pathological condition, the diagnosis and treatment of which should be carried out by specialists. If detected in time, the disease can almost always be treated with good clinical effect.

If you notice that you have pain or discomfort during sexual intercourse, then see if they depend on your cycle, and whether there are any other complaints, cycle disorders or psychological problems. Having considered the problem, be sure to consult a gynecologist. Pain during sex is not normal, at least, and can then lead to more serious reproductive problems. Find a doctor you trust and follow his recommendations. Take care of yourself and be healthy!

Pain during sex often indicates the presence of certain gynecological problems.

Pain during sex can be physiological, psychological, or pathological. To determine the cause of pain and prescribe therapy, you should consult a gynecologist.

What are the pains during sex?

Pain sensations are divided into superficial and deep. Superficial pain is an unpleasant pain, typical for inflammation of the vagina, and deep pain is typical for inflammation of the ovaries, uterus, in the presence of adhesions and scars after surgical procedures.

Pain in the external genitalia and in the abdomen is possible during and after sex (severe and nagging pain).

Localization of pain

Pain during sex in girls can be located in the ovaries (on one or both sides), in the groin area, in the lower abdomen. Pain sensations are also concentrated in the walls of the vagina.

Why does pain occur during sexual intercourse?

The causes of pain during sexual intercourse are varied:

• Defloration process. The thickness of the hymen and its ability to rupture determine the intensity of pain that a girl will experience during her first sexual intercourse.
• Intact hymen. In an anatomical sense, defloration does not always occur during the first sexual intercourse, since the hymen can only stretch or tear slightly. In this case, every sex session is painful at the beginning.
• Uncomfortable position. Recurrence of pain during sexual intercourse is possible again and again if you do not tell your partner about the discomfort and do not change position.
• Having an STD. Due to damage to the vaginal mucosa by pathogenic microflora, a woman may experience severe pain both during and after sexual intercourse, which is accompanied by pain and burning. Greenish mucus may appear from the vagina, as well as bloody discharge with an unpleasant odor.
• Inflammatory process in the pelvis. If a woman has endometritis, then during sexual intercourse she experiences pain in the uterus. Pain during sexual intercourse in the lower abdomen is explained by irritation of the inflamed uterine mucosa after penetration of the penis. This contributes to the appearance of spotting after sex. In the case of adnexitis (inflammation of the appendages), pain during sexual intercourse can be both sharp and aching. Also, with inflammatory pathologies of the appendages, an increased body temperature is observed.
• Impaired hydration of the genital tract during arousal. The small amount (or absence) of lubrication produced by the female body can lead to further discomfort. This process, in addition to psychological problems, is often observed in connection with a reduced amount of estrogen produced during the menopausal period or during menopause.
• The presence of vulvitis or colpitis. In the presence of vulvitis, the mucous membranes of the external genitalia are inflamed, so pain is felt even before penetration begins. With colpitis, pain is experienced directly during sexual intercourse, since the inflamed vagina is injured from the inside.
• Adhesive disease of the pelvis, which develops as a result of surgical interventions, endometriosis or inflammatory processes of the uterus and appendages.
• Vaginismus. Vaginismus is a muscle spasm due to a cramp. It can arise due to psychological disorders, and if a woman cannot cope with them herself, she needs to make an appointment with a sex therapist and psychologist. Spasm can appear not only during sex, but also during a visit to the gynecologist or in case of mistrust or fear of a specialist.
• Presence of ovarian cysts. The cause of pain during sexual intercourse in the lower abdominal area, or rather the ovaries, can be cysts or rupture of these neoplasms.
• Venous stagnation of blood in the genitals, which can cause severe pain during sexual intercourse of a cramping or aching nature. Stagnation of blood can be a consequence of either the lack of sexual life or its irregularity, as well as sexual dissatisfaction.
• Malignant tumor of the cervix. Dyspareunia manifests itself in the third or fourth stage of carcinoma and is accompanied by the discharge of scarlet or dark brown blood from the vagina.
• Presence of cystitis. The bladder is located close to the uterus, its inflammation can cause dyspareunia, since the organ is in contact with the uterine wall.
• Scars in the perineum formed as a result of childbirth, surgical interventions or ruptures of the perineum.
• In case of bending of the uterus (retroflexio position). According to statistics, it occurs in approximately 20% of women and corrects itself after childbirth. If this does not happen, it is necessary to select the most comfortable sex positions that do not cause discomfort or pain.
• Vaginitis. The causative agents of this inflammatory process are pathogenic microorganisms (gonococci, trichomonas, chlamydia, mycoplasmas and pathogenic fungi).

How to get rid of pain during intercourse

Before taking any action, you need to contact a gynecologist to find out the causes of pain. If the cause is a disease, appropriate therapy is necessary, and often both partners must be treated.

If the reason is psychological, the help of an appropriate specialist is necessary to form a more trusting relationship between partners.

In any case, you cannot ignore unpleasant sensations during sexual intercourse, because they can lead to unpleasant consequences, both physical and moral.

Dyspareunia, otherwise known as “painful intercourse,” is the terminology used for all types of pain during sexual intercourse. A woman may experience pain during sex during penetration, during intercourse and/or after intercourse. It can be localized anywhere in the intimate area: clitoris, labia or vagina, etc. The pain can be any: sharp, burning, burning, dull or paroxysmal, it depends on individual susceptibility.

How are dyspareunia and vaginismus related?

There are many causes of pain during sexual intercourse, with dyspareunia and vaginismus being the most common. characterized by involuntary contraction of the intimate muscles of the vagina. When attempting sexual intercourse, vaginal spasm can cause discomfort in the perineum, burning, pain and inability to insert the penis.

Any cause of sexual pain can provoke vaginismus. In these cases, vaginismus remains even after the original problem is resolved.

Possible causes of pain during sex in women

• vulvodynia or vestibulodynia;
• inflammation of the genitourinary system;
• neoplasms of the genitals or pelvis;
• vaginal dryness;
• independent childbirth complicated by ruptures;
• vulvar cancer;
• history of radiation therapy;
• vaginal infections, fungal or bacterial, some, etc.;
• skin diseases - lichen sclerosus;
• side effects when taking certain medications;
• in the pelvic and genital area;
• during ;
• allergic reactions to pads, condoms, topical contraceptives and/or spermicides;
• condition after diagnostic painful pelvic examinations;
• trauma due to sexual violence;
• female genital mutilation;
• Bartholin gland cyst;
• sports injuries;

It is important to note that vaginismus can coexist with the above pathologies and remain after they are eliminated.

Pain during sexual intercourse in women is in most cases removable if the cause is identified and eliminated.

With dyspareunia of psychological origin, the development of pain is determined by several aspects:

• predisposing factor;
• formation of a stable reflex;
• waiting syndrome.

In this case, individual therapy with a psychologist will be effective.

Which women are more likely to experience pain during sexual intercourse?

There are no specific parameters by which a woman’s predisposition to pain during sex can be unambiguously determined, but it is believed that problems may arise for those representatives of the weaker half who experience significant discomfort during a gynecological examination or insertion of a tampon. The psychological characteristics of women who suffer from dyspareunia may have common features:

• negative attitude towards sexual intimacy;
• discord in family relationships;
• possible diseases of the female genitourinary system;
• concomitant extragenital pathology.
• Often there is traumatization, surgical interventions, and psychological trauma after sexual violence.

Types of dyspareunia

There are two types of pain during sex: primary and secondary dyspareunia.

Primary implies the complete absence of orgasmic release ever and the receipt of positive emotions from intimacy, secondary - loss of pleasure from sex as a result of certain reasons.

Dyspareunia is also divided depending on the place of manifestation during sex, isolated superficial (damage to the vestibule of the vagina, labia) and deep (deeply located internal structures, uterus, appendages, bladder, rectum, etc. are affected).

How to get examined if you have pain during sexual intercourse

If it is painful for a woman to have sex, she should consult a gynecologist. And only if a physiological cause is excluded, a consultation with a psychologist is recommended.

For gynecological examinations, narrow speculums and moisturizers are used to reduce the likelihood of pain.

It is mandatory to examine smears: for atypia, microflora and sexually transmitted infections, preferably using the PCR method.

It is possible to inoculate vaginal discharge on nutrient media and determine sensitivity to drugs.

Diseases that cause pain during sexual intercourse

Vulvodynia

Painful sensations in the vulva area can be the result of any infection, including fungal. Vulvar discomfort manifests itself against the background of decompensated diabetes mellitus, bacterial vaginosis and other diseases.

Once you experience pain during sex, there is a chance that pain will also manifest itself outside of sexual intercourse.

Vulvodynia is characterized by a lack of response to therapy.

Inflammation of the vestibule of the vagina - vulvar vestibulitis- a chronic process accompanied by pain during sex, more often develops against the background or when affected by fungal pathogens.

Insufficient hydration

Vaginal dryness can be one of the reasons for pain during sexual intercourse. Normally, before insertion of the penis, the glands produce abundant secretions, this promotes better glide of the penis and facilitates the penetration of sperm to the egg. A woman’s hormonal background changes with age, so the level of estrogen, starting from 39 to 45 years old, begins to gradually decrease, which leads to vaginal dryness and tissue atrophy. A slight traumatic factor is enough for microcracks to appear, and with them pain. This condition can be corrected in two ways: the use of special lubricants during sexual intercourse, irrigation of the vagina with decoctions of calendula and chamomile, or, as prescribed by a doctor, hormone replacement therapy.

Pain during sex after childbirth

After an uncomplicated spontaneous birth, if the required recovery period is observed before resuming sexual activity, women rarely experience dyspareunia. Sometimes unpleasant sensations in the intimate area appear during breastfeeding, which is caused by changes in hormonal levels and a state of hypersensitivity.

Postpartum dyspareunia, if there have been no ruptures or injuries, usually goes away on its own within a few months of the start of regular sexual activity.

Endometriosis

Pain during sex that occurs against the background requires hormonal therapy. As a rule, pain with endometriosis is associated with the phase of the menstrual cycle. When hormonal therapy is prescribed, the patient’s well-being improves.

Adhesions and idiopathic dyspareunia

The cause in the pelvis may be previous inflammatory and infectious diseases or surgical interventions. To improve the condition, use with dissection of adhesions, physiotherapeutic effects.

When it is not possible to establish the cause of pain during intimate relationships in women, we are talking about so-called idiopathic dyspareunia. Experts believe that the leading factor in the development of this pathology is psychological disorder.

Bartholin gland cyst

A round formation filled with secretion produced by the Bartholin gland. A woman can palpate it herself. A Bartholin gland cyst, once it reaches a significant size, can interfere not only with sex, but even while walking. More often, the excretory duct becomes blocked due to sexually transmitted infections, for example, gonorrhea, trichomoniasis, but it can also appear due to nonspecific inflammation or poor hygiene. A small cyst can be observed conservatively; a large Bartholin cyst (up to 4–5 cm) requires surgical treatment.

Post-radiation colpitis

Some tumors of the female genital organs and intestines are treated with radiation therapy. Exposure to rays is harmful not only to cancer cells, but also to normal ones. Radiation therapy leads to atrophic processes. With radiation colpitis, pain is a frequent companion not only during sexual intercourse, but also at rest. In this situation, gynecological oncologists prescribe suppositories with Methyluracil for a course of up to 30 days and laser therapy.

Allergic reactions

Pain during sex often develops from contact with an allergen, which can be anything:

• latex condom;
• intimate hygiene detergent;
• lubricants;
• spermicides;
• scented pads;
• synthetic underwear;
• sexual devices.

Fortunately, this phenomenon is temporary, and when contact with the intolerant substance is eliminated, itching, swelling, redness and pain during sex in the vagina go away on their own. If the body reacts too violently and the manifestations are significant, the doctor may recommend antihistamines for systemic and local action.

What else can cause pain during sexual intercourse?

During the first sexual intimacy, the hymen ruptures, which is accompanied by minor pain. If the hymen has just been torn, pain may occur during subsequent sexual intercourse. The problem can be solved simply: the doctor can eliminate the defect with a scalpel.

The content of the article:

Pain during sexual intercourse is experienced by 1 in 10 women; the causes of pain during sex are always different.

Let's try to figure out what interferes with enjoying intimacy and is a cause for concern, causing pain during sexual intercourse in women.

What kind of pain occurs during sex?

Vaginal dryness pain

Pain occurs when the penis is inserted into the vagina, and continues during frictions (movements) during sex.

Cause: vaginal dryness, lack of sufficient lubrication.

This problem occurs in 1 out of 4 women. Factors influencing the appearance of vaginal dryness include:

Atrophy of vaginal tissue during menopause (this is a common cause of insufficient lubrication),
hormonal imbalances,
taking certain medications,
psychological fear of intimacy.

You can eliminate pain during sexual intercourse using a lubricant (additional lubricant) or a special vaginal cream. Humidifiers are sold in pharmacy chains.

Pads, various intimate hygiene products, and excessive use of vaginal douching can irritate the delicate vaginal mucosa.

Urogenital candidiasis

During sex, a woman experiences itching in the area of ​​the external genitalia; during sexual intercourse, she experiences painful sensations (and sometimes pain) in the vagina; a whitish discharge with a characteristic sour odor may appear.

After sex, a woman may experience burning and pain when urinating.

It is necessary to answer that with thrush, vaginal discharge does not always occur, and the only sign of candida infection is pain in the vagina.

Cause: Thrush (candidiasis) of the vagina, infection with the fungal pathogen Candida albicans.

What to do? Make an appointment with a gynecologist, take smears, get recommendations, and undergo careful treatment. Your partner may need examination and treatment.

Acute vulvovaginitis

If you have sharp pain during sex, pain after sex, or discharge, the cause may be acute vulvovaginitis.

It is necessary to undergo diagnostics for pathogens of sexually transmitted infections, take a smear for flora and sensitivity to antibiotics.

Ovarian cyst

Nagging pain in the right or left groin area, radiating to the lumbar region, down the abdomen. It intensifies with deep penetration of the penis into the vagina.

Cause: ovarian cyst (ovarian tumor). Most cysts are harmless and disappear on their own in about 3 menstrual cycles. You should not delay your visit to the gynecologist; ovarian tumors can be benign (cyst) or malignant (cancer). Only after research can a correct diagnosis be made. A large ovarian cyst can rupture, and then only emergency hospitalization with surgery can save the woman’s life.

If the problem is “harmless” cysts, it is better to try the “woman on top” position during sex, this will help you control the depth of penetration.

Tumor formations of the uterus

Uterine fibroids are the most common; its clinical manifestations are characterized by pain in the lower abdomen, frequent urge to urinate, pain in the uterine area during sexual intercourse, changes in the nature of menstruation (heavy, lasting longer).

What to do? Consultation with a gynecologist, transvaginal ultrasound; The doctor selects treatment individually in each case.

Tumors of the uterus are not only benign, but also malignant. In the initial stages, the clinical manifestations of both fibroids and uterine cancer are very similar; a woman alone is not able to make a correct diagnosis.

Cervical erosion (cervical tumor)

Pain during sexual intercourse is mild, but after sex there is brownish bloody discharge from the vagina.

What to do? Urgently see a gynecologist for colposcopy, possible cauterization of erosion. If a tumor pathology of the cervix is ​​diagnosed, further treatment by a gynecological oncologist, depending on the stage of cervical cancer.

Urinary tract infection

After sexual contact, the urge to urinate becomes more frequent, with pain, and the feeling of incomplete emptying of the bladder may be disturbing. Sometimes the pain radiates to the lumbar region.

What to do? Take a general urine test, make an appointment with a urologist, gynecologist (examination for sexually transmitted diseases).

Vulvodynia

Pain in the genital area occurs not only during sexual intercourse, but also during any contact with the genitals: when riding a bicycle, during a gynecological examination, or when inserting a tampon.

Cause: hyperactivity of the nerve endings of the vagina in response to long-term infections, taking antibacterial drugs.

What to do? Consult a gynecologist and psychotherapist.

Venous congestion in the pelvic area

Venous stagnation is characterized by aching pain and a feeling of “fullness” in the lower abdomen. Additionally, it is worth paying attention to the appearance of vascular networks, characteristic of varicose veins, swelling of the lower extremities, episodes of exacerbation of hemorrhoids, heaviness in the legs after exercise.

What to do? Consultation with a vascular surgeon or gynecologist is necessary.

If the disease has not reached an advanced stage, lifestyle adjustments and medications may be sufficient to eliminate this problem. An active sexual life helps reduce congestion in the pelvis, since during orgasm a woman experiences a redistribution of blood and improves blood circulation in the genital organs.

Vaginal changes after childbirth

The development of unpleasant sensations during sexual intercourse in a woman is especially expected after a difficult birth. Sometimes, for obstetrics, surgical aids are used and sutures are placed on the perineum, which leads to the formation of adhesions in some women. Adhesions are connective tissue that lacks elasticity, which is why it is possible to feel pain during sex.

Early onset of sexual activity after childbirth, especially if postpartum stitches were placed, can lead to complications that will accompany pain during intimacy.
Within 3-4 months, as a rule, the painful sensations disappear, and the woman can again enjoy intimacy.

If vaginal pain persists for more than 6 months, you can consult a surgeon about excision of adhesions.

Using a lubricant will help reduce pain. Perineal massage using a painkiller - anesthetic - helps well. It can also be used during intimacy.

Endometriosis

Pain with endometriosis feels similar to menstrual pain, which spreads throughout the pelvis. With deep penetration of the penis into the vagina, increased pain occurs. The pain may continue for several hours after sex.

This clinical picture is typical for endometriosis, a disease in which the tissue lining the uterine cavity spreads to other organs. Endometriosis is one of the causes of female infertility. According to statistics, about 17% of women suffer from this pathology.

What to do? Contact a gynecologist, it is possible to perform an operation or prescribe hormonal treatment, which will correct the situation.

Neuralgia of the pelvic nerves in a woman

Neuralgia of the pelvic nerves is one of the causes of pain during sexual intercourse. When the body changes in space, the pain may recede. The diagnosis is quite difficult to make, since the symptoms are similar to a number of pathological conditions manifested by pain in the vagina. A gynecological and urological examination is carried out, and if clinical and diagnostic indicators are normal, they are referred to a neurologist for consultation.

Taking NSAIDs (non-steroidal anti-inflammatory drugs) and physical therapy can help relieve pain.

In conclusion, we note that pain is the body’s reaction to trouble, an attempt to attract attention, therefore any painful sensations cannot be ignored.

The average price of a gynecologist consultation in Moscow is 1600 rubles, neurologist - 1850 rubles, oncologist - 2800 rubles.

Examination using the PCR method for STIs 4064 rubles.

Transvaginal ultrasound examination (ultrasound with a vaginal sensor) average cost in Moscow is from 850 rubles.