Emotional factors might be associated with many types of painful intercourse. Not enough lubrication. This is often the result of not enough foreplay. A drop in estrogen levels after menopause or childbirth or during breast-feeding also can be a cause.
Certain medications are known to affect sexual desire or arousal, which can decrease lubrication and make sex painful. These include antidepressants, high blood pressure medications, sedatives, antihistamines and certain birth control pills. Deep pain usually occurs with deep penetration. It might be worse in certain positions. Causes include:. Emotions are deeply intertwined with sexual activity, so they might play a role in sexual pain.
Emotional factors include:. It can be difficult to tell whether emotional factors are associated with dyspareunia. Your ob-gyn or other health care professional also can help you address problems with sexual response. Pain during sexual intercourse can be a warning sign of many gynecologic conditions. Some of these conditions can lead to other problems if not treated:.
Your medical and sexual history, signs and symptoms, and findings from a physical exam are important factors in determining the cause of your pain. Sometimes, tests are needed to find the cause. A pelvic exam or ultrasound exam often gives clues about the causes of some kinds of pain. Further evaluation, sometimes involving a procedure called a laparoscopy , may be needed. You also may be asked about medications that you are taking, whether you have any medical conditions, and past events that may affect how you feel about sex, such as sexual abuse.
Other health care professionals may be consulted for further evaluation and treatment, such as a physical therapist or a dermatologist a specialist in diseases of the skin.
If you have pain during sex, see an ob-gyn or other health care professional. There also are some self-help measures you can try to relieve pain during sex:. Endometriosis : A condition in which tissue that lines the uterus is found outside of the uterus, usually on the ovaries, fallopian tubes, and other pelvic structures.
Episiotomy : A surgical incision made into the perineum the region between the vagina and the anus to widen the vaginal opening for delivery. Laparoscopy : A surgical procedure in which an instrument called a laparoscope is inserted into the pelvic cavity through a small incision.
The laparoscope is used to view the pelvic organs. Other instruments can be used with it to perform surgery. Masturbation : Self-stimulation of the genitals, usually resulting in orgasm. Pelvic Inflammatory Disease : An infection of the uterus, fallopian tubes, and nearby pelvic structures.
Perimenopause : The period before menopause that usually extends from age 45 years to 55 years. Ultrasound Exam : A test in which sound waves are used to examine internal structures. Vagina : A tube-like structure surrounded by muscles leading from the uterus to the outside of the body. Vestibule : The space within the labia minora into which the vagina and urethra open. Copyright by the American College of Obstetricians and Gynecologists.
All rights reserved. Read copyright and permissions information. Emotions that inhibit arousal and interfere with lubrication can make intercourse painful, especially if those emotions make it difficult to relax.
Shyness, embarrassment, sexual anxiety, and a lack of body confidence are just a few causes of emotions that might get in the way of a normal physical response.
Some women experience vaginal dryness and painful intercourse following childbirth, as their hormone levels slowly recover; breastfeeding mothers may experience similar symptoms for as long as they continue to nurse. Receiving treatment for breast or ovarian cancer also can affect estrogen levels and lead to painful sex. Other possible causes of discomfort during intercourse include pelvic floor muscle dysfunction, nerve damage, perineum trauma, and vaginismus — or the involuntary tightening of vaginal muscles during sex.
Finding the right solution for sex-related pain depends on its underlying cause. In addition to performing a comprehensive physical exam, including a pelvic exam, we ask about your medical history to find out if you have any conditions or take any medications that may obstruct your normal sexual response. We also ask about your sexual history, to find out if any events in your past affect how you feel about sex. Hormone replacement therapy HRT , or the supplementation of reproductive hormones that your body no longer makes, has long been the go-to treatment option for menopausal women affected by vaginal dryness and sexual pain.
Skip to content. Pain during sex is a common problem for women. Anger wants women to know about painful sex:. Jennifer T. Anger, MD. Dryness is the most common cause. Many conditions may cause pain during sex. Some conditions that can be at the root of the problem: Pelvic floor dysfunction: The pelvic floor muscles—the ones you tighten when you want to stop passing urine quickly—can become painfully tight.
It can cause an achy pelvis and pain with any kind of insertion.
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