Ouch! Painful Sex and Getting Pregnant

Ouch! Painful Sex and Getting Pregnant

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The one thing about sex is that is should never be painful unless the woman is breaking her virginity, and then it can be painful for the first few times after. Claim Your 20 Free Pregnancy Tests – Click Here

Another cause for pain during sex is being in an uncomfortable position, and all it takes is changing the position a few times to find the right and enjoyable one. In fact, finding the right position can make a world of a difference when it comes to having enjoyable sex. If the man complains about sex being uncomfortable, then that is a clear sign that the position was the biggest problem.

Another common reason for some pain during sex as well is not having enough foreplay beforehand, because of the fact that foreplay actually prepares the reproductive organs for sex. Sexual arousal causes the reproductive organs to shift which helps bring comfort and pleasure during sex which is something that many people probably did not know. But having enjoyable sex is almost impossible if there is no foreplay at all in the picture.

However, after a certain point, sex should become a very enjoyable experience and there should be no pain associated with it- especially when a good position has been found and the couple has been getting hot and heavy with one another beforehand.

However, if a woman is experiencing pain during sex and she has been having sex for a long time then that is abnormal and can be a cause for concern due to an underlying medical condition. If there is a medical condition that is getting in the way of allowing her to experience joy during sex that is causing the pain then it very well could be affecting her fertility as well. Let’s look at the possible causes as to why a woman would be experiencing pain during sex, which is also called dyspareunia.


The Common Causes of Dyspareunia

Whenever dyspareunia is in the picture, it makes the whole sexual experience grueling rather than enjoyable. That means these women who experience pain during sex dread having sex instead of looking forward to it, and only agree to do it only to please their partners which is never a good reason to have sex.

However, there are some causes that can be rectified without any kind of medical intervention- but that is more the exception and not the rule. Let’s look at the possible causes here:

Vaginal Dryness.

Vaginal dryness can cause sex to be slightly uncomfortable or it can be extremely painful. The cause for this is declining or low estrogen levels, and it is common for perimenopausal and menopausal women to experience this. Another cause for vaginal dryness is whenever a woman is having sex during the least fertile times in her menstrual cycle. This is why whenever ovulation is near, cervical mucus is abundant. However, during the least fertile times, there is very little cervical mucus. A simple remedy for all of this is using lubricant. Women that are attempting to get pregnant should only stick with lubricants that are sperm-friendly. Remnants of the spermicidal lube can stick around during fertile times of the cycle which can kill off sperm and get in the way of pregnancy happening. For women that are not trying to get pregnant or that are menopausal can use any kind of lubricant to help rectify this issue.

Pelvic Inflammatory Disease (PID).

PID is a cause for painful sex upon entry and this is a serious underlying medical issue. This disease is caused by bacteria entering the reproductive system and women who have this illness can be asymptomatic other than having painful sex. However, some women who have this disease can also have flu-like symptoms and a lot of pain in general. Certain STDs can cause it too.


Endometriosis is a common cause of painful sex, and pain is even felt during ovulation and menstruation. This condition is caused by the lining of the uterus growing outside of the womb which causes heavy bleeding, scarring and a lot of pain.

Ovarian cysts.

Most of the type mild ovarian cysts do not have an impact on sex and do clear up over time. However, the severe cysts can cause dyspareunia. Ovarian cysts are more common in women who have PCOS and endometriosis.


Fibroids are non-cancerous tumors that grow inside of the uterus in many women and this is a common cause for painful sex. However, fibroids that grow by the cervix cause the most sexual pain. Additionally, after sex, fibroids can lead to spotting.



Adhesions are tissue bands that are formed within and between organs and are also the cause for very painful sex. This can be caused by different sources such as after having a D&C or other intrauterine surgeries. There is also pelvic pain associated with adhesions even during times when no sex is involved. Women who have this kind of pelvic pain after having this kind of surgery need to see their doctors as soon as possible for this reason.

Vaginal agenesis.

Vaginal agenesis is also known as Mayer-Rokitansky-Küster-Hauser syndrome or MRKH syndrome is when the vagina is not fully developed. Therefore sex would be painful in this case. It is a rare condition and 1 in 5000 women are born with this. However, surgery can create a neovagina, which allows women with the condition to have a normal and pain-free sex life.

Intact or especially tight hymen

The hymen is a thin membrane that encircles the vaginal opening, and even though it does not cover the entire vaginal opening- it has a small hole that stretches out over time.Though once in a great while it can cover the complete opening. Occasionally, the hymen might be very thick, tight or fails to stretch naturally and it can cause dyspareunia. This, however, can be corrected with surgery.


These above possible conditions would explain why sex would be very painful. And women who are planning to get pregnant who experience dyspareunia are very concerned if the reason behind it could cause them to be infertile. The broad answer to that questions is that it depends. It depends on the cause of the pain and let’s now look at the individual conditions that cause dyspareunia.

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Dyspareunia and Fertility

It has been outlined what the causes of painful sex can be due to, but some are causes for concern in regards to getting pregnant. Others are not and just need to have corrections in order to correct any issues with fertility.

The cause for vaginal dryness behind the sexual pain is an easy one to determine whether or not a woman is not fertile. A woman that is menopausal is obviously no longer able to have kids since menopause is defined whenever a woman has not had a period for at least a year. A woman that deals with dryness due to being perimenopausal can still technically get pregnant since she is still getting periods. However, if vaginal dryness is caused by having sex at the least fertile times of the month, then there is nothing at all wrong there.

If a woman wants to conceive and has normal and pain-free periods, then she will need to start tracking her ovulation. That means one way she can do it is by checking her daily cervical mucus texture. If there is little mucus, then this means she is not at a fertile time of the month and that will be the cause of vaginal dryness. But if the cervical mucus is abundant and looks like egg-whites, then she is fertile and having sex at that time will be comfortable and enjoyable. If she is still dealing with pain even during fertile times, then there is a good chance that she has other conditions like endometriosis, PID, ovarian cysts or fibroids.


Endometriosis and Painful Sex

Endometriosis, unfortunately, can cause infertility because it is the uterine lining which is shed during menstruation growing outside of the uterus, and the lining grows on the fallopian tubes, ovaries and other areas which can cause scarring in addition to plenty of pain. With the right treatment such as surgeries, fertility can be restored. However, there are cases when nothing can help women who have a severe case of the condition. Many women with endometriosis have been successfully able to conceive via IVF. Some end up having to hire a surrogate to carry their pregnancies in severe cases.


PID and Painful Sex

If a woman is dealing with dyspareunia due to PID, this can be a sign of the PID causing infertility. However, again it depends on the cause of this condition and how quickly it is taken care of. More often than not, if the PID is treated, fertility can be restored. However, if fallopian tubes are blocked, then the only way conception can happen is through IVF which means that is when fertility would be affected. If PID is diagnosed, it needs to be treated right away which has nothing to do with fertility. The longer a woman waits to have it taken care of, it can become deadly.


Ovarian Cysts and Painful Sex

If ovarian cysts are the cause of dyspareunia then the cysts themselves would not be the cause for fertility problems, however, the reason behind the cysts might be especially if the causes are PCOS and endometriosis. Both conditions can cause infertility and women who have either condition usually need intervention in order to get pregnant.



Fibroids and Painful Sex

If fibroids are the cause of pain, it can get in the way in regards to fertility because fibroids can increase the chances of a miscarriage. If there are fibroids found in the uterus, they will need to be surgically removed before attempting to conceive.

If the problem behind painful sex is due to an intact or especially tight hymen, it will have to be surgically removed in order for a pregnancy to happen. This will not affect fertility otherwise.

However, if a woman is dealing with pain as a result of adhesions, it will also need to be treated right away because untreated adhesions can definitely lead to infertility.


MKRH and Painful Sex

Lastly, if the pain from sex is because a woman has MRKH syndrome, she will unfortunately not be able to get pregnant. Many women who have this condition do not have a uterus or have a very small one which cannot carry a pregnancy. Though girls are aware of having this condition before they even think about having kids because they end up finding out due to the fact that they have not had their period at all by the time they are 15.

MRKH syndrome

That in itself is a warning sign that there is a problem, especially if these girls are not overly athletic and are at least of average weight. Girls that are very athletic and very underweight are known to not get their periods until they are over 15, and some can get it as late as 18 as well.

There are some women who have this condition that does have functioning ovaries even with the absence of a uterus and have the potential to have their own biological kids via a surrogate if they choose to go down that route.

However, even though MRKH syndrome is usually discovered before sexuality even becomes an interest to these girls- many other conditions behind the painful sex above are not tackled right away because many women who are dealing with painful sex are afraid to discuss the issue at all.


Women Who Experience Dyspareunia Need to See Their Doctors

Even though women who are dealing with painful sex are afraid to talk about it, they really need to see their doctors if this has been a problem no matter how recent. The earlier the reason behind dyspareunia is found, the odds will be in her favor that she will be able to enjoy sex again. Additionally, if the reason behind her having painful sex can cause infertility- the earlier it is tackled, the better odds she will have to have a successful pregnancy.

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Maureen Stephens, BS, RN
Maureen Stephens, BS, RN | ConceiveEasy
Ms. Stephens has spent over twenty years in the healthcare world, specializing in obstretical and medical/surgical nursing. She joined ConceiveEasy as she has a strong interest in educating and empowering women and promoting fertility awareness.