Interviewer: There is pain when you have sexual intercourse. Is this a normal thing or should you be concerned? That's coming up next on The Scope.
We're talking today with She's the expert in all things woman. Dr. Jones, we got an e-mail asking about pain during sexual intercourse. That doesn't sound normal, but again, I'm not an expert, so you tell me, is that normal?
Dyspareunia: Pain during Sex
Dr. Jones: Well, let's talk a little bit about pain with intercourse. It's got a fancy named called "dyspareunia." If you heard that name you wouldn't know that meant pain with sex, but that's what it means.
So first of all, one always needs a little bit more information. My guess is that every single woman on the planet has had dyspareunia, pain with sex, at least first, and that was the first time. It's not uncommon. In fact, it is common for women to have pain with sex the first time.
Is It Normal to have Pain during Sex?
Now, when we think about what's normal, normal is something that happens to more than 5% of people. So when they actually asked 428 women of reproductive age, so that would be 12 to 50, if they had pain with intercourse, 75% of them responded. Now, that meant 25% weren't responding because either they didn't have sex or they didn't want to talk about it, so we don't know about that 25%. But of those that responded, 39% said they had never had pain with intercourse, and I know they're lying because they at least had pain the first time. Twenty-seven percent said they'd had pain some time in their life, and 35% had dyspareunia at the time of the survey. So that means pain with intercourse, by our definition, our medical definition of normal, it means that pain with intercourse is normal, meaning more than 5% of women have pain with intercourse.
Common Causes of Dyspareunia
Now, having said that it probably is normal doesn't mean that it's nice. So let's back up a little bit and talk about why women might have pain with intercourse. Other than the first time, when tissues are getting stretched with intercourse the first time, one always worries about, number one, if there's an infection. So certainly, women who have a yeast infection, some women with sexually transmitted infections like gonorrhea and chlamydia, those are situations where someone could have pain with intercourse. And if it's new pain with the same partner, then one begins to worry about, is it something in the vagina like a yeast infection, is it an infection in the pelvis like a sexually transmitted disease, or do you have an ovarian cyst or something in your pelvis that, when it gets bounced around, hurts a little.
Pain during Sex Post-Menopause/Post-Partum
The second concern is for women who are post-menopause or post-partum. So women who are nursing after they give birth have very low estrogens during the time that they nurse, and if they nurse for a long time, meaning more than six months, they might find their tissues get quite thin. And women who are post-menopausal, their tissues, their vaginal tissues, are quite thin, and that hurts. So if it's a post-menopausal woman, we have good reasons to understand that painful intercourse could happen, and we have good treatment.
Anxiety Causing Pain During Sex
Number three, new partners, new positions, new anxieties, is there something about this particular intercourse or this new partner that makes you uncomfortable so you're having sex when you're not actually well-lubricated? So one begins to say, "Is there something new in your life, a new partner, a new position? Are you using something different? Are you allergic to some of the sex toys or lubricants that you're using?" So we'll ask that.
So are you normal to have pain with sex? And the answer is, yes. Is it nice? And the answer is, no. Can we do something about it? And the answer is, most of the time we can. Talk to your clinician. We can usually make it better.
updated: May 13, 2021
originally published: November 5, 2015
