CAUSES OF PAINFUL SEX

 Pain During Sex: Causes, common factors and impact on infertility

Sex shouldn’t be painful. However, nearly three out of four women will experience some sort of painful sex in their lifetime. 

Painful sex (also known

as dyspareunia) can interfere with getting pregnant. For one, painful sex may indicate an underlying medical condition that is negatively affecting your fertility.

Secondly, painful sex itself can make getting pregnant difficult to impossible. If you can’t tolerate sexual intercourse, especially around the time of ovulation, you won’t be able to get pregnant. Learn what's normal and what's not when it comes to sexual pain, what medical conditions may cause painful intercourse, and youwhat you should do if you're facing this problem.

Note: While this article is focused on sexual pain in women, it’s important to state that men can also experience sexual pain. Sexual pain in men can also cause difficulties with conception...

Is Pain During Sex Ever Normal?

Occasional discomfort during sex can be normal. For example, the first time a woman has sex may involve some discomfort. This may be due to inexperience and anxiety for both partners. However, a first sexual encounter isn’t supposed to hurt. The myth that sex for the first time “should” cause pain and bleeding is untrue. Even first time sex can feel good.

Another possible normal cause of painful sex is having sex in an uncomfortable position. Positions that allow for deep thrusting can lead to the cervix getting bumped, which can be painful. Changing positions or avoiding uncomfortable ones can resolve this issue easily.

Another possible normal cause of discomfort during sex is not taking enough time for foreplay. The reproductive organs actually shift during sexual arousal. The cervix moves up and back when you're turned on, and this shift makes sex more comfortable.

With all that said, pain and occasional discomfort are not the same things. Pain that is consistent or prevents you from having sex is another ball game altogether.

🙏🏽Causes of Painful Sex and Infertility.🙏🏽

The medical term for painful sex is dyspareunia. Painful sex can be a symptom of an underlying medical condition. Some of those conditions can negatively impact fertility or make staying pregnant more difficult.

There are several possible causes of painful intercourse that may also impact fertility:

➡️ 1) Adhesions: 

Adhesions are bands of tissue that can lead to pain during sex, as well as infertility and repeated miscarriage. Also known as Asherman's syndrome, uterine adhesions can be caused by intrauterine procedures, like a D&C (sometimes performed after a miscarriage), or after a hysteroscopic myomectomy.

➡️ 2) Endometriosis: 

Painful sex with endometriosis may be worse around ovulation and near menstruation. This pain is usually felt deeper, rather than upon entry. Other endometriosis symptoms may include severe menstrual cramps, pain on urination or defecation (especially around your period), or general pelvic pain.

➡️ 3) Fibroids:

 Fibroids are non-cancerous tumors that grow on or inside the uterine walls. They can cause painful intercourse. Fibroids can occur anywhere on the uterus, but those that grow by the cervix are most likely to cause painful intercourse. They may also lead to spotting during or after sex.

➡️ 4) Intact or especially tight hymen:

 The hymen is a thin membrane that encircles the vaginal opening. It doesn't typically cover the entire opening but has a small hole that stretches out over time. Sometimes, the hymen doesn't naturally stretch or is unusually thick or tight, causing painful intercourse. Surgery can correct this without impacting fertility.

➡️ 5) Ovarian cysts: 

Most ovarian cysts will eventually disappear on their own, but 5 to 10% may require surgery. Ovarian cysts don’t usually cause painful sex, but more problematic ones can. A cyst alone is not necessarily a fertility issue, but cysts can be caused by conditions (like PCOS and endometriosis) that do impact fertility.

➡️ 6) Pelvic Inflammatory Disease

 (PID): PID is another possible cause of painful sex, typically pain felt deeply as opposed to upon entry. PID symptoms can be similar to endometriosis and other diseases.

➡️7) Vaginal agenesis: 

Malformations or absence of a uterus make pregnancy impossible. Some women can still have a biological child via surrogacy.

➡️ 8) Vaginal dryness: 

This can range from a slight discomfort issue to a pretty intense pain, especially when combined with overall low estrogen levels. This pain tends to occur upon vaginal entry. A lack of cervical mucus can indicate hormonal imbalance, but it can also occur due to medication side effects.

While infertility related to these conditions may not easily be dealt with, the pain caused by them should be treatable with medications, physical therapy, lifestyle changes, or surgery. Don’t assume you have to learn to live with the pain. Talk to your doctor about your options.

🙏🏽Take away🙏🏽

Pain during sex is not your fault. It is not something you should feel ashamed of. It’s a medical condition and doesn’t define you. Unfortunately, not every doctor knows how to properly respond to or treat these conditions. If your doctor can't help or doesn't take you seriously, go to someone else. Keep speaking up until you find the help you deserve.

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