Pain During Sex? Here's What Your Body's Trying to Tell You

Pain during sex is common, but it's definitely not normal. So if being intimate is making you physically uncomfortable, it's time to get help.

"Sex is for procreation but also for pleasure, and that pleasure is harder to achieve if sex is painful," says Maria Sophocles, MD, board-certified ob-gyn and Medical Director of Women's Healthcare of Princeton in Princeton, New Jersey.

Figuring out the culprit behind your discomfort can take some detective work, but it's worth the effort, she adds. Here's a look at some of the most common causes of pain during sex, plus what you can do to make things feel good again.

Sexually transmitted infections including chlamydia and gonorrhea can cause pain or burning during sex, according to the American Academy of Family Physicians.

Herpes, too, can lead to small blisters on the penis or vaginal area that can burn or feel sore.

Yeast infections and other vaginal infections, like vaginitis, can cause pain during sex along with itching, burning and an increase in discharge.

Urinary tract infections or even eczema in the genital area can cause discomfort too, per the Mayo Clinic.

Feelings of depression or anxiety, stress, fear of intimacy or even worries over how you look can all make it harder to get aroused. If you have a vagina, that can make it harder to become adequately lubricated, says Dr. Sophocles, which can make sex uncomfortable.

Painful sex during menopause is, unfortunately, a common problem.

"When our estrogen levels fall with menopause, most women will experience some dryness, since estrogen is what helps keep our vaginas moist," explains Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University School of Medicine.

The lack of natural lubrication leads to vaginal tissues becoming thinner and less flexible, which can result in pain and burning during sex.

Painful sex that develops after childbirth or while breastfeeding stems from hormone shifts too. "After childbirth, there is a drop in ovarian estrogen production, which deprives the vaginal tissue of its ability to make moisture," Dr. Sophocles says.

Injury or trauma during labor and delivery, like an episiotomy, can also potentially lead to sexual discomfort, per the Mayo Clinic.

Conditions like endometriosis, pelvic inflammatory disease, uterine fibroids, ovarian cysts and pelvic floor dysfunction can all make sex uncomfortable, according to the Mayo Clinic. "The pain usually occurs with deep penetration, not upon insertion at the beginning of intercourse," Dr. Minkin explains.

Antidepressants, high blood pressure meds, sedatives, antihistamines and birth control pills can make it harder to get aroused. That, in turn, can reduce lubrication and make sex dry and uncomfortable, the Mayo Clinic notes.

Inflammation of the prostate caused by a bacterial infection or an abnormal immune system response, prostatitis can make ejaculation uncomfortable. It can cause other symptoms too, like chronic pelvic pain, pain during or after urination or frequent urination, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Vaginismus is when the vaginal muscles involuntarily spasm any time penetration is attempted, according to the Cleveland Clinic. This can make sex painful, but it can also happen during pelvic exams or when inserting a tampon.

The exact cause of vaginismus isn't clear, but it may happen when the person has a fear of or negative feelings about sex. Other risk factors include having an anxiety disorder and a history of surgery or childbirth injuries such as vaginal tears.

Pain that's negatively affecting your sex life is typically caused by an underlying problem, like an infection, a gynecologic condition or hormonal changes. Seeing your doctor to get to the root cause can help make sex more comfortable, and in some cases, could help protect your health in other ways.

It's best to talk about your symptoms directly if you can. But if you're having trouble getting the conversation started, try saying something like, "I am sexually active but sometimes it is uncomfortable," Dr. Sophocles recommends. From there, your provider can ask more specific questions about what you're feeling, so you can figure out the best solution.