Sexual Pain Disorders in Women: Causes And Treatments

Written by - Reviewed by Consumer Health Digest Team

Published: Jul 31, 2013 | Last Updated: Jan 4, 2019

Sexual Pain Disorders in Women

What are Sexual Pain Disorders?

Sexual pain disorders afflict ten to twenty percent of women and involve painful intercourse. Sex is meant to be pleasurable and an act of intimacy but a majority of women do not enjoy the experience. They often blame themselves though painful sex may be due to certain medical conditions, psychological wellbeing and lifestyle choices. The various medical conditions that are often manifested in terms of painful sex include:


Dyspareunia is a medical condition characterized by vaginal or deep pelvic pain as a result of sexual intercourse or attempted penetration. The pain is either consistent or recurring. Dyspareunia is often as a result of vaginal infections or surgery.


Vaginismus is condition where the outer third of the vaginal muscles involuntarily contract during attempted penetration making sex painful or even impossible.

Atrophic Vaginitis:

This condition involves vaginal atrophy due to low estrogen level. The vagina dries up and thins making sex painful. This condition is mostly experienced by menopausal women but younger women can also be afflicted.


This refers to pain on the vulva vestibule as a result of physical touch or attempted vaginal penetration.

What are the Physical Factors Contributing to Sexual Pain Disorders?

The physical factors contributing to sexual pain disorders may be genetic or acquired where a woman initially enjoyed pain free sex but later developed a sexual pain disorder. These factors include:

  • Genetic conditions such as an imperforate hymen
  • Congenital vaginal abnormalities
  • Genital surgery
  • Genital modifications such as piercings
  • Physical injuries sustained through shooting or stabbing
  • Sexual molestation leading to vaginal tearing

What are the Causes of Sexual Pain Disorders?

Causes of Sexual Pain Disorders

Sexual pain disorders have various causes ranging from psychological to physical. Some of these causes are:

  • Anxiety as a result of anticipated pain due to a history of painful sex
  • Low estrogen resulting in vaginal drying
  • Poor vaginal lubrication
  • Bacterial infections in the vagina and urinary tract
  • Vaginal irritation due to douching, perfumes or latex allergy
  • Stress
  • Relationship distress
  • Injury during childbirth
  • Neurologic conditions such as neuromas
  • Sexually Transmitted Infections

What are the Signs and Symptoms of Sexual Pain Disorders?

Sexual pain disorders are primarily characterized by painful sex. Other symptoms are as follows:

  • Hyper contractile vaginal muscles
  • Poor vaginal lubrication
  • Pain in the vaginal area during prolonged physical activity such as walking

What Type of Impact do Sexual Pain Disorders have on a Woman’s Life?

Sexual pain disorders have negative effects on a woman’s life. For one, they hinder her ability to enjoy being intimate with her man. In addition, most women who suffer from this condition often blame themselves. This can lead to psychological distress which can affect their overall well being. Relationships have also been known to end as a result of sexual pain disorders due to sexual dissatisfaction. This is particularly common where the condition is as a result of psychological factors and medical tests shown everything is normal. Marriages are especially prone to divorce.

Furthermore, psychologists have suggested that women who have experienced sexual pain disorders in their past and have had the condition treated still experience pain during sex not because they suffer from any condition, but because they anticipate pain. Because of this, women who have a history of sexual pain disorders have a hard time getting past their history even after getting medical help.

Differential Diagnosis of Sexual Pain in Women

Diagnosing sexual pain disorders can be tricky considering the various causes. To diagnose the condition, the following should be considered:

  • Sexual history
  • Surgical history
  • Obstetric history
  • Medication history on whether the patient has been using oral contraceptives that may be affecting estrogen levels
  • Social history on issues such as sexual molestation
  • Psychological history on whether the patient has recently suffered from mental disorders such as stress and depression
  • Medical history on a recent occurrence of sexually transmitted infections and urinary tract infections

This information, though overly comprehensive, will enable your doctor to pinpoint exactly what is causing the problem. Therefore, honesty is a must if you want to get rid of the problem as quickly as possible

How effective is CBT in Treating Female Sexual Pain Disorder?

CBT or Cognitive Behavioral Therapy is based on a highly accredited theory that the mind controls how the body behaves. Therefore, changing our thinking patterns can have a significant impact on how our bodies react to situations. CBT is an effective treatment is an effective treatment for sexual pain disorders especially Vaginismus. This is because patients may feel pain during sex because their minds anticipate it. Countering this kind of thinking may take time but it is highly effective in such cases.

How to Treat Sexual Pain Disorder?

Hormone Replacement Therapy:

Hormone replacement therapy where estrogen and progesterone are prescribed to patients is a highly effective treatment. This therapy alleviates vaginal dryness and thinning and is particularly effective for menopausal women who have low estrogen levels. In addition, studies suggest that administering testosterone as well is helpful as it boosts a woman’s libido.


Administering antibiotics is an appropriate treatment plan for patients who suffer from sexual pain disorders as a result of bacterial infections. Once bacterial infections such as yeast infection and urinary tract infections get cleared up, the sexual pain disorders also go away.

Dilation Exercises:

Dilation exercises are manually performed on the vaginal opening with fingers or dildos to widen the vaginal opening in order to enable pain free penetration. This is often prescribed to patients with Vaginismus.

Sex Therapy:

Sex therapy involves a series of counseling sessions either alone or with your partner. The sessions give women invaluable advice on how to be more comfortable during sex. In addition, they teach sexual techniques that tend to be more pleasurable for women. This is a good way to go for women who suffer from sexual pain disorders as a result of psychological distresses and childhood conditioning where they are taught negative things about sex.

In conclusion, most women who suffer from sexual pain disorders suffer in silence and blame themselves. Nonetheless, getting medical help is crucial as sex is meant to be an enjoyable experience for both men and women. Therefore, do not shy away from getting help. If anything, empowerment is all about being bold enough to admit that you need help.

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