Pain during sex is common and should never be ignored. If your soreness is a frequent occurrence, it may be time to speak with your doctor.
The pain you feel around the vulva could be caused by lubrication issues, a yeast infection or even STIs. But you could also be suffering from conditions like vulvodynia or endometriosis.
Muscle strain
A muscle strain is a soft tissue injury, the equivalent to spraining a ligament. It occurs when a muscle or a muscle tendon is subjected to more physical stress than it can handle, often due to a sudden increase in the duration, intensity or frequency of exercise.
Symptoms of a strain include pain, swelling and bruising. A severe strain can cause numbness and tingling, which requires medical attention.
Your healthcare provider will diagnose a muscle strain with a physical exam and a detailed history of your symptoms. He or she may also order an ultrasound or MRI to check for tears and fluid buildup.
Most mild to moderate strains heal within a few weeks with at-home treatments. These treatments can include rest, ice and heat, compression and elevation of the affected area. Nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil) and acetaminophen help reduce pain, swelling and inflammation.
Cramps
Cramps are a type of tight muscle spasm that is painful and doesn’t let go. They can affect any muscle under your voluntary control (skeletal muscles). They may be confined to one muscle or involve several muscles in groups, such as feet, hands, arms, abdomen and along the rib cage. Ordinary cramps have a sudden onset and feel hard and knotted to the touch. They last from seconds to several minutes, whereas fleeting twitches usually dissipate after a few minutes. Also, find out if the cramps occur at rest or only during or after exercise and if they are alleviated by stretching the affected muscles.
Muscle cramping can be caused by many things, including overworking muscles, dehydration and an inadequate diet, especially in terms of minerals and electrolytes. Taking supplements, such as calcium and potassium, can help prevent cramping. In addition, a prescription muscle relaxer can reduce pain and spasms.
Vascular spasms
Vascular spasms are a prolonged tightening or narrowing of arteries, which reduces blood flow through that artery. This reduced flow can cause less oxygen to the nearby tissues. These contractions happen when smooth muscle in an artery overreacts to the signal to constrict.
In the fingers and toes of people with Raynaud’s phenomenon, this vasoconstriction causes them to feel cold, numb or tingly and may turn them white or blue. In the coronary arteries, which supply your hardworking heart muscle with oxygen-rich blood, sudden vasoconstriction can cause a heart attack.
Your doctor can diagnose vasospasms by studying your symptoms and medical history. They can also do imaging tests such as magnetic resonance imaging (MRI) or CT angiography to observe the area of the body affected by reduced blood flow. Medications like calcium channel blockers, such as verapamil or diltiazem, can help to relax the muscles in your blood vessels and improve the condition of your arteries. Other medications, such as ACE inhibitors and statins, can also improve artery health.
Adrenal dysfunction
The adrenal glands, located above the kidneys, make a number of hormones that help control blood pressure, regulate metabolism, and influence how your immune system functions. Adrenal insufficiency, or Addison’s disease, is a condition that occurs when your body does not make enough of these hormones. Symptoms of this condition include fatigue, weakness, loss of appetite, abdominal pain, and weight loss. It can be caused by stress, autoimmune diseases, or suddenly stopping steroid medications used to treat other conditions.
If you experience these symptoms, talk to your doctor about them. He or she may run tests, such as tuberculosis screening and imaging tests, to find the cause of your problem. Treatment includes taking hormones to replace those your body is not making. These hormones include cortisol, which helps break down fats, proteins, and carbohydrates, controls blood pressure, and affects the way your body works.
Muscle imbalances
There are over 650 named skeletal muscles in our body, and they all serve a different function. For optimal movement and functional performance, opposing muscle groups need to coordinate with each other. This requires a balance of strength, length, and tone. If one of these muscles is too weak to carry out its function, the body calls on close-by muscle pairs to help.
The result is that these muscles become overworked, leading to injury and discomfort. This imbalance can be caused by a variety of everyday activities or sports-related injuries, or due to a lack of exercise or congenital bone deformities (e.g. leg shortening).
Muscle imbalances can also be caused by one-dimensional training, in which the muscles are strengthened primarily through “pushing” exercises (e.g. bench press) while the “pulling” muscles are neglected. This can cause the back muscles to tighten and the hip flexors to shorten, creating a “hunched” posture.
Nerve compression
Nerve compression can occur at specific anatomic sites during sexual activity, such as the lower back and pelvis. These nerves can be compressed or pinched during sexual activity, leading to pain and tingling sensations. This can be exacerbated by certain positions or movements, which makes it important to avoid or adjust sexual activities to reduce the risk of these symptoms.
If you have an underlying condition, such as neuropathy or varicose veins, sexual activity may aggravate your symptoms. Managing the underlying cause, along with medications to control your nerve pain, may help alleviate your symptoms.
Practicing proper warm-up and stretching before sexual activity can prepare your muscles for physical exertion. Additionally, practicing good communication with your partner can allow you to find comfortable positions that minimize strain on the legs and pelvic area. Keeping hydrated by drinking plenty of water before, during and after sexual activity can also reduce the risk of muscle cramps and fatigue.
