Pain with Sex

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Pain with Sex

Pain during sexual intercourse, known as dyspareunia, is a common issue among women that can significantly impact their sexual satisfaction and overall quality of life.


There are various potential causes of pain with sex, and understanding the underlying factors is crucial for effective treatment.

Physical causes of dyspareunia may include vaginal dryness, which can result from hormonal changes during menopause or certain medications. Infections, such as yeast or urinary tract infections, can also lead to discomfort during intercourse. Conditions that affect the pelvic region, such as endometriosis, pelvic inflammatory disease (PID), or fibroids, may contribute to pain with sex. Additionally, pelvic floor muscle dysfunction or vulvodynia, can also be culprits for dyspareunia.

Factors affecting pain with sex

Emotional and psychological factors can also play a role in pain with sex. Stress, anxiety, and a history of trauma or sexual abuse may lead to tension and discomfort during sexual activity. These emotional issues can create a cycle of fear and avoidance of sexual intimacy, exacerbating the problem.


The treatment for pain with sex depends on its underlying cause. For physical causes such as vaginal dryness, the use of water-based lubricants or vaginal moisturizers can provide relief. Pain with sex can also be attributed to genitourinary syndrome of menopause (GSM), formerly known as vulvovaginal atrophy. GSM occurs due to hormonal changes, particularly decreased estrogen levels, which can lead to thinning, dryness, and inflammation of the vaginal tissues. This condition can cause discomfort, burning sensations, and pain during sexual intercourse, making it one of the possible causes of dyspareunia in menopausal or postmenopausal women. Fortunately, GSM can be effectively treated with vaginal estrogens. These medications come in various forms, including creams, tablets, rings, and suppositories. Vaginal estrogen therapy helps to replenish the estrogen levels in the vaginal tissues, promoting their health and functionality. By restoring moisture and elasticity to the vaginal walls, vaginal estrogens can alleviate pain and discomfort during sexual intercourse. Additionally, they can improve the overall vaginal health, reducing the risk of urinary infections. 

Addressing any underlying infections or medical conditions through appropriate medical treatment is essential.

For conditions affecting the pelvic region, such as endometriosis or fibroids, a combination of medical management and, in some cases, surgical intervention may be necessary. 

Pelvic floor physical therapy can be beneficial in cases of pelvic floor muscle dysfunction. Women with vulvodynia may find relief with topical medications, nerve blocks, and surgery. 

When emotional or psychological factors contribute to dyspareunia, sexual therapy or counseling can be beneficial. Communication between partners and addressing any relationship issues can also play a significant role in improving sexual experiences.

A comprehensive evaluation can help identify the specific cause of dyspareunia and guide the appropriate treatment plan. With the right approach and support, women can find relief from pain with sex and regain a fulfilling and enjoyable sexual life.

Schedule an Appointment

If you are interested in learning more about your treatment options for Pain during Sex, your first step is to schedule an appointment with Dr. Dubinskaya. To get started, contact our office by calling 424-210-9030 or filling out our online form.

MEET Dr. Alexandra Dubinskaya

A leader in women’s sexual health

Dr. Alexandra Dubinskaya is a board-certified, fellowship-trained Urogynecologist and Sexual Health specialist whose mission is to enhance women’s quality of life by improving their pelvic and sexual health. Dr. Dubinskaya’s focus is on making a difference in people’s lives through state-of-the-art, compassionate, and personally tailored care.

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