Dyspareunia refers to pain during sex, and can be caused by decreased libido, endometriosis, sexually transmitted infections (STIs), allergies to latex condoms, phimosis or prostate inflammation of the prostate. Both men and women can experience dyspareunia.

Depending on the underlying cause, dyspareunia can present with additional symptoms, like genital burning, itching, irritation, sores, discharge and discomfort when urinating.

You are advised to consult a gynecologist, urologist, or family doctor if your pain interferes with pleasurable sex, or if you have dyspareunia with additional symptoms.

Why does it hurt when I have sex?

The main causes of dyspareunia are:

1. Low libido

A low libido is one of the main causes of pain and burning during intercourse, especially in women, as not having a libido or being "in the mood" can reduce vaginal lubrication and make penetration more painful.

Low libido can be related to several factors like stress or the use of medications like contraceptive, antidepressants and antihypertensives. Read more about what causes low libido and how to treat it.

What to do: You should see your doctor if you persistently experience low libido to determine whether it is related to another health condition or caused by a medication. Some patients may find that adding aphrodisiac foods can also help to boost libido.

Seeing a psychologist can also be beneficial for relieving stress or finding strategies to resolve any internal or relationship struggles.

2. Skin irritation

Skin irritation or contact dermatitis can be caused by the use of genital soaps or lubricants. Compromised skin integrity can contribute to more discomfort and pain during sex.

Skin conditions that affect the genital area can also lead to other symptoms, like itching, swelling, redness or genital sores.

What to do: You should avoid using products that can be irritating to the genital skin, and to consult a doctor if your symptoms do not resolve on their own. Your doctor may prescribe topical corticosteroids and/or oral antihistamines to help reduce irritation.

3. Hormone imbalances

Dyspareunia in women can be a sign of hormonal imbalances. Abnormal estrogen levels, for example, as associated with low libido and reduced vaginal lubrication, which can lead to pain during sex.

Abnormal estrogen levels are more common in women who are entering menopause, but can also occur after giving birth or when breastfeeding.

What to do: Women experiencing dyspareunia due to hormone imbalances can use lubricants during sex to help reduce friction and pain during sex.

However, it is important to consult a gynecologist if this discomfort persists. Women who are confirmed to be menopausal may be prescribed hormone replacement therapy or antidepressants. Check-out some natural remedies for menopause that you can incorporate into your treatment plan.

4. Endometriosis

Endometriosis is a chronic inflammatory condition that affects women. It is characterized by the abnormal growth of endometrial cells outside of the uterus, which can attach to the intestines, ovaries, fallopian tubes or bladder, as well as the back of the vagina or lower part of the uterus. Having displaced endometrial cells can cause dyspareunia, and can lead to pain after sex as well.

Other sighs and symptoms of endometriosis include severe cramps during menstruation, heavy periods, and frequent pelvic pain. Learn more about endometriosis symptoms and how they can present.

What to do: Treatment for endometriosis should be guided by a gynecologist, who may prescribe oral birth control, an IUD and anti-inflammatories to help manage symptoms. In more severe cases, surgery may be advised.

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5. Sexually transmitted infections (STIs)

Sexually transmitted infections (STIs), such as trichomoniasis, genital herpes, chlamydia or gonorrhea, are the main causes dyspareunia in both women and men.

In addition to pain during sex, STIs can lead to symptoms like genital itching, burning, discharge, and sores.

What to do: STI treatment should be guided by your doctor, and varies depending on the type of infection confirmed. Most STIs can be treated with antibiotics.

6. Urinary tract infections (UTIs)

Urinary tract infections (UTIs), such as cystitis or urethritis, are most commonly associated with pain and burning with urination, but can also cause painful sex.

These infections are typically caused by bacteria that enter the urinary tract through the urethra. If left untreated, they can reach the bladder, ureters or kidneys, which can lead to a more complicated infection.

What to do: If you suspect your are experiencing UTI symptoms, you are advised to see your doctor for assessment and treatment. The medication prescribed will typically depend on the microorganism causing the infection. Read more about the UTI treatment your doctor may consider.

To promote a quick recovery, is also important to maintain adequate hygiene, drink plenty of fluids, avoid unprotected sex and to wear cotton underwear.

7. Postpartum

The postpartum period can be very uncomfortable for women, especially following a vaginal birth, as the genital area is often sore and can be wounded.

Postpartum bleeding can persist for several weeks after childbirth, even after all sexual contact has been cleared, which can make sex uncomfortable.

What to do: You should speak to your doctor about when sexual activity can be resumed after giving birth. Typically, your doctor will clear sex after 4 to 6 weeks, when bleeding has subsided and the risk for infection has reduced. However, women are encouraged to resume sex once they feel comfortable.

Pompoir techniques, which involves contracting the pelvic muscles during penetration, can also help to reduce dyspareunia in the postpartum period.

8. Vulvovaginitis

Vulvovaginitis is characterized by inflammation of the vulva and vagina, which can occur due to fungal or bacterial infections, irritation, skin conditions, menopause or pregnancy.

This condition can present with symptoms such as redness, swelling or itching, which can cause discomfort or pain during sex.

What to do: If you suspect you may have vulvovaginitis, you are advised to see your doctor for assessment and diagnosis. Depending on the underlying cause, this condition can be treated with antibiotics or antifungals, used orally or topically.

9. Yeast infection

A yeast infection is a common fungal infection that is typically caused by imbalances in genital microbiota. It is characterized by the excessive growth of Candida albicans, which is a type of fungus is naturally found in the genitals. An overgrowth of this fungus can lead to symptoms, including pain and burning during sex.

Other common yeast infection symptoms include intense itching, redness, swelling and white discharge.

What to do: Treatment for candidiasis should be done under the guidance of a gynecologist, who usually recommends the use of antifungals in the form of ointments or tablets, such as miconazole, fluconazole or itraconazole, for example. Check out the ARTICLE MAPPED TO EN: the main remedies for candidiasis.

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10. Prostatitis

Prostatitis, an inflammation of the prostate, is a common condition in men that can lead to dyspareunia, especially during ejaculation or urination.

What to do: Men are advised to consult a family doctor or urologist if symptoms of prostatitis arise. Treatment for prostatitis usually involves the use of anti-inflammatories, as well as antibiotics, if the inflammation is caused by an infection.

Some men may find relief in taking a hot bath or preparing a sitz bath to relieve pain from sex.

11. Vaginismus

Vaginismus is the involuntary contraction of a woman's pelvic floor muscles, which prevents vaginal penetration during sex. It can lead to very intense dyspareunia.

Vaginismus can occur at any stage of a woman's life and may be related to physical or psychological causes, like fear of getting pregnant, a history of sexual abuse or chronic UTIs.

What to do: You should consult a gynecologist to determine the underlying cause of vaginismus. This way, the doctor can advise the most appropriate treatment, which may involve cognitive-behavioral therapy, pelvic exercises or medication.

12. Uterine conditions

Uterine conditions, like a prolapsed uterus, a retroverted uterus, adenomyosis, uterine fibroids or even ovarian cysts, can cause pain before, during or after sex.

What to do: Treatment should be guided by a family doctor gynecologist, and will vary depending on the condition diagnosed.

13. Erectile dysfunction

Erectile dysfunction is a sexual disorder in men that is characterized by the inability to achieve or maintain an erection in order to have sex. Flaccidity during sex can cause dyspareunia in both men and women.

What to do: You should consult your family doctor or a urologist if you frequently experience problems with maintaining an erection. Your doctor may recommend diet changes (like reducing your sugar, fat and alcohol intake), as well as medications and stress management.

Check-out home remedies for ED that you can incorporate into your treatment plan.

14. Phimosis

Phimosis is characterized by the difficulty or inability to pull your foreskin back and expose the head of the penis. This can cause very intense dyspareunia.

This condition typically resolves during puberty, but can persist into adulthood.

What to do: Phimosis can typically be treated with a minor surgical procedure which involves removing excess skin.

15. Peyronie's disease

Peyronie's disease is a penile condition characterized by the appearance of fibrotic tissue, or rigid scars, that cause an abnormal curvature of the penis when erect. This shape can to pain during erection and difficulty with penetration.

This disease is typically associated with minor trauma from sex or contact sports, which eventually leads to penile inflammation and scar formation during the healing phase.

What to do: Treatment should be guided by a urologist, which may vary depending on the patient's symptoms, the curvature of the penis and the stage of the disease. More severe cases may require the use of anti-inflammatories or even surgery.

16. Latex condom allergy

A latex condom allergy is another common cause of dyspareunia, as it can cause genital irritation and symptoms like redness, intense itching or swelling.

What to do: You should opt for condoms made-up of other materials, like polyurethane or polyisoprene.

Moderate to severe genital irritation and swelling and be treated with anthistamines, anti-inflammatories and/or corticosteroids.

Dyspareunia (Painful Sex): 16 Causes & What to Do