Causes of painful sex in women

The place and importance of sex in a relationship cannot be overplayed. The lack of it in a relationship oftentimes leads to many issues that both partners find difficult to talk about. Sex is wonderful; it is a thing of joy and it should be enjoyed and not endured. Despite the importance of sex, however, a lot of things could happen which will make a woman not to want sex. One of such is pains during sexual intercourse.

In many cases, a woman can experience painful sex if there is not sufficient vaginal lubrication. When this occurs, the pain can be resolved if the female becomes more relaxed, if the amount of foreplay is increased, or if the couple uses a sexual lubricant.

In some other cases, a woman can experience painful intercourse if one of the following conditions is present:

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Vaginismus: This is a common condition in which there is a spasm in the vaginal muscles, mainly caused by the fear of being hurt.

Vaginal infections: These conditions are common and include yeast infections.

Problems with the cervix: Opening to the uterus. In this case, the penis can reach the cervix at maximum penetration, so problems with the cervix (such as infections) can cause pain during deep penetration.

Problems with the uterus: These problems may include fibroids that can cause deep intercourse pain.

Endometriosis: A condition in which the endometrium; tissue lining the uterus grows outside the uterus.

Problems with the ovaries: Such problems might include cysts on the ovaries.

Pelvic inflammatory disease: The tissues deep inside become badly inflamed and the pressure of intercourse causes deep pain.

Ectopic pregnancy: A pregnancy in which a fertilised egg develops outside of the uterus.

Menopause: The vaginal lining can lose its normal moisture and become dry.

Sexually transmitted diseases (STD): These may include genital warts, herpes sores, or other forms of STDs.

Vulva or vagina injury: These injuries may include a tear from childbirth or from a cut episiotomy in the perenium area of skin, between the vagina and the anus that is made during labour.

A lot of things could make a woman feel pains during sex. Some of them are serious while some are not. Ideally, the assessment should be done by a doctor who is a specialist in this field; a gynaecologist specifically.

Dr Akin-Tunde Odukogbe, consultant obstetrician and gynaecologist, University College Hospital, (UCH) Ibadan, Oyo State, stated that  pain during sex becomes an issue when the woman concerned feels it, or when the partner complains or avoids having sex with her due to her complaints and also particularly when it becomes associated to other complaints like swellings along the genitals and lower abdomen, ulcers, pain in the lower abdomen, painful menses, abnormal vaginal discharge, fever, urinary symptoms and so on.

According to him, penetrative sexual intercourse is one of the most pleasurable experiences of human beings. But it requires a lot of synergy between the minds and body organs of the partners involved for it to be pleasurable. Pain is one of the manifestations when sexual intercourse is not pleasurable. Both partners can experience pain.

Pain for the woman can be superficial around the vaginal opening or deeper in the lower abdomen and the causes of either or both are:

Lack of relaxation: Muscular tenseness of the vaginal opening can occur during the first episodes of intercourse, from various fears or when there is inadequate foreplay.

Lack of lubrication: The vaginal walls produce a thick mucoid secretion which lubricates the movement of the penis in and out of the vagina. Its production requires the woman being sexually aroused during foreplay. If not produced, the friction results in abrasions and pain.

Diseases in the genitals and lower abdomen; Infections, ulcers, swellings, forgotten foreign bodies, pregnancy occurring in the wrong place, unhealed wounds in the vaginal entrance, the vagina, womb and the lower parts of the abdomen can cause pain when touched by the penis during thrusts.

Roughness during intercourse: During deep thrusts, roughness can result in laceration of the vaginal walls, sometimes with bleeding into the lower abdomen.

According to Dr. Odukogbe, apart from low quality of life, marriage break-ups, irritability at home or at work, some of the conditions causing the pain may lead to loss of job, threaten future fertility or cause death.

Before treatment is possible, adequate assessment by a physician or gynaecologist in many cases of the woman and sometimes the couple together is mandatory. Sometimes this can be simple questioning, especially when the painful experience is occasional, but may require more extensive investigation when the condition is threatening marital bliss or life itself.

Treatment can also be very simple, for example, giving advice only but, at times, this is complex when life-threatening diseases are detected.