Causes of pain during intercourse. Pain in the abdomen during sex, what to do? A man should be careful

Intimate relationships between a woman and a man are an important and integral part of a fulfilling life. Sex is important not only for obtaining physical satisfaction, but also for a sense of psychological comfort. However, sexual relations are not always pleasurable, especially when the partner feels discomfort.

Women are characterized by a typical a rare thing

painful intercourse in which they do not

can get the desired pleasure.

This is bad for the psychological

status and personal relationship with a man.

Pain that occurs during sexual contact in medical terminology is called dyspareunia.. It can occur at any stage of sexual intercourse and does not depend on the age of the woman. Symptoms of the disease can have different intensity, character and localization.

The reason for the appearance of pain during intercourse can be judged only after receiving all the results of the examination. Sometimes the causes of such pain are quite banal: incorrect body position, vaginal dryness, psychological discomfort next to an inexperienced partner.

The frequent manifestation of dyspareunia may indicate many diseases of the genitourinary or reproductive system that have a non-infectious or infectious origin.

Doctor's questions when taking an anamnesis and establishing the cause of pain:

Collection of anamnesis

Are there any other sexual disorders - reduced lubrication, lack of orgasm?

Have any treatment attempts been made?

Are there discharges with an unpleasant odor and a change in their color?

Have sexually transmitted infections, including herpes and human papillomavirus, been previously detected?

Have you had abdominal and genitourinary surgeries, chemotherapy and radiation therapy?

Was there a aggravated obstetric history: childbirth with episiothromy, forceps, trauma?

History of chronic gynecological diseases to establish early diagnoses - chronic pelvic pain, uterine fibroids, endometriosis, salpingitis, etc.?

What contraception is used now and what was used earlier (different intrauterine devices, diaphragms, caps, sponges, gels, foams?

Have skin diseases been established - eczema, psoriasis, other dermatitis?

Are there any disturbances in the functioning of the urinary system - cystitis, urethritis, irritable bowel syndrome, diseases of the colon?

Is there Behçet's syndrome and diabetes?

Is there an increased sensitivity to topical products - ointments, creams, lotions, as well as intimate hygiene products - wet wipes, colored toilet paper?

Questions about the nature of pain:

What kind of pain - deep during movement, before the act at the entrance or after the act?

If the pain is deep, then on which side is it localized: on the left, on the right, or on both sides?

Is there burning and itching?

Is the pain sharp, aching, severe, or burning?

Does the nature of the pain depend on the chosen posture?

Is the pain situational (occurs in certain situations or depends on the partner, does it depend on the cycle of menstruation) or generalized (does not depend on the circumstances and the partner)?

Has it appeared recently or has it been observed throughout the sexual life?

Is there an addiction to alcohol and drugs?

Collection of psychosocial information

Has this problem been observed in sexual intercourse with another partner?

Has the problem been discussed with a partner?

Have any steps been taken to correct the problem?

Was there a history of rape and battery? Are there any other stressors?

Do you have depression, anxiety, or other disorders?

Causes of dyspareunia

All the reasons that cause discomfort and pain during intercourse can be clearly divided into 2 groups:

Diseases of the urinary system or genital area of non-infectious and infectious nature.

Psychological factors associated with the fear of pain after an unsuccessful sexual contact.

Before establishing the true cause, it is necessary to make sure whether a woman has sufficient sexual arousal before the act. Usually, insufficient excitement is observed in case of conflict between partners, instability of relationships, lack of technique for mastering the techniques of foreplay and games. Unfortunately, very quickly psychological aspects adjoin all this. And if at first insufficient lubrication occurs only with an inadequate technique of sex, then later this state is repeated and becomes expected during intercourse.

Pain associated with sexual intercourse

Pain during sex can be a symptom of a variety of pathological conditions, have different etiologies and occur in different parts of the anatomical genital area.

Infectious diseases:

Endometriosis is a pathological disease of the uterine mucosa, in which particles of the mucosa are located in uncharacteristic places: the serous and muscular layers of the uterus, in the peritoneum, ovaries and the walls of internal organs.

Vaginitis is an acute or chronic inflammation of the vagina. Fungi, mycoplasmas, Trichomonas, gonococci, chlamydia and pathogenic non-specific microorganisms act as the causative agent of the disease. Often the disease can appear against the background of recurring hormonal disorders.

Cystitis is an inflammatory process in the bladder.

Urethritis is an inflammation of the tissues of the urethra.

Cervicitis and inflammation of the appendages (salpingitis, chronic endometritis).

Adhesive disease in the pelvis develops after a previous chronic or acute inflammation in the abdominal cavity.

Body conditions and non-communicable diseases:

Injuries, postpartum tears and postoperative sutures.

Insufficient lubrication - in young women it is caused by the inactivity of the excitation phase, in women in menopause - a lack of estrogens.

Venous congestion - is formed with complete abstinence from sex or irregular intimate contacts, when blood stagnates in the vessels of the pelvic organs.

Retroversion of the uterus (posterior deviation, bending of the uterus) - an abnormal location of the uterus in relation to the rest of the pelvic organs.

Vaginal atrophy - observed most often during menopause after menstruation stops, is a dryness of the vaginal mucosa against the background of a constant lack of sex hormones estrogen.

Cysts and fibroids are malignant and benign tumors localized on the reproductive organs in the pelvis.

The weakening of the tone of the lower part of the pelvis - leads to the prolapse of the uterus.

Size discrepancy or anatomical incompatibility is a rather rare occurrence, because the vagina is well extensible, and in addition to clinical gigantism in a man, pain during sex with normal lubrication in a woman should not be disturbed by size discrepancies.

How does dyspareunia manifest?

Dyspareunia can manifest itself before the onset of sexual intercourse, at the time of the first penetration of the male member into the vagina and its translational movements, and also after the completion of sexual intercourse. Depending on the individual characteristics of each woman, pain can take on various forms: sharp or acute pain, tingling, discomfort, sometimes burning.

Chronic pain of moderate and low intensity is characteristic of diseases of non-infectious origin. If during intercourse there is a sharp pain, this may indicate a pathology of the uterus, appendages and ovaries of an acute inflammatory nature.

When psychological factors become the cause of painful sensations, pains can have different intensity and localization, and also disappear without a trace when a sexual partner or situation changes.

Superficial pain at the entrance

The occurrence of pain at the beginning of sex can be a complication of various diseases of the lips and vestibule, and can be combined with insufficient arousal or hydration and vaginismus. Also, if pain is observed at the beginning of sexual intercourse, this may indicate the development of fungal or bacterial vaginitis, mucosal atrophy, vulvodia or vulvar dystrophy that has arisen against the background of genital herpes. On a gynecological examination, the doctor may notice ulcers and cracks in the vestibule of the vagina. After successful treatment of an infectious disease in the presence of herpetic eruptions, the pain is eliminated. Pain on palpation along the urethra and Bladder indicates urethritis of various origins.

deep pain

Deep pain during sexual contact is described by women as "like something is being driven inside." The most common cause of them is adhesions, stagnation of blood in the small pelvis, endometriosis, less often endometritis and inflammation of the appendages, even less often retroversion (abnormal location) of the uterus and weakening of the tone of the pelvic floor.

Diseases of the urinary system, in addition to the main symptoms (pain, pain and burning during urination), are complemented by pain during sex.

The same applies to bowel diseases - inflammation of the colon, irritable bowel syndrome, etc. tend to be accompanied by pain during intimacy.

In menopausal women, dryness in the vagina, insufficient excitation phase and atrophic changes make it difficult to move the penis, causing pain inside and at the entrance. Thus, the vaginal cavity does not lengthen or expand in response to arousal, painful sensations intensify and become very strong with pressure from the penis on the cervix or certain postures.

Depending on the location of the pain, it can be provoked by the following reasons:

At the entrance to the vagina	deep pain	And at the entrance, and deep pain
Lack of hydration and arousal Vulvar vestibulitis Colpitis (vaginitis) vaginismus Vulvodynia Urethritis	Chronic cervicitis Venous stasis of blood in the pelvis Retroversion of the uterus Pathology of the urethra and appendages Endometritis and inflammatory processes in the pelvis endometriosis Adhesions in the pelvis	Sjögren's syndrome Vaginal dryness (vaginal atrophy) Insufficient lubrication After surgery, trauma and childbirth

Pain during intercourse after pregnancy

The nature of the origin of postpartum pain remains unclear. According to one study, pain in 40% of patients was non-localized, 45% of women had pain at the entrance, at the suturing of the gaps. Moreover, based on the complaints of the patients, they did not depend on whether it was the first childbirth or not. Six months after childbirth, non-localized pains are eliminated, in some cases, pain persists for a year.

Psychological causes of pain

In addition to gynecological diseases that contribute to the development of dyspareunia, this process can also occur at a subconscious level, when for some reason psychological reasons the woman refuses to have sexual intercourse.

Fear of sexual intercourse

A common cause of pain is defloration, characterized by a feeling of fear of intimacy. With defloration, pain occurs due to an anguish hymen at the first intercourse. The cause of this violation can be fear of a partner, fear of pregnancy, cruelty on the part of a partner, lack of love and other factors that prevent a woman from relaxing. In many ways, the state of a woman during sexual intercourse depends on the behavior of her partner, but she can only overcome the fear of defloration herself. If you cannot do this on your own, it is recommended to contact a professional psychologist or sexologist for help.

vaginismus

The cause of pain can also be vaginismus - a condition that is often observed in the complication of defloration, when a woman cannot overcome her fears associated with an unsuccessful sexual experience for a long period of time. With vaginismus, there is an uncontrolled and involuntary, sharp, painful spasm of the muscles of the vagina, which makes it impossible to complete a full sexual intercourse.

Pain during pregnancy with intimacy

Some women experience pain during sex during pregnancy. This condition most often occurs at the level of the subcortical centers of the brain. A woman has a fear that the penetration of the penis into the vagina will lead to pregnancy complications or harm the fetus. Most doctors believe that dyspareunia is a condition characteristic of gynecological diseases and is not directly related to pregnancy.

Uncertainty in one's sexuality and in oneself, an inferiority complex

Often a tendency to be overweight, figure flaws and other physical defects lead to a woman's complexes. She has thoughts about her unattractiveness and not sexuality in the eyes of a partner. Of course, this has a characteristic effect on a woman's sexual life, can cause an inferior phase of arousal and pain during sexual contact.

Diagnostic methods

You can determine the causes of dyspareunia at an appointment with a psychotherapist, sexologist, urologist or gynecologist. At the first stage of diagnosis, the specialist collects the patient's history, in which the woman describes the main symptoms, complaints and conditions for the onset of pain. Suspecting the presence of gynecological diseases in the patient, she can be sent for diagnostic and laboratory tests:

Detailed or general clinical analyzes of urine and blood.

Research using ultrasound of the pelvic organs.

Screening for infections, including those transmitted through sexual contact without barrier contraception.

Based on the examinations, the doctor will be able to refute or confirm the organic nature of dyspareunia associated with a particular disease. If the cause of the disease state cannot be found, it means that we are talking about its psychological origin.

Differentiation of disorders, the development of which causes pain during sex:

Diagnosis	Symptoms	Causes	Research data	Assessment of the way forward
Dyspareunia of unknown origin	Deep pain or pain at the start of sex	Unknown	There were no signs of other disorders	Psychological examination required
Pain in the vulva (vulvodynia)	Complaints about irritation on entry, burning, lack of benefit from treatment, pain while sitting and cycling (when pressing on the vulva)	Irritants, infections, or pain of unknown origin	Erythema on the skin or no changes, pain on palpation. In the presence of pigmentation, ulcers or nodules, you need to look for another pathology	A thorough examination, colposcopy, biopsy of suspicious areas, application of acetic acid to open areas
Vulvar vestibulitis (a type of vulvodynia)	Dull aching pain, itching, burning, inflammation of the vestibular region of the vulva, pain at the entrance	Unknown	Flat erythema without ulcers, with blurred or clear edges, sharp pains are observed when touched with a cotton swab
vaginismus	Difficulty inserting a tampon, finger, penis, pain at the entrance, muscle spasm at the entrance to the vagina	Unknown, muscle reflex or psychological causes	On palpation, there is vaginal spasm, difficulty inserting a speculum	Important physical and psychological examination, patient history
tissue atrophy, violation of natural moisture during arousal	Difficulty and pain when inserting the penis, friction, irritation, vaginal dryness	Stretching and a decrease in the secreted natural lubrication of the vagina, estrogen deficiency, problems with the onset of arousal surgical intervention	During examination, special attention is paid to the integrity of the mucosa, the fullness of the labia, the presence of cracks, the identification of the level of ease of injury to the mucosa, the presence of pubic alopecia	Discuss the meaning of foreplay, sensations during arousal
Adhesions, endometriosis of the uterus	Deep pain, painful sensations of menstruation origin	With adhesions, the causes are infectious diseases, surgery, with endometriosis - the causes are unclear	The uterus and appendages are inactive, the presence of nodules is observed	Laparoscopy
Diseases of the uterine appendages	Deep pain, often localized only to the left or right	ovarian cyst, genital infections	Appendages painful, enlarged, inactive	Laparoscopy
Abnormal placement of the uterus, weakening of the tone pelvic floor, uterine fibroids	deep pain	Special anatomical placement of the uterus	Prolapse or enlargement of the uterus	Try to change positions during intercourse (posture - woman on top)
venous congestion	Deep pain, pain after sexual contact in the pelvis	Unknown, in women suffering from varicose veins veins, the risk of congestion is increased	Without features	According to the characteristics of pain
Interstitial cystitis, urethritis, cystitis	Feeling of pressure over the pubis, increased urge to urinate	Unclear etiology and infections	Pain on palpation of the urethra and bladder	Urinalysis, Urine culture tank
Chronic cervicitis, pelvic inflammatory disease, endometritis	deep pain	infections	Pain when the cervix is displaced, the cervix is easily injured, the uterus is painful, the presence of discharge	Laparoscopy, colposcopy, infection tests, bacterial culture

Treatment of dyspareunia

Treatment of discomfort and pain during sexual intercourse is determined depending on the causes that provoked their occurrence. If the cause of dyspareunia lies in inflammatory processes, medication is prescribed to eliminate the focus of the disease. In diseases such as a cyst or ovarian fibroids, endometriosis is often prescribed surgery. Dyspareunia, which occurs at the psychological level, is treated at the consultations of a psychologist or sexologist.

You can not ignore the systematically repeated painful sexual intercourse, and it is not recommended to self-medicate. Only an experienced and qualified doctor will be able to find the cause of pain during sexual intercourse, conduct effective treatment and give a woman effective recommendations to return to a comfortable and fulfilling sexual life.

Referring to the huge variety and number of reasons that contribute to the development of dyspareunia, every woman should understand that this condition cannot be triggered and wait for the pain during intimacy to go away on its own. The sooner a woman turns to a doctor for help, the more effective it will be to eliminate the factor that caused this pathological condition and the faster the treatment will be completed.

Our whole body is designed in such a way as to bring us joy and pleasure. Sexual relations between spouses are no exception. This is an opportunity to express each other all your tenderness and love. But what if a woman experiences constant pain during intercourse? If serious attention is not paid to this issue, then these unpleasant sensations can develop into a reflex and, thus, create problems in the relationship of the spouses.

If you do not pay attention to your health in time and continue to be embarrassed to talk with a doctor about the pain that occurs during intimate intercourse, then gradually the brain will begin to perceive such relationships as a command for pain. The result is a vicious circle. When the cause is finally identified and, if possible, removed, the woman will, out of habit, experience pain instead of pleasure. So what are the reasons intimacy can cause pain in a woman?

Defloration

Defloration is otherwise known as deflowering. The girl is very worried and is afraid of the first intimate relationship. This causes spasms of the muscles of the body, especially the vagina. Which is what actually causes pain.

The hymen itself is thin and elastic. It is so arranged that during the first sexual intercourse it stretches smoothly and is not the real cause of pain or bleeding. In very rare cases, the hymen is dense and with many nerve endings. When a girl is tense and experiences strong excitement and even fear of the first sexual intercourse, her muscles tense up, painful sensations appear, and bleeding may even occur.

vaginismus

This is a little known, but very common disease. What is it connected with? If a woman has experienced sexual abuse to one degree or another or she was brought up in such a way that any sexual relationship is a great evil, then during sexual contact, a spasm of the muscles of her vagina can reflexively occur, which will lead to severe pain.

Pain during penetration does not occur due to the object, but due to severe emotional stress. This often happens at a gynecological appointment: due to tension, the muscles of the genital tract become very tense, and as a result, it is either very difficult or completely impossible to insert a gynecological speculum.

In both situations, the cause of pain is precisely the spasm caused by the strong emotional stress of the woman, her fear. In order to cope with this disease, it is necessary to seek help from a sexologist and a psychologist as soon as possible. If the disease is not started, then the treatment will give fairly quick and good results.

Inflammatory processes

If during intercourse and not only a woman experiences sensations such as burning, itching or pain (even if after a long pause), then you should immediately contact your gynecologist. These are signs of the presence of inflammatory processes in the genitals of a woman. And both spouses need to see a doctor. The gynecologist will prescribe the necessary examination, during which he will be able to establish the cause of such unpleasant sensations and prescribe treatment.
While treatment is being carried out, it is better for spouses to abstain from sexual relations, or use a condom. In addition, the presence of inflammatory processes does not always mean cheating on a spouse.

Often, itching and burning can be the result of the penetration of one's own microflora into an environment that is unnatural for it (for example, E. coli, fungi or staphylococci, etc.). In their own habitat, they are completely safe. But if for some reason this microflora has got into a new environment for itself, it begins to multiply intensively and cause a lot of inconvenience. If treatment is not started on time, such processes can lead to serious complications, including cervical cancer.

Adhesive processes

If during an intimate relationship a woman experiences pain in the lower abdomen, this indicates the presence of adhesions in the pelvic organs. If various inflammatory processes were previously transferred, then the risk of adhesions in these organs is very high. The presence of periodic pain in a woman may also indicate their presence.

Medical studies have shown that in almost the vast majority of women in the pelvic organs there may be adhesions of varying severity. However, for most women, these spikes do not even make themselves felt. However, during intercourse in some positions, they can manifest as severe pain in the lower abdomen. This cannot be ignored.

It is imperative to visit a doctor so that appropriate treatment is prescribed. Very often it is physiotherapy procedures that are most effective. But in severe cases, surgical intervention is required. In addition, sexual intercourse during the first year after childbirth can also cause pain in the lower abdomen in a woman. This is due to the presence of postpartum injuries, tears and sutures.

endometriosis

If during intercourse a woman very often experiences pain in the lower abdomen, spotting occurs, and during menstruation a woman experiences severe pain, then this may be endometriosis. With such a disease, the mucous membrane of the uterus grows beyond its borders and on various organs. If this disease is not treated, sexual relations will become completely impossible due to constant severe pain, and this benign tumor can degenerate into a malignant one.

Venous congestion

If a woman experiences aching pain during intercourse in the lower abdomen, radiating to the spine, during menstruation and during intimate relationships, then this is a sign of venous stasis of blood in the pelvic area. This disease can be caused by various factors: past inflammatory processes, birth trauma, constant lack of orgasm during intercourse, sedentary image life or big physical exercise. All this leads to weakening of the pelvic muscles and varicose veins.

If this disease is left unattended, the pain will gradually increase, and subsequently diseases such as uterine fibroids, endometriosis, mastopathy, etc. may develop. To prevent this disease, you need to contact your gynecologist as soon as possible. He can prescribe various physiotherapy procedures, recommend special exercises that strengthen the muscles and veins in the pelvic area.

Neuralgia of the pelvic nerves

This disease gives itself out as a severe sharp pain in the lower abdomen, which becomes even stronger during intercourse and gives to the leg. It is extremely rare and little studied. More often we encounter neuralgia of the facial and intercostal nerves. But such a phenomenon takes place, therefore medical intervention is mandatory.

With neglected neuralgia of the pelvic nerves, a woman experiences constant and very severe pain, even at rest. Therefore, it is better not to bring yourself to such torment, but to consult a doctor. As a rule, various physiotherapy procedures, warming up, etc. are prescribed.

Insufficient amount of lubricant

In order for an intimate relationship to give pleasure to a woman, her body must secrete a sufficient amount of lubrication. If this does not happen, then sexual intercourse, instead of pleasant sensations, will only cause pain. But this problem is fixable. Contacting your gynecologist will help identify the cause of the lubrication deficiency and eliminate it. You can also use special intimate cream-gels called lubricants. Such gels contribute to good hydration of the female genital tract and protect the mucous membrane. Lubricants are purchased in pharmacies.

What can't hurt

The above reasons are very, very serious. They cannot be ignored. It is necessary to take action as soon as possible and seek medical help. But what can prevent you from seeing the truth in the eye? These are various myths about the causes of pain during sexual intercourse. Below are the most common variants of such speculation and their exposure.

Cervical erosion.

Cervical erosion is ulcers on the cervix, which are reddened and in some cases begin to bleed when touched. As a rule, erosion is detected only during a gynecological examination. Pain sensations and brown discharge can appear only in the presence of already very neglected erosion. In any case, with the appearance of pain in the lower abdomen during intercourse, it is necessary to contact a gynecologist and a sexologist as soon as possible.

Anatomical incompatibility of partners.

Anatomical incompatibility is the incompatibility of the sexual organs of partners. This is a very rare occurrence, occurring in only 1% of women. Basically, the tissues of the genital tract are very elastic, and the size of the penis in no way can be the cause of pain. Therefore, when they occur, it is better to avoid fantasies and consult a doctor.

Summarizing

To sum up the above discussion, we should not take lightly the pain signals that our body gives us. It is always either physical or psychological problems that require prompt intervention by a specialist. It is better to detect and prevent the disease in the early stages than to deal with various complications for a long, expensive and exhausting time.

Regular visits to the gynecologist in itself helps a woman to monitor her health. But if various gynecological problems are identified, then three factors play a huge role in their resolution: the treatment of the disease itself, the restoration of psychological balance and the loving support of a life partner.

A happy marriage cannot be without mutual trust. Therefore, it is very important for spouses to be extremely frank with each other, especially in such delicate matters. This requires effort on the part of both spouses, but family happiness is worth it. In addition, such a trusting relationship helps to overcome even very serious diseases.

Stories from our readers

Pain during intercourse is a problem that both beginners and experienced women face. They don’t always guess to go to the doctor with this complaint - the first believe that at the beginning this is the norm (but how long can the onset last?), the second analyze that this didn’t happen with a past partner, so it’s a man or incompatibility "- and as a result, everyone experiences their feelings literally within themselves, without receiving help.After a while, the body gets used to pain as a given and begins to wait for it in advance - a conditioned reflex is fixed - a woman begins to be afraid and avoid intimacy or experience pain even when the cause eliminated, and the doctors tell her - "nothing should hurt" - but she remembers that in this situation it hurt - and the body gives out the expected sensation from the archives of memory. Therefore, it is not necessary to delay, endure, heroize with pain, this “health watchdog”, as academician I.P. Pavlov called it, should make you immediately consult a doctor and find out the reason.

Causes of pain during intercourse (in chronological order during a woman's life):

1. Defloration. main reason- fear. It causes all the muscles of the body to contract, especially the muscles of the vagina. There are cases when the hymen is thick and richly supplied with nerve endings, but most often it is elastic and extensible, at first proximity it does not tear, but stretches, and does not cause sharp pain (therefore, the absence of bleeding during defloration is rather the norm than pathology). So the main pain sensations arise from fear. Only you can overcome it yourself, if you know what is happening to you, trust your first man, know for sure that you are reliably protected from unwanted pregnancy and infection. For the first time, you need to protect yourself with a condom - foreign microbes, normal for one organism (men), entering a new organism (female), cause an inflammatory reaction in it - inflammation of the vagina (colpitis) and bladder (cystitis) - the most common complication of defloration. To relax and help prevent spasm, a warm, familiar, calm environment, a warm bubble bath, a glass of relaxing wine / champagne, trust in a partner (fear is often caused not only by the unknown, but also by the fear of seeming not the way he would like), sufficient foreplay and receiving pleasure girl before the sexual intercourse itself. But the main cure for fear, which binds the muscles and causes pain, is love. In women who have lost their virginity out of love, and not out of curiosity or because the age / partner / situation has come up, everything happens in appropriate conditions, without haste, unnecessary nervousness, gently and painlessly.

2. Vaginismus. If intimacy (the first in life or the first with a specific partner or there was rape) was unsuccessful, the fear of it can gain a foothold in the subconscious and cause muscle spasm in advance, making sexual intercourse impossible. The pain does not arise from the penetration of the penis, but from the compression of one's own muscles (the same pain sometimes occurs during a gynecological examination - fear of the situation causes the muscles to contract so that modern plastic speculums break :). When a woman trusts a gynecologist and relaxes, everything happens painlessly. There is only one mechanism - the pain does not arise from a foreign body in this case, but from a spasm of one's own muscles - i.e. and in this case you need to treat yourself, change your attitude to the issue, find partners, trust in which will allow you to relax. Vaginismus, which the woman herself cannot cope with, requires treatment by a psychotherapist and a sex therapist.

3. The integrity of the hymen. Proximity is not the first for a long time, but it hurts like the first time. True, it passes in the process, but at the beginning it is always unpleasant. As a rule, the hymen does not tear at the beginning, but only stretches or tears a little, but remains. Sometimes virginity in the anatomical sense is violated for the first time only in the process of childbirth. And before that, some discomfort? At the entrance "at the beginning of sexual intercourse remains. With an understanding of the situation, a sufficient amount of lubrication and gentle treatment of the partner, this problem is easily solved.

4. Inflammation. If discomfort (pain, burning, itching, friction, feeling of dryness) occurs in the vagina during intercourse or immediately after, the cause is most likely an inflammatory process. You need to go to the doctor and get tested for infections. Sexual life at this time should be limited and carried out only under the protection of a condom. To be treated for what they find, it will be necessary for the two of them to use the same drugs at the same time, protecting themselves with a condom during treatment, regardless of the results of the analysis of the man. Routine tests in men rarely reveal an infection, the main focus of which is in the prostate gland, so you either need to do bakposev after provocation and prostate massage, or not examine anything, but simply treat both, based on the rule that the microbes of partners are always the same. Inflammation is not necessarily caused by pathogens, sexually transmitted diseases, ie. it is not necessary to immediately blame the partner for treason if inflammation is suspected: most often inflammation is caused by the normal flora of the human body: fungi, E. coli, staphylococcus and other normal microorganisms. It's just that when they get into a "foreign" environment (into the female genital tract from the male or from the skin, from the intestines, mouth, etc.) and an insufficient level of protection (? reduced immunity, "menstruation, pregnancy), they begin to multiply and cause inflammation . They just need to be treated competently, and not to look for someone to blame.

5. Spikes. The result of previous inflammation of the appendages or intestines. If you have ever had periodic aching pains in the lower abdomen during hypothermia or episodes of delayed or loose stools or bowel disease in childhood, then you have the right to have an adhesive process in the small pelvis. If you have never had such complaints, he also has the right to be, because the inflammation could be asymptomatic. Most adult women have spikes, and for many they do not bother or cause harm. For some, they hurt when stretched v when examined on a gynecological chair and during intimacy - while the pain, unlike the above cases, is in the depths of the abdomen and depends on the posture and aggressiveness of the act. In most cases, the selection of comfortable postures saves if the pain persists constantly and worries outside of sexual life - it is necessary to treat a chronic inflammatory process - including with the help of physiotherapy.

6. Injuries, ruptures, stitches after childbirth and operations. The solution to the problem can be surgical or not: the use of lubricants, the development of the muscles of the pelvic floor, the selection of postures and pace.

7. Endometriosis. This diagnosis is often made by women themselves on the basis of spotting before or after menstruation. However, the main symptom of endometriosis is pain that appears or increases before menstruation and passes with it. If these discharges are painless, it is not endometriosis. If they are painful + there is pain during sexual activity and during bowel movements on the eve of menstruation, these may be signs of endometriosis. Pain during intimacy is also felt inside and is strong enough to make sexual life impossible or painful at this time of the cycle.

8. Venous congestion. Irregular sex life, insufficient satisfaction, abstinence, dissatisfaction with relationships - as a result, blood rushes to the organs, but there is no proper outflow. At first it is a feeling of heaviness, dissatisfaction, pulling pain after intercourse without sufficient discharge. Over time, the only cure - regular sex life with satisfaction becomes not a deliverance, but, on the contrary, an aggravating factor: the edematous walls of the vagina hurt from the sexual intercourse itself, there is a sharp pain during proximity. This condition is not only unpleasant - it is also dangerous: it is a predisposing factor in the development of many gynecological diseases: uterine fibroids, endometriosis, mastopathy, ovarian dysfunction, etc. Try not to bring the emerging dissatisfaction to anatomical changes: learn to please yourself and teach this partner: You will bring joy to yourself and to him, while maintaining a healthy body and healthy relationships in the family. The main treatment by the doctor is physiotherapy and gynecological massage - in fact, a surrogate for sexual intercourse - so it is more pleasant to cure yourself of venous stasis at home with the help of your beloved man and toys from the sex shop. Women with varicose veins of the legs are particularly predisposed to this cause of pain.

9. Neuralgia of the pelvic nerves. Pain along the walls of the pelvis, aggravated by touch (sexual intercourse, examination on a chair, ultrasound with a vaginal probe), often sharp, shooting, radiating to the leg. Neuralgia happens anywhere: facial, intercostal - there is pelvic neuralgia: the nerve can become inflamed from hypothermia, from a present infection, from stress. It is treated in the same way as other neuralgia: pepper plaster, warming ointments, physiotherapy.

10. Insufficient release of lubrication. Could be a consequence psychological state(unwillingness of intimacy, subconscious rejection of a partner - sometimes a woman does not realize this consciously, and then the body hints to her in this way; fear of becoming pregnant), removal of the Bartholin gland that secretes lubricant (its inflammation is bartholinitis, transferred earlier) or hormonal disorders (postpartum period, taking hormonal contraceptives, menopause). With hormonal disorders that require correction, taking drugs of female sex hormones helps, if they are not contraindicated. In other cases, in the process of disassembling with your I, you need to use artificial moisturizers (lubricants) - special intimate gels sold in pharmacies and intimate shops, for example, Montavit gel.

Pain in the process of sexual intimacy is a fairly common problem that worries the female half in most cases, affecting any age range of the life cycle. Many do not pay due attention to the warning signs, determining the insignificance of their manifestation and hoping for a quick and favorable outcome of the anxiety that has arisen.

The mechanism of pain formation during sexual intercourse is the development characteristic feature with the introduction of the penis into the lumen of the vagina at the initial stages or with deeper penetration and subsequent jerky movements. Various factors can contribute to the occurrence of pain, which include not only organic manifestations in the change in the physiological parameters of the female body, but also psychological disorders.

Pain during intercourse: causes

Photo: Pain during intercourse

Identification of the true cause of the development of a pain symptom requires a more in-depth study of the problem and the establishment of the degree of excitation of the female body before sexual intercourse. Insufficient preparation for the rendezvous process may occur at the following points:

instability of relations with one partner;
existing conflict of reciprocity;
not using techniques and techniques of pre-excitation.

In such a situation, the psychological factors of pain formation are very quickly triggered in the absence of sufficient hydration of the vaginal mucosa, and with the constant repetition of the use of inadequate techniques of mutual caresses and games, this is an expected factor in sexual intimacy.

Characteristics of pathological changes

During sexual intercourse, it can be a sign of various forms of pathological disorders affecting any anatomical region of the female genital area, and at the same time having various causes underlying the disease. The main group of pathological conditions of the infectious plan, causing the development of a pain symptom, include:

Endometriosis. Represents a pathological proliferation of the mucous tissue of the uterus with their possible appearance in its internal tissues, affecting the muscular or serous layer, as well as nearby organs, namely in the ovaries, abdominal surface, walls of internal structures.
Adhesive process that affects organs located in the retroperitoneal space. Pathology is formed after the transferred form of an acute inflammatory process, manifested by the occurrence of pain in women during intercourse.
Vaginitis. Refers to an inflammatory process that develops when a pathogenic pathogen enters the body, which includes the entire group of infections transmitted through sexual intercourse. In addition, the disease can develop with hormonal instability of the female body.
cystitis, . The pathological process of inflammation affects the urinary organ and the channel for removing fluid from the body.
Chronic form of salpingitis, cervicitis, endometritis. It characterizes the sluggish process of inflammation with periodic manifestation of the stages of its exacerbation, which are determined by the typical symptoms of the disease.

Organ disorders

The following conditions that provoke the development of pain during intercourse in women are classified as non-infectious characteristics of the disorder:

The frequent suggestion of size incompatibility in partners should be pointed out, which can cause pain during intercourse. This is a very rare condition, since the walls of the vagina are extremely elastic and, with a sufficient phase of female arousal, accommodate the available dimensions of the partner. An exception to this rule can only be the manifestation of clinical signs of gigantism in a man.

Pain manifestation parameters

The formation of a disturbing symptom in the process of sexual intimacy can manifest itself in the following cases:

directly when the penis is immersed in the vaginal space;
at the first sexual intimacy;
during motor activity;
after the process is completed.

Why after intercourse pain? The sensations that arise are perceived by each woman differently, taking into account the intensity of their severity. Signs can have the following types of manifestation, characterizing the presence of pain symptoms:

tingling;
discomfort;
a sharp attack of pain or pulling sensations.

The presence of constant pain of low intensity is characteristic of non-infectious disorders. Development severe pain after intercourse indicates the pathology of the structures of the genital area of an acute inflammatory form, requiring a comprehensive diagnostic examination. If psychological factors have become the cause of the development of pain discomfort, then the symptom may have a different distribution and disappear spontaneously when a partner or environment changes.

The structure of the localization of sensations

Most often, the manifestation of pain at the beginning of sexual intercourse is associated with the development of complications of various pathological disorders, such as an infectious lesion of the vestibule and lips, desiccation of the mucosa, vaginismus, etc. In the process of diagnosis, the specialist visually determines the presence of a deformation lesion of the tissues of the genital area. On palpation of the urinary organ and the presence of pain during urination after intercourse indicates the development of urethritis, to establish the specifics of the course of which, an additional laboratory examination is carried out.

Internal pain in the lower abdomen during intercourse is a consequence of current pathological disorders, namely:

adhesions, endometriosis, congestion;
less often the inflammatory process and weak muscle tone;
pathologies of the urinary tract, when against the background of frequent emptying of the urinary organ, burning and cramps in the urethra, pain symptoms are observed during sex;
diseases intestinal tract, defining a localized inflammatory process that may be accompanied by pain in the abdomen during intercourse.

Psychological aspects of the appearance of pain

The occurrence of pain discomfort during sexual intercourse can also develop at a subconscious level, affecting the psychological sphere of perception of the female body. Depending on the level of intensity of their manifestation, a woman may intuitively refuse sexual contact. These parameters include the following characteristics:

Feeling afraid of sexual intimacy. It occurs at the beginning of sexual life, forming a sensation of pain during the first sexual intercourse, which is provoked by a rupture of the virgin vaginal septum.

The reasons for the development of fear can be the incompetence of a partner in the technique of sexual intimacy, fear of unplanned conception, lack of mutual love and other factors that do not allow a woman to mentally relax and get the required level of pleasure. It is necessary to overcome the threshold of fear on your own, in case of no effect and recurrence of signs of pain, it is recommended to seek advice from a specialized specialist.

Photo: Pain during intercourse

A sharp, spontaneous spastic contraction of the muscular layer of the vagina, which is called vaginismus, is based on already existing fears of past experiences of sexual intimacy. The development of the condition causes pain and does not allow to fully complete the process.
Uncertainty and failure, when a woman, concentrating on her own shortcomings, spontaneously develops a fear of sexual intimacy. This condition does not allow to achieve the required level of excitation and contributes to a more intense perception of pain.

Methods for identifying the causes of pathology and the principle of treatment

The consultation of such specialized specialists as a gynecologist, urologist, psychotherapist, sexologist will help to identify the basis for the development of pain in the lower abdomen after intercourse. As an additional examination confirming the established diagnosis, the following methods are used:

laboratory diagnostics;
ultrasound and tomographic examination of the genital organs;
identification of infectious carriage with identification of the nature of the existing pathogen or confirmation of the level of purity of the microflora.
Natural remedy Uretramol, based on natural ingredients, juniper and oak bark, perfectly copes with all male problems, we recommend for use.

Treatment of abdominal pain that occurs after or during intercourse depends on the established causes that contribute to their appearance. With the current process of inflammation of an acute or chronic plan, a spectrum of drug exposure is prescribed, which completely eliminates the focus of the pathological disorder. In some cases, such as endometriosis, fibroids or cystic tissue growths, surgery is also used.

An interesting video about the psychological factors of pain during intercourse

Psychological adjustment of the patient's condition is carried out independently or in the process of counseling with a psychotherapist. In any case, the pain that occurs after sexual intercourse should not be left to chance. Only a competent examination with the establishment of the true causes of its development will help to quickly and effectively eliminate disturbing manifestations, which will naturally restore the fullness and comfort of sexual intimacy.

Given the multiplicity and multidirectionality of the causes of the development of pain discomfort, it is necessary to remember and appreciate your own health, while not expecting a successful self-expiration of the process. Than in more early period the cause of the development of pain is identified, the faster it will be eliminated along with the provoking factor that caused the development of the pathological disorder.

What diseases can be indicated by pain and discomfort during sexual intercourse, in which case is this considered the norm, and in which case can it be a consequence of a psychological trauma of the past? We talk about this and much more with an obstetrician-gynecologist.

Lana Zhukovskaya
obstetrician-gynecologist of the 1st City Clinical Hospital
Postgraduate student of the Department of Obstetrics and Gynecology, Belarusian State Medical University

In this matter, it is very important to distinguish the physical causes of pain from psychological ones (because pain during intercourse can be the result of psycho-traumatic factors), as well as from vaginismus (when uncontrolled and excessive contraction of the vaginal muscles is observed during intercourse, usually associated with a aggravated anamnesis - with previous psychological trauma).

In other cases, we should talk about dyspareunia - discomfort during intercourse or soreness in the genital area and small pelvis during sex. Moreover, dyspareunia can occur in both men and women. But we're talking about women.

Causes of pain during intercourse

Causes of pain can vary, and assumptions need to be made depending on the location of the pain.

If pain is localized in the area of the entrance to the vagina , then most often the reasons can be:

inflammatory processes in the vagina (vulvovaginitis, colpitis);
excessive dryness in the vagina, which is most often associated with hormonal disorders or with age-related changes, when the estrogen content is reduced;
condition after reconstructive (plastic) operations on the vagina: restoration of the walls, hymen, etc.;
condition after childbirth, if there were tears and suturing.

Treatment in each case is etiotropic, i.e. aimed at eliminating the cause, - explains the gynecologist. - If the cause of discomfort is an infection, it is necessary to be tested for STIs together with a sexual partner and conduct a full course of treatment. If the discomfort is caused by hormonal disorders in adulthood, it is recommended to use lubricants (“lubricants”) during intercourse in order to avoid microtrauma of the vagina. If the cause is hormonal disorders in reproductive age- It is necessary to undergo an examination and normalize the hormonal status.

When it comes to "deep" pain during intercourse , closer to the vaults of the vagina, to the cervix, then the causes of pain may be as follows:

inflammatory diseases of the pelvic organs (inflammation of the ovaries and / or fallopian tubes);
the presence of ovarian cysts from 3-4 cm or more;
the presence of a myoma large sizes;
the presence of endometrial lesions;
adhesive process of the pelvic organs with its significant severity.

It is worth noting that pain in the pelvic area during intercourse is not always associated only with diseases of the female genital organs, sometimes its cause lies in diseases of the genitourinary system, for example, it is caused by cystitis (most often interstitial). Also, pain can be associated with bowel diseases, such as Crohn's disease, "irritable bowel syndrome."

According to the gynecologist, there is a case when moderate discomfort during intercourse is normal. This is the period of ovulation. Due to the fact that during the release of the dominant follicle, the ovary membrane is torn and a certain amount of fluid enters the abdominal cavity, women, even without sexual intercourse, may experience pain in the lower abdomen in the middle of the cycle. Sexual intercourse can strengthen it somewhat, but this will not indicate pathology.

Also, sometimes there are situations in which pain during intercourse is due to the physiological characteristics of the genital organs of partners. In such cases, it is recommended to choose the most sparing positions in which the woman regulates the process in order to reduce the risk of injury and eliminate the occurrence of pain during sex.

Separately, I would like to note that it is very important to pay attention to the presence of contact spotting after intercourse. If they are, you should consult a doctor and check the condition of the cervix.

Bloody discharge after sexual intercourse may be the result of inflammatory changes in the cervix, erosion, a cervical canal polyp and a malignant tumor of the cervix. However, sometimes such contact discharge can be associated with excessively active sexual intercourse, when the vaginal walls are traumatized and microtraumas (abrasions, mucosal tears) form. But at the same time, visiting a specialist will still not be superfluous, because. the presence of such injuries can serve as a background for the development of infection.

Pain during intercourse as a result of psychological trauma

There are situations when a woman complains of discomfort or pain during intercourse, but an examination by doctors shows that everything is in order with her. In this case, we can say that, most likely, the woman had a traumatic experience in the past. And it doesn't have to be rape or attempted rape. For example, the reason may be a previous relationship with a partner, which for some reason did not work out and still causes psychological pain to a woman, and sexual intercourse causes negative associations. The atmosphere in which the girl was brought up by her parents is also important: if sex has always been associated with something shameful and unacceptable, the first years of sexual life can be difficult due to the fact that it is difficult for a woman to accept her body and accept sexual life as an absolutely normal process, not associated with shame and fear.

If there are psychological problems in relations with a real partner (lack of trust, unresolved conflicts), this can also cause discomfort during intercourse.

Also, the cause of psychological trauma may be the pain that took place earlier, on which the woman had a fixation. For example, there was a physical cause of the pain, which was eliminated, but the memory of it is so strong that the woman subconsciously expects and is afraid of the repetition of painful sensations, which is why she cannot relax. As a result, there is not enough natural lubrication of the vagina and relaxation of the muscles of the vagina, which complicates the process of sexual intercourse and causes discomfort to partners.

Women are embarrassed to talk about it

According to Lana, women rarely go to the gynecologist with complaints of pain during intercourse.

For some reason, we believe that it is shameful to discuss such issues even with a gynecologist. And if the conversation comes up about this, it often begins with the words of the patient, “Forgive me, there is such a situation ...”. Although personally I always try to explain that intimate life and women Health directly related, and there is nothing to be ashamed of.

Everything related to pain during intercourse, discomfort, inability to achieve orgasm - with these questions, you should safely go to the gynecologist. Because these complaints can prompt specialists to think about any disease. Very many of these complaints have a clear physical cause that can be eliminated.