Sexual intimacy is meant to be an enjoyable experience that draws you and your partner closer together. But when sex becomes painful, you may find yourself doing anything and everything just to avoid it.

While there’s no doubt that painful intercourse can have a major impact on your life and your relationship with your partner, it’s nothing to agonize over or feel embarrassed about. This fairly common problem — three in four women experience pain during sex at some point in their lives — can usually be resolved with the right approach.  

The signs and symptoms of dyspareunia
Dyspareunia, or frequent pain during intercourse, involves feeling pain at any point just before, during, or following sex. This pain may affect part of your vagina, or you may feel it in your pelvic region, lower back, uterus, or bladder.

Some women feel pain only during sexual penetration, while others feel discomfort even when using tampons. You may experience deep pain with each thrust, or your pain may slowly emerge following normal sex. Some women continue to feel throbbing or burning pain long after intercourse.  

Possible causes of painful intercourse
Pain during sex happens to women for many different reasons, including physical problems, gynecological conditions, and emotional issues.

Emotions that inhibit arousal and interfere with lubrication can make intercourse painful, especially if those emotions make it difficult to relax. Shyness, embarrassment, sexual anxiety, and a lack of body confidence are just a few causes of emotions that might get in the way of a normal physical response.  

Shifting hormones is another thing that can disrupt your body’s sexual response and make intercourse uncomfortable. Low estrogen levels mean that women are more likely to experience vaginal dryness — and painful intercourse — as they approach menopause, but menopause isn’t the only time a woman’s estrogen levels might decline.

Some women experience vaginal dryness and painful intercourse following childbirth, as their hormone levels slowly recover; breastfeeding mothers may experience similar symptoms for as long as they continue to nurse. Receiving treatment for breast or ovarian cancer also can affect estrogen levels and lead to painful sex.

Other possible causes of discomfort during intercourse include pelvic floor muscle dysfunction, nerve damage, perineum trauma, and vaginismus — or the involuntary tightening of vaginal muscles during sex.

Treatment solutions for sexual discomfort

Finding the right solution for sex-related pain depends on its underlying cause. If that cause isn’t readily apparent, a more exhaustive investigation can often reveal the reason for persistent discomfort.

In addition to performing a comprehensive physical exam, including a pelvic exam, we ask about your medical history to find out if you have any conditions or take any medications that may obstruct your normal sexual response. We also ask about your sexual history, to find out if any events in your past affect how you feel about sex.  

Effective treatment for one woman may simply mean changing a prescription medication that interferes with natural lubrication, while a woman who’s living with the aftereffects of an episiotomy or perineum tear from a recent childbirth may get the best results from physical therapy or surgery.

Hormone replacement therapy (HRT), or the supplementation of reproductive hormones that your body no longer makes, has long been the go-to treatment option for menopausal women affected by vaginal dryness and sexual pain.

Although HRT in the form of low-dose topical vaginal estrogen can be highly effective for some women, it’s a short-term solution that isn’t medically appropriate for all women.

You should avoid HRT if you have a personal or family history of heart disease and related risk factors like high cholesterol and high triglycerides; you also should avoid it if you have a personal or family history of breast cancer, blood clots, stroke, gallbladder disease, or liver disease.

Laser therapy for vaginal health
If you’re looking for a safe, non-invasive way to address painful intercourse brought on by low estrogen levels, MonaLisa Touch® laser therapy is an innovative and highly effective long-term solution.

In addition to eliminating vaginal dryness without the need for messy lubricants, hormone replacement therapy, or surgery, laser therapy also helps prevent further complications, including vaginal atrophy.

MonaLisa Touch uses fractional CO2 laser technology to revitalize the tissues that line the vaginal canal. By restoring proper trophic balance to these tissues, the treatment directly addresses the underlying conditions that cause painful sex.

In just three quick treatment sessions, MonaLisa Touch activates the production of new collagen and revitalizes the vaginal mucosa to help restore normal vaginal functional and pain-free sexual intimacy.

MonaLisa Touch is successful for nearly 90% of women affected by hormone-induced vaginal dryness and sexual pain, and it’s an excellent solution for younger women, cancer patients, and other women who can’t safely receive HRT.