There are many reasons women in their reproductive years can experience painful sex. Some common conditions that can be at the root of the problem for women in their thirties and forties include:
Postpartum painful sex: 90% of women reported pain the first time they had sex after childbirth, from 6 weeks - 18 months for caesarean and vaginal births. Why might you experience painful sex after birth?
1) Vaginal dryness during breastfeeding: When you breastfeed oestrogen levels decline, causing a thinning of the vaginal tissue along with loss of lubrication and an elevated pH that can make women more susceptible to infections, vaginal dryness and sexual pain.
2) Vaginal tears and scarring: Tears to the perineum (the skin between the vagina and the anus) and the vaginal wall are very common during childbirth. Sometimes a surgical cut (episiotomy) is performed during labour as well. Even small tears or stitches lead to scar tissue, as part of the healing process, that can cause discomfort vaginal tightening and discomfort during intercourse.
3) Pelvic muscle trauma: The pelvic floor muscles elongate during pregnancy and they are stretched with birth. As a result, the muscles usually tighten up in response. For some women, a traumatic or painful childbirth experience can instigate over contraction and tightening of the pelvic and vaginal muscles, which can cause pain during intercourse.
Hormonal birth control: Hormonal birth control pills can cause fluctuations in hormones and an imbalance of your oestrogen/progesterone ratio that mimic the second half of the menstrual cycle, which is a progesterone-dominant, low-oestrogen state. When your oestrogen levels drop the tissue in the vagina becomes dry and sex becomes painful.
Vaginal Infections: Bacterial, yeast infections, or sexually transmitted diseases (STD's) can cause pain during sex and usually have other symptoms, like discharge or odor. Watch out for any symptoms or abnormality and in case you feel there is something wrong, book an appointment with your gynaecologist.