When Sex Hurts

Vaginismus or Pelvic Floor Muscle Dysfunction. In this condition, the vaginal and perineal muscles involuntarily spasm with attempted sexual activity. This can make vaginal entry very difficult or even impossible. Vaginismus can occur after a trauma (such as nonconsensual sex), or it can be related to underlying physical conditions, including musculoskeletal injuries or vestibulodynia. Vaginismus is often treated with dilator therapy (in which women are taught relaxation techniques while using progressive-sized dilators in their vagina) and physical therapy.

Urinary tract conditions, such as cystitis, or fungal infections can also cause pain upon intercourse, as can endometriosis, or a uterus that has "dropped" or prolapsed.

Time to Speak Up

Unfortunately, most women do not talk to their health care providers about sexual pain or problems, nor do their health care providers bring up the topic. In an international survey of 391 women by the Women's Sexual Health Foundation, fewer than 9 percent of women said their health care professionals had ever asked if they had sexual problems. Obviously, if you don't bring up the topic of sex with your health care professional, it won't get addressed. So speak up!