Why Does it Hurt When I Have Sex?

Dyspareunia is the medical term for pain during sex. 

Painful intercourse in women can occur for several reasons: 

• You might suffer from endometriosis, a condition in which the lining of the uterus (endometrium) extends outside the uterus, and attaches to and irritates organs in your abdomen. Or adenomyosis where endometrial tissue grows into the muscular wall (myometrium) of the uterus.
• You may have adhesions (scar tissue) from a previous infection or surgery, which can form between the organs in your abdomen, or between the organs and the abdominal wall. Adhesions may trigger pain by causing organs to move away from their normal location or to become fixed (stuck) in an abnormal position.
• Inadequate vaginal lubrication causing dryness can contribute to sexual pain.  Common reasons for vaginal dryness can include conditions contributing to low estrogen levels (induced, surgical or natural menopause, after childbirth, or during the breastfeeding) or medications that are associated with lack of sexual arousal (antihypertensives, antidepressants, antihistamines, sedatives, and certain hormonal agents).
• Or you might have uterine fibroids or myomas, which are benign (non-cancerous) growths in the wall of your uterus.
• And you may even have an ovarian cyst, a fluid-filled sac that grows inside your ovary and that can cause pain.

Other less common causes of pain during intercourse include:

• trauma or surgery of the genital organs,
• infections or inflammation of the vulva, vagina, or pelvis
• vaginusmus (painful spasms of the muscles of the vagina)
• history of sexual abuse
• psychological conditions (depression, anxiety, relationship dynamics, stress)

Depending on what is causing your pain, there are several treatments, ranging from prescribing medication to keep endometriosis from growing or to shrink a fibroid -- to laparoscopic (minimally invasive) surgery to remove scar tissue or cysts.  A frank discussion with your medical provider will help to elucidate the causes and treatment options for dyspareunia.

Learn more -

The American Society for Reproductive Medicine has several resources to help you make the choice that is right for you: 

Start with the  ASRM Topic Index  where you can find information on:

•  Adhesions 
•  Endometriosis 
•  Fibroids 
•  Menopause 
•  Sexual Dysfunction 

ASRM has  Fact Sheets and Booklets  written with you in mind such as:

• Endometriosis 
• Endometriosis and Infertility: Can Surgery Help? 
• Endometriosis: Does It Cause Infertility? 
• Laparoscopy and Hysteroscopy 
• Managing Pelvic Pain 
• Minimally Invasive Surgery 
• Sexual Dysfunction and Infertility 

Or find out what your physician is reading:

ASRM Practice Guidelines, including:  

• "Endometriosis and infertility"
• "Removal of myomas in asymptomatic patients to improve infertility and/or reduce miscarriage rate"
• "Treatment of pelvic pain associated with endometriosis"