Painful Intercourse (Dyspareunia)

Painful intercourse, also known as dyspareunia, is more common than many women realize, but it is never something you should have to tolerate. Discomfort during or after sex can affect physical comfort, emotional wellbeing, and relationships. At Complete Care ObGyn, our Henderson OB/GYN team provides compassionate, confidential care to identify the cause of painful sex and help you find lasting relief.

If intimacy has become uncomfortable or painful, you are not alone, and effective treatment is available.

What Is Dyspareunia?

Dyspareunia refers to pain that occurs during or after vaginal intercourse. The pain can vary in intensity and may be:

• External (entry pain): Discomfort felt at the vaginal opening
• Internal (deep pain): Pain felt deeper in the pelvis during penetration
• Occasional or persistent
• Linked to specific positions or present every time

Understanding where and when the pain occurs helps guide diagnosis and treatment.

Common Causes of Painful Intercourse

Dyspareunia often has more than one contributing factor.

Physical causes may include:

• Vaginal dryness, especially during menopause or postpartum
• Hormonal changes related to perimenopause, breastfeeding, or certain medications
• Vaginal atrophy or thinning of vaginal tissues
• Endometriosis
• Pelvic inflammatory disease (PID)
• Ovarian cysts or fibroids
• Urinary tract infections or bladder pain syndrome
• Sexually transmitted infections (STIs)
• Vaginismus or pelvic floor muscle tension

Emotional or psychological factors may include:

• Past trauma or negative sexual experiences
• Anxiety, depression, or relationship stress
• Fear of pain leading to involuntary muscle tightening

Many women experience a combination of physical and emotional contributors.

When to See a Provider

You should schedule an appointment if you:

• Avoid intimacy due to pain or fear of discomfort
• Experience new or worsening pain with intercourse
• Notice dryness, burning, itching, or irritation
• Have difficulty with arousal or orgasm because of discomfort
• Are unsure whether your symptoms are normal

Sex should never be painful, and early evaluation often leads to better outcomes.

Evaluation and Diagnosis

During your visit, your provider will take time to listen and understand your concerns. Evaluation may include:

• A detailed discussion of symptoms, sexual history, and health changes
• A gentle pelvic exam to assess vaginal and pelvic tissues
• Testing for infection, inflammation, or hormonal changes when needed
• Imaging such as pelvic ultrasound if deeper pelvic causes are suspected

We prioritize a respectful, trauma-informed approach and proceed at a pace that feels comfortable for you.

Treatment Options

Treatment depends on the cause of pain and your personal goals.

Non-hormonal support may include:

• Vaginal lubricants and moisturizers
• Pelvic floor physical therapy for muscle tension or vaginismus
• Sexual health counseling when emotional factors are involved

Hormonal treatments may include:

• Low-dose vaginal estrogen for dryness or tissue thinning
• DHEA vaginal suppositories
• Systemic hormone therapy for broader menopausal symptoms

Additional options may include:

• Vaginal laser therapy for tissue restoration
• Medical treatment for underlying conditions such as endometriosis or infection
• Referral for trauma-informed counseling if past experiences contribute to pain

Your care plan is designed collaboratively, with comfort, safety, and effectiveness as top priorities.

Support for Sexual Health and Wellbeing

Painful intercourse can affect confidence, relationships, and quality of life. With the right care, many women experience significant improvement and are able to enjoy comfortable, fulfilling intimacy again.

Schedule an appointment with Complete Care ObGyn in Henderson, NV to discuss painful intercourse and explore treatment options tailored to your needs.