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 vaginal pain: 90% of women reported painful sex after childbirth and breastfeeding, anywhere from 6 weeks - 18 months postpartum.
1) Vaginal dryness during breastfeeding: When you breastfeed estrogen levels plummet, causing a thinning of the vaginal tissue, inflammation along with loss of lubrication and an elevated pH. The drastic change in hormone levels can lead to atrophic vaginitis making women who are breastfeeding more susceptible to infections, vaginal soreness, dryness and painful sex. The condition can persist for as long as a woman breastfeeds because throughout this time estrogen levels will remain relatively low — high estrogen levels would inhibit milk production.
2) Vaginal tears and scarring: Tears to the perineum (the skin between the vagina and the anus) and the vaginal wall are very common. 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 estrogen/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 gynecologist.