Painful Intercourse

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What is painful intercourse?

Painful intercourse is recurrent pain or discomfort in the genitals during or after sexual intercourse. The pain may be described as a raw sensation or as a burning, itching or stinging feeling. Painful intercourse is medically known as dyspareunia.

Depending on the cause, painful intercourse may be a persistent problem or it may occur sporadically. It could improve or worsen with movement or sexual activity. Further, painful intercourse may range in intensity from mild to severe. Symptoms caused by injury often have a sudden onset, such as those following sexual abuse. Other symptoms may develop slowly, such those related to infectious disease.

The causes of painful intercourse vary widely among individuals and they can be organic, emotional, or psychogenic. One of the most common is pain or discomfort in the vulva (vulvodynia), which may be due to skin irritation from rashes or household chemicals. Painful intercourse may also occur if you have experienced any damage or injury to any of the external structures of the vulva (the genitals) or to the internal sexual organs, such as the vagina, cervix, ovaries or uterus. Further, recurring infections, such as vaginal yeast infections or sexually transmitted diseases, can be associated with painful intercourse. Precancerous conditions and vulvar or cervical cancer can also cause pain during intercourse.

At times, painful intercourse is related to a chronic, underlying disease that affects not only the reproductive system but also other parts of the body. Sometimes perceived painful intercourse is actually due to psychological symptoms following sexual abuse, rape, or trauma.

Painful intercourse alone is rarely a serious medical condition; however, it may be associated with symptoms of a serious or life-threatening condition. Seek immediate medical care (call 911) if you have sudden high fever (higher than 101 degrees Fahrenheit), severe pain, chills, or rapid heart rate (tachycardia).

If your painful intercourse is persistent or causes you concern, seek prompt medical care.

What other symptoms might occur with painful intercourse?

Painful intercourse may accompany other symptoms. These vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the sexual organs may also involve other body systems.

Vulvar symptoms that may occur along with painful intercourse

Painful intercourse may accompany other symptoms affecting the vulvar region including:

  • Bleeding
  • Burning feeling
  • Itching feeling
  • Rash
  • Raw sensation
  • Stinging
  • Throbbing

Other symptoms that may occur along with painful intercourse

Painful intercourse may accompany symptoms related to other body systems including:

  • Bloody or pink-colored urine (hematuria)

  • Difficult or painful urination, or burning with urination (dysuria)

  • Fever and chills

  • Infertility

  • Nerve problems that cause pain, numbness or tingling

  • Rash in other areas of the body

Symptoms that might indicate a serious condition

In some cases, painful intercourse may be a symptom of a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have painful intercourse along with other serious symptoms including:

  • Abdominal, pelvic, or lower back pain that can be severe

  • Chills

  • High fever (higher than 101 degrees Fahrenheit)

  • Rapid heart rate (tachycardia)

  What causes painful intercourse?

Infections and skin disorders may cause painful intercourse. Disease or injury of any of the structures in the vulvar region can result in painful intercourse. In addition, painful intercourse can be caused by underlying conditions that involve the body as a whole, including the genitourinary tract and gastrointestinal tract. This will result in painful intercourse and an itching, tingling or burning sensation.

Common causes of painful intercourse

Painful intercourse may be caused by the following:

  • Allergic reactions to birth control products, such as latex or foams

  • Anxiety or stress

  • Injury from sexual abuse

  • Irritation to the nerves in the vulvar region

  • Rashes in the vulvar region

  • Recurring yeast infections

  • Sexually transmitted infections, such as gonorrhea, Chlamydia and herpes

  • Scarring from previous pelvic surgery

  • Skin irritation from chemicals, such as detergent, soap, and feminine hygiene products

  • Vaginal dryness after menopause

  • Vaginismus (involuntary muscle spasms of the vaginal wall)

Gynecologic causes of painful intercourse

Painful intercourse can also be caused by conditions that affect the genital organs including:

Serious or life-threatening causes of painful intercourse

In some cases, painful intercourse may be a symptom of a serious or life-threatening condition that should be immediately evaluated by a health care provider. These include:

  • Cancers of the vagina, uterus, cervix, or other adjacent organs

  • Pelvic inflammatory disease (PID, infection of a woman’s reproductive organs)

Questions for diagnosing the cause of painful intercourse

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your painful intercourse including:

  • Are you currently receiving treatment for any other health conditions?

  • Do you always have pain with intercourse?

  • Do you have any other symptoms?

  • How long have you experienced painful intercourse?

  • What medications are you taking?

What are the potential complications of painful intercourse?

The potential complications of painful intercourse depend on their cause. Getting prompt treatment of injuries or infection can help you avoid serious complications, such as deformity or widespread infection. Painful intercourse associated with serious medical conditions may have long-term and even potentially life-threatening complications. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential problems. Left untreated, conditions that cause painful intercourse may lead to the following complications:

  • Abscess

  • Adverse effects of treatment for painful intercourse

  • Chronic vulvodynia

  • Infertility

  • Sepsis (life-threatening bacterial blood infection)

  • Sexual dysfunction

  • Spread of cancer

  • Spread of infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 16
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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