Women The cause of the pain may be anatomic or physiologic, including but not limited to lesions of the vagina, retroversion of the uterus, urinary tract infection, lack of lubrication, scar tissue, abnormal growths, or tender pelvic sites. Some cases may be psychosomatic, which can include fear of pain or injury, feelings of guilt or shame, ignorance of sexual anatomy and physiology, and fear of pregnancy. In women, common causes for discomfort during sex include # Infections. Infections that mostly affect the labia, vagina, or lower urinary tract like yeast infections, chlamydia, trichomoniasis, urinary tract infections, or herpes tend to cause more superficial pain. Infections of the cervix, or fallopian tubes like pelvic inflammatory disease tend to cause deeper pain. # Cancer of the reproductive tract, including the ovaries, cervix, uterus, or vagina. # Tissue Injury. Pain after trauma to the pelvis from injury, surgery or childbirth. # Anatomic variations. Hymenal remnants, vaginal septa, thickened undilatable hymen, hypoplasia of the introitus, retroverted uterus or uterine prolapse can contribute to discomfort. # Hormonal causes: #* Endometriosis and adenomyosis #* Estrogen deficiency is a particularly common cause of sexual pain complaints related to vaginal atrophy among postmenopausal women and may be a result of similar changes in menstruating women on hormonal birth control. Estrogen deficiency is associated with lubrication inadequacy, which can lead to painful friction during intercourse. Vaginal dryness is often reported by lactating women as well. Women undergoing radiation therapy for pelvic malignancy often experience severe<unk>  due to the atrophy of the vaginal walls and their susceptibility to trauma. # Pelvic masses, including ovarian cysts, tumors, and uterine fibroids can cause deep pain. # Pain from bladder irritation:<unk>  is a symptom of a disease called interstitial cystitis (IC). Patients may struggle with bladder pain and discomfort during or after sex. For men with IC, pain occurs at the moment of ejaculation and is focused at the tip of the penis. For women with IC, pain usually occurs the following day, the result of painful, spasming pelvic floor muscles. Interstitial cystitis patients also struggle with urinary frequency and/or urinary urgency. # Vulvodynia: Vulvodynia is a diagnosis of exclusion in which women experience either generalized or localized vulvar pain most often described as burning without physical evidence of other causes on exam. Pain can be constant or only when provoked (as with intercourse). Localized provoked vulvodynia is the most recent terminology for what used to be called vulvar vestibulitis when the pain is localized to the vaginal opening. # Conditions that affect the surface of the vulva including LSEA (lichen sclerosus et atrophicus), or xerosis (dryness, especially after the menopause). Vaginal dryness is sometimes seen in Sjögren's syndrome, an autoimmune disorder that characteristically attacks the exocrine glands that produce saliva and tears. # Muscular dysfunction: For example, levator ani myalgia # Psychological, such as vaginismus. Most vaginal pain disorders were officially discovered or coined during a time when rape was more normalized than it is now (marital rape was only recognized as non-consensual by all 50 US states in 1993). Some in the medical community are now starting to take into account factors like rape/sexual assault/ fear of rape/sexual harassment as strong enough psychological stressors to cause such pain disorders. Men In men, as in women, there are a number of physical factors that may cause sexual discomfort. Pain is sometimes experienced in the testicular or glans area of the penis immediately after ejaculation. Infections of the prostate, bladder, or seminal vesicles can lead to intense burning or itching sensations following ejaculation. Men suffering from interstitial cystitis may experience intense pain at the moment of ejaculation. Gonorrheal infections are sometimes associated with burning or sharp penile pains during ejaculation. Urethritis or prostatitis can make genital stimulation painful or uncomfortable. Anatomic deformities of the penis, such as exist in Peyronie's disease, may also result in pain during coitus. One cause of painful intercourse is due to the painful retraction of a too-tight foreskin, occurring either during the first attempt at intercourse or subsequent to tightening or scarring following inflammation or local infection. Another cause of painful intercourse is due to tension in a short and slender frenulum, frenulum breve, as the foreskin retracts on entry to the vagina irrespective of lubrication. In one study frenulum breve was found in 50% of patients who presented with<unk> . During vigorous or deep or tight intercourse or masturbation, small tears may occur in the frenum of the foreskin and can bleed and be very painful and induce anxiety, which can become chronic if left unresolved. If stretching fails to ease the condition, and uncomfortable levels of tension remain, a frenuloplasty procedure may be recommended. Frenuloplasty is an effective procedure, with a high chance of avoiding circumcision, giving good functional results and patient satisfaction. The psychological effects of these conditions, while little understood, are real, and are visible in literature and art.
Dyspareunia
Vaginismus
Delayed ejaculation
Hyperesthesia
Penile pain
Dyschronometria
Blennorrhoea
Hypomenorrhea