Pain during intercourse is very common – almost 3 out of 4 women experience pain during intercourse at some point in their lives. For some women, the pain is only a temporary problem, while for others the problem is long-term. The medical term for painful intercourse is dyspareunia, defined as persistent or recurring genital pain that occurs just before, during, or after sex. Treatment focuses on the cause and can help eliminate or reduce this common problem. Pain during sex can be a sign of a gynecological problem, such as ovarian cysts or endometriosis. It can also be caused by problems with sexual response, such as a lack of desire (the feeling of wanting sex) or a lack of arousal. The physical causes of painful intercourse differ depending on whether the pain occurs at the entrance to the vagina or during deep penetration. Emotional factors can be associated with many types of painful intercourse. Pain during penetration can be related to a number of factors, including: Vaginal dryness. This is often the result of insufficient foreplay. A drop in estrogen levels after menopause or childbirth, or breastfeeding, can also be a cause. Certain medications are known to affect sexual desire or arousal, which can lead to vaginal dryness and make sex painful. These include antidepressants, high blood pressure medications, sedatives, antihistamines, and some birth control pills. Injury, trauma or irritation. This includes injury or irritation from an accident, pelvic surgery, female circumcision, or an incision made during childbirth to widen the birth canal (episiotomy). Inflammation, infection or skin disorder. An infection in the genital area or urinary tract can cause painful intercourse. Eczema or other skin problems in the genital area can also be a problem. Vaginismus. These involuntary spasms of the vaginal wall muscles can make penetration painful. A problem present at birth. The lack of a fully formed vagina (vaginal agenesis) or the development of a membrane that blocks the vaginal opening (imperforate hymen) can cause dyspareunia. The pain of deep penetration may differ in certain positions. Causes include: Diseases and conditions. The list includes endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, pelvic floor dysfunction, adenomyosis, hemorrhoids, and ovarian cysts. Surgeries or medical treatment. Scars from pelvic surgery, including hysterectomy, can cause painful intercourse. Medical treatments for cancer, such as radiation therapy and chemotherapy, can cause changes that make sex painful. Treatment options vary depending on the cause of the pain. If an infection or medical condition is contributing to the dyspareunia,treating the cause may resolve the problem. Changing medications known to cause vaginal dryness also addresses the cause of the pain. For many postmenopausal women, dyspareunia is caused by vaginal dryness as a result of low estrogen levels. Often this can be treated with topical estrogen applied directly into the vagina. References: https://www.acog.org/womens-health/faqs/when-sex-is-painful