Pain during sex before your period can be caused by things like a lack of vaginal lubrication, changes in estrogen levels (especially after menopause), or abnormalities inside the uterus. You can try a different sexual technique or foreplay, using a nonhormonal lubricant or moisturizer.
Pain that occurs before, during or after sex is called dyspareunia. It can affect intimacy in a relationship and make women less willing to have sex.
Vaginal Pain
Occasional pain down there during sex is normal, especially for women who are having sex for the first time. But pain that’s constant or comes and goes can be a sign of a problem.
Pain in the vulva can be caused by many things, including infections, hormone changes, and various health conditions, such as fibromyalgia and scleroderma. It can also be a symptom of anxiety or depression. It’s important to talk to your doctor about the pain you’re experiencing, and remember that it is not your fault.
Dyspareunia, which is the medical term for painful sex, can affect both men (male dyspareunia) and women (female dyspareunia). It’s not always clear what causes it. Dyspareunia can be due to problems with the cervix or other areas of the reproductive system. It can also be a side effect of some medications, such as antidepressants and antipsychotics.
Other common causes of vaginal pain during sex include sexually transmitted infections, such as chlamydia and herpes, and conditions such as endometriosis. The pain can also be a result of trauma, such as physical abuse or sexual assault. In some cases, it’s a symptom of an underlying condition like PTSD.
If the pain is caused by something you can treat at home, try using a water-soluble lubricant before having sex and washing your vulva with warm or cool lukewarm water afterward. You can also use a topical anesthetic, such as lidocaine gel, which is available at your local drugstore or pharmacy. Another treatment is to wrap a frozen ice cube or gel pack in a towel and hold it against your vulva for a few minutes. You can also try a soothing herbal remedy, such as aloe vera or chamomile tea. If the pain is caused by a serious health issue, your doctor may need to run some tests to find the cause. They might do a pelvic exam or an ultrasound to look for cysts on your ovaries or a Bartholin cyst. They might take a sample of tissue from your vulva to examine it for cancer or other conditions.
Pelvic Floor Pain
Your pelvic floor muscles are like a hammock that supports several organs in your lower abdomen. They wrap around your bladder, uterus and rectum (in women). During “fight or flight” situations, such as during sex, they tighten and then relax to allow you to breathe, urinate, defecate and have a bowel movement. If the muscles are hypertonic, or always tensed, it causes problems.
Pelvic floor dysfunction can be caused by a number of conditions such as painful bladder syndrome, endometriosis, pain with intercourse and irritable bowel syndrome. It can also be caused by the inflammation of the prostate (prostatitis). In some cases, symptoms such as a burning sensation when passing wee and a feeling that you need to urinate often or immediately after exercise, or during sex, may be similar to a urinary tract infection or UTI (uncommon in women).
Dr Manwaring adds that some people with chronic pelvic pain do not get taken seriously, despite the fact that they report their symptoms to a range of health professionals. She suggests you should see a GP who specialises in women’s health, and also a specialist pelvic floor physiotherapist or continence nurse. A physiotherapist can help you with exercises to improve muscle tone and connect the brain to the pelvic floor muscles, and teach you how to do this yourself.
Other health professionals who can help include a gynaecologist and a men’s health GP, a gastroenterologist and a urologist. It’s important to have a multidisciplinary team working together on your chronic pain management, as this approach has been shown to be the best. This might also involve a clinical sex therapist, a psychologist and other complementary therapists. A combination of treatments may be required to reduce your pain, including a variety of medications, exercise, massage, mindfulness and other therapies.
Other Types of Pain
There are a wide range of causes for pain during sex. The pelvic floor physical therapist can help you pinpoint the cause and recommend treatment to make it easier for you and your partner to enjoy sexual activity. Pain during sex can be caused by infections, nerve conditions or other medical issues such as endometriosis (tissue that lines the uterus grows outside of the uterus), adenomyosis (tightening of the ovarian muscles) and hymen lacerations (an abnormal opening in the hymen). Psychological problems such as anxiety or depression can prevent sexual arousal and lead to pain. Pain can also be caused by damaged foreskin due to rubbing or irritation and by sexually transmitted diseases (STIs).
If you experience painful sex before your period, it’s important to see your doctor. The earlier you address the problem, the faster you’ll get relief and return to enjoying sexual intimacy.
Dyspareunia, which is pain or discomfort in the lower part of your vagina, can happen at any age, but it is more common in women who have reached menopause. Symptoms may include a burning sensation when you have sex, pain during sexual penetration or urination and bleeding after sexual intercourse. Dyspareunia is caused by a decrease in the amount of lubrication or anatomical changes. It can be treated with the use of sexual lubricants, medication for infections or surgery.
Pelvic pain, including dyspareunia, can occur at any time of the month. It’s often worse around ovulation or during menstruation, but can also be brought on by a variety of factors such as a urinary tract infection, constipation or bowel problems, bladder or pelvic surgeries and certain types of cancers. You can reduce your risk of pelvic pain by following good hygiene, using a wide variety of birth control methods and getting tested for sexually transmitted diseases.
