Painful Intercourse
Most women who are sexually active with a partner at some point in their life may experience a sharp pain during intercourse. This sensation, unfortunately is a common experience. This pain typically occurs for one of several reasons. First, during intercourse, small amounts of air could be getting trapped within the vaginal canal, causing sharp sensations of pain. To minimize the amount of air, try re-inserting the penis. Another common cause of the sharp pain is when a woman is not sexually stimulated enough. Often this experience occurs in long term relationships, where couples are more likely to get into the pattern of having penile-vaginal intercourse without the same degree of foreplay as before during the initial courtship (lasting 3 months to 2 years). Often in long-term relationships the idea that penile-vaginal intercourse will occur at some point in the night is assumed, and as a result minimal time is spent building up to that moment. Thus, the solution is easy, increase stimulation. A third common reason women may be experience a sharp pain during intercourse occurs when the penis is hitting up against her cervix. To decrease pain, change positions and/or stop thrusting as deeply. Another cause for this sensation is that the woman is simply tender from recently engaging in a lot of intercourse. Sometimes, women can get 'raw' on the inside of their vaginal walls. If this is the case, then stop engaging in intercourse, and engage in other forms of sexual play. Wait several days before resuming intercourse. Fifth, a sharp pain during intercourse could indicate something slightly more serious such as endometriosis. Endometriosis is a fancy way of saying that the uterine lining grows outside of the uterus, such as in the fallopian tubes, on the ovaries, or even in the intestines, which can cause other types of pain and symptoms. If this is the case, go to your local GYN. Sixth, the woman could be suffering from PID, and lastly, it is possible that the woman pulled her pelvic sling muscle. If this is the case, again go to your local GYN. In any event, given the array of different possible causes of painful intercourse, it is highly recommended that the woman make a doctor’s appointment. A gynecologist will be able to properly diagnoses, and thus treat the problem appropriately
update 30 oct 2009. source
Painful intercourse (dyspareunia)
What causes it?
Vaginismus
Vaginismus can cause both deep and superficial pain and is a common cause of pain during sex. It's a spasm of the vaginal muscles, caused mainly by fear of being hurt.
This spasm is often so painful that intercourse is impossible – sometimes for years.
Some women with vaginismus have never been able to have full sex or even use tampons. They also tend to be very fearful of vaginal examinations and so may never have had a smear test.
Vaginismus arouses strong emotions, and women who have it are often very angry with partners, doctors and themselves. But the condition is no one's fault.
Common causes include:
* a restrictive upbringing, in which the woman was brought up to view sex as nasty or dirty.
* an upbringing in which the woman was given the idea that the vagina is very narrow and so sex must be very painful.
* a background where rape or childhood sexual abuse has taken place. Experiences like these understandably make women fearful of sex and of being hurt.
* painful vaginal infections.
* unease with their partner – perhaps at an unconscious level.
It is a common misconception that women with vaginismus dislike sex altogether.
In fact, many women with this condition enjoy closeness with their partners.
Many get great pleasure from love play and some are able to reach orgasm in this way. But the enjoyment ceases when penetration is attempted or suggested.
In the UK, women doctors who have been trained by the Institute of Psychosexual Medicine have by far the greatest experience of treating vaginismus.
What are the other causes of deep pain during sex?
* Problems with your cervix: the man's penis hits the cervix at the farthest extent of his thrust. So infections of the cervix and tender places on it can cause pain during deep penetration. This is called 'collision dyspareunia'.
* Womb trouble: various womb disorders, including fibroids, can cause deep intercourse pain.
* Endometriosis: this very common disorder often affects the womb and surrounding tissues. It makes them very tender, particularly near period times. The pressure of the penis on an area of endometriosis may cause intense, deep pain.
* Ovary problems: cysts on the ovary can cause deep pain. Pain may also be caused if the tip of the penis hits an unusually positioned ovary.
* Pelvic inflammatory disease (PID): this is caused by infection, and has become more common in the UK largely thanks to the bug called chlamydia. If chlamydia isn't treated, there is quite a chance of PID developing. In PID, the tissues deep inside become badly inflamed and so the pressure of intercourse causes deep pain.
* Ectopic pregnancy: this means a pregnancy outside the womb, usually in the Fallopian tube. Pressure on it can be very painful.
What are the other causes of more superficial pain?
Lack of lubrication
This can be due to nervousness, hang-ups and failure to relax. Unskilled foreplay by the man is a common cause, especially when it doesn't go on long enough. (Many women would like half an hour – but don't get it!)
Well-endowed partner
Some women complain that their partner’s penis is too big.
In fact, when a woman is aroused and relaxed, the vagina extends by several inches – so any female should be able to accommodate any male.
But being unused to a larger man or previous problems with bladder infections or endometriosis can lead to anxiety and tension about sex.
A recent invention may be of use here. It's called the 'Come Close' and is a kind of cushioned ring that the man wears on the base of his penis. This reduces the length of the penis that goes into the vagina.
Menopausal or post-menopausal dryness
This is usually due to a fall in female sex hormones. Treatment with HRT pills or hormone cream will usually put matters right. Ordinary sex lubricants will help, too.
Vaginal infections
These are very common. The one that huge numbers of women get is thrush. But there are numerous others, such as trichomonas. The blisters of herpes can also be really painful.
Injury
Injury to the vulva or vagina can occur during rape or sexual assault and later cause dyspareunia.
Much more commonly, injury is caused by a childbirth tear or the episiotomy cut that is often made during labour. Badly healed stitching can also cause pain.
Genital warts
These are awfully common in these days of fairly promiscuous sex. Occasionally the warts can cause pain, especially if they get infected.
Vulvitis
This means inflammation of the vulva (the opening to the vagina). It can be due to all sorts of causes, including chemicals in bubble-baths or soaps.
Haematoma of the clitoris
I first encountered this about 30 years ago, but it's still not widely known. It's a bruise (or collection of blood) in the clitoris, caused by excessive friction. It nearly always gets better within a few weeks.
Urethral caruncle
This is a tender patch that develops at the urinary opening.
Foreign body in the vagina
The usual culprit is a forgotten tampon. It may cause pain, especially if the tampon leads to an infection.
Vulvodynia
A distressing and long-lasting condition in which the outside part of the sex organs (the vulva) is so sensitive, just touching the area makes the woman jump with pain.
Its cause is not yet known, but it can often be successfully treated.
Cancer
This is a rare cause of intercourse pain, but it must be borne in mind for a woman who develops this kind of pain for the first time after the age of 40.
Does intercourse pain affect men?
Sometimes men experience pain during intercourse.
Common causes are skin disorders on the penis such as eczema or psoriasis.
It can be that the woman's vagina is too tight for her partner. A good sex lubricant can help here.
Occasional causes of male pain include:
* thrush – in which case the female partner will probably have thrush too
* a forgotten stitch left in the woman's vagina after childbirth
* an IUD thread or a displaced IUD in the vagina
* Peyronie's disease – a male disorder that causes bending of the penis.