7 Causes and Treatments for Sexual Discomfort

If sex hurts, a woman can find it hard to get into the mood for intimacy, her partner feels frustrated, and no one's happy. Discomfort during intercourse isn't uncommon, and, fortunately, there are effective treatments that can help you get your sex life back on track.

7 Causes and Treatments

1. Vaginal dryness. As women get older and make less estrogen, dryness can result, says Bat Sheva Marcus, Ph.D., clinical director of the Medical Center for Female Sexuality in New York City. Being on birth control pills can also make the vagina feel dry, she says. To treat dryness, women may use a water-based lubricant. "Or they can get artificial estrogen for the vagina, which plumps up the vaginal mucosa," Marcus says.

2. Tightening of the vaginal muscles. "It's extremely common for the muscles to go into spasm," Marcus says. "It is possible to retrain the muscles to relax."

3. Dyspareunia. This is deep pain within the vagina, Marcus explains. Among the causes are infections or abnormal structures in the reproductive organs, though the pain  may also occur when a woman isn't completely aroused.  "The deep pain could be caused by a penis that is so long it bumps up against the vaginal canal, causing pain," Marcus says. Relaxation exercises can help, medications may be used to treat any underlying infection, and a water-based lubricant may be recommended during sexual intercourse.

4. Thinning of the vaginal walls and changes in the uterus. As women age, vaginal thinning definitely can cause pain on intercourse, says Lynn Anderson, PhD, ND, and an ACE-certified fitness instructor. "During menopause there tends to be a prolapse of the uterus," she says. "And this can cause pain." Treatment includes kegel exercises, she says, because these strengthen the walls of the uterus and vagina. Anderson also recommends eating foods that are rich in phyto estrogens, like dark greens and soy products. "They aren't the same as having an estrogen patch, but they can be helpful to keep estrogen flowing through the body," she says.

5. Vaginismus is a psychological condition that causes vaginal muscle spasms. It can result in great discomfort but relieved by a water-based vaginal lubricant.

6. Sexually Transmitted Diseases (STDs) can actually cause pain during intercourse, and since some of them are asymptomatic, a woman may not even be aware she has one, says Debra Laino, DHS, M.ED, MS. If you have multiple sexual partners, be sure to be screened for STDs, and make sure that your partner gets tested as well.

7. Poor body image. "If you have body image issues, chances are that you are in emotional discomfort, too," Laino says. "If you don't even want to look at yourself, it can be hard to find sex enjoyable." And if it's not enjoyable, it can even be painful.