Dyspareunia (Painful Intercourse)

You can help reduce or manage pain during sex with some simple home care tips, including:

• Applying an ice pack wrapped in a towel to the vulva after sex
• Setting aside a relaxing time for having sex
• Taking a warm bath to ease inflammation
• Trying sexual activities and positions that reduce pain
• Using an over-the-counter water- or silicone-based lubricant for vaginal dryness

Additionally, maintaining good genital hygiene, practicing safe sex and attending regular medical check-ups can prevent genital and urinary infections that contribute to painful intercourse.

Medications can treat underlying causes or help alleviate pain. Your provider may recommend:

• An alternative form of birth control, such as birth control pills, an implant, a patch or an intrauterine device
• Antibiotics, antivirals and antifungal medications to treat infections
• Antidepressants, which can treat psychological factors and can help reduce nerve pain
• Botulinum toxin injections, which can address pain in your pelvic floor muscles
• Hormone therapy which may help women with sexual dysfunction
• Medications for endometriosis
• Prescription topical estrogen creams or a drug called ospemifene to address dryness and other symptoms related to menopause
• Over-the-counter pain relievers or anti-inflammatories taken before intercourse

When sexual tension, a lack of arousal or trauma contribute to painful intercourse, you may benefit from counseling to overcome those causes.

• Cognitive behavioral therapy: Working with a mental health professional can help you address anxiety, depression and previous psychological trauma that contributes to your physical pain.
• Pelvic floor physical therapy: Your provider may recommend combining other therapies with this specialized physical therapy, which can help address tight pelvic floor muscles.
• Progressive desensitization: This type of guided therapy helps you become more comfortable with physical touch.

Usually, the last option for treatment, surgery, can help if other options no longer provide relief. Your provider may recommend surgery to correct pelvic organ abnormalities, treat endometriosis, remove uterine fibroids and address other underlying causes of your pain.