For some women, pain during sex is all too common. As many as women in the United States have reported feeling pain during intercourse at some time during their lives.

“Dyspareunia” is the scientific medical term for painful intercourse. It refers to pain that can be felt before, during, and after sex.

The pain may occur anywhere in your genital area. For example, many women with this symptom report pain that occurs:

  • in and around the vulva
  • in the vestibule, which is the very opening of the vagina
  • in the perineum, which is the delicate area of soft tissue between the vagina and the anus
  • within the vagina itself

Some women report also feeling pain in their lower back, pelvic area, uterus, or even bladder. This pain can make sexual intercourse difficult to enjoy. In fact, an found some women will avoid sex altogether.

Diagnosing dyspareunia can be extremely difficult for doctors because the condition is so often complicated by emotional discomfort and shame. Many women feel embarrassed to tell their doctors that they’re avoiding sex because it hurts too much.

There are many possible causes of dyspareunia, ranging from simple infections or vaginal dryness to more complicated conditions such as ovarian cysts or endometriosis. Natural life events, such as childbirth or aging, can also cause dyspareunia. Even so, many women associate painful sex with a fear of sexually transmitted infections or feelings of failure.

If you’ve been experiencing painful sex, you’re not alone. Here’s a closer look at some conditions linked to painful sex, along with their symptoms.

Contact dermatitis

Contact dermatitis is a skin issue that can cause tears or cracks in the delicate skin of your vulva. This makes sex very painful. It’s often brought on when women have allergic reactions to perfumed soaps, lubricants, condoms, or douches.

Endometriosis

Endometriosis occurs when the tissue that normally lines the inside of your uterus is found in other parts of your body, usually the pelvic region. Symptoms may appear in ways that make it difficult to diagnose the condition. For example, symptoms can include an upset stomach, diarrhea or constipation, upper body pain, excessive urination, or a painful stabbing sensation. This array of symptoms is often mistaken for other conditions, such as appendicitis, irritable bowel syndrome, mental illness, or ovarian cysts.

Vulvodynia

This condition occurs when chronic pain in your vulva lasts for more than three months, and isn’t linked to a general infection or medical condition. The sensation felt is generally described as burning, and it can be irritated simply by sitting for too long.

Vaginitis

Some women with vaginitis experience painful inflammation. It’s often caused by a bacterial or yeast infection. Others develop the condition during menopause or after contracting a skin disorder.

Vaginismus

Vaginismus is a condition that causes vaginal muscles at the opening of your vagina to painfully spasm and tighten involuntarily. This makes it difficult or even impossible for a penis or sex toy to enter. This condition can have both physical and emotional causes. These causes can include hormonal changes, fears about sex, injuries, or skin conditions. Many women with vaginismus have difficulty using tampons and getting pelvic exams.

Ovarian cysts

If women have larger ovarian cysts, they can be aggravated by the penis during sex. These cysts are sometimes even torn open, leaking fluid. Ovarian cysts can be caused by another underlying condition, such as endometriosis, or can develop during a pregnancy.

Pelvic inflammatory disease (PID)

PID leaves the fallopian tubes, ovaries, or womb inflamed. In turn, this makes sexual penetration very painful. This condition is often a sign of a larger issue caused by an infection. It should be treated right away.

There are a range of other reasons painful sex may occur, including:

  • vaginal dryness
  • extreme fatigue
  • problems within a romantic relationship
  • uncertain feelings toward sex that might stem from shame, guilt, fear, or anxiety
  • everyday life stresses around work or money
  • changing estrogen levels or atrophy caused by perimenopause or menopause
  • allergic reactions to perfumed soaps or douches
  • medications that effect sexual desire, arousal, or lubrication such as certain birth control drugs

If you’re experiencing painful sex, it may be helpful to consider if using a lubricant would help. Think about whether you’ve started using any new products recently that might be irritating your skin.

If your symptoms don’t improve, it’s important to seek medical advice. Your doctor can determine if you might have a health condition that needs treatment.

Your doctor can help you determine what may be causing you pain during sex. When talking to your doctor, it’s helpful to be specific. Try to provide details about exactly where the pain is coming from and when it occurs. For example, does it occur before, after, or during sex?

Some women find keeping a journal that documents their recent sexual history, feelings, and pain levels to be helpful. If you take notes about your symptoms, you can bring them to your appointment. Remember, your doctor wants to help figure out what’s causing the pain, and to help make it stop.

Sex is supposed to be pleasurable, and it can be frustrating when it’s not. If you’re experiencing pain during sex, you’re not alone, and it’s not your fault. Talking to your doctor may be the first step you take toward learning what’s causing your pain and ultimately finding a treatment.