If You Feel Burning Or Stinging During Sex, You Definitely Want To Let Your Doctor Know
Once you've experienced vaginal discomfort or burning after sex, it can be hard to get into the mood next time you and your partner want to get intimate because sex should be fun and not painful. But the reality is many women struggle with this (duh!). In fact, three out of four women experience some pain during intercourse at some point in their lifetime, according to the American College of Obstetrics and Gynecology (ACOG). You're definitely not alone.
Don't worry—the solution could be as simple as ramping up foreplay or swapping out a personal care product that you’re allergic to. But if you consistently have pain during or right after sex, it’s worth investigating what the cause is, says Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University.
“You may have burning upon entry, not because of an inability to lubricate, but because lack of lubrication is the body's defense mechanism in anticipation of pelvic pain. In addition to dryness, the muscles at the opening of the vagina contract to prevent painful penetration,” Dr. Streicher explains.
Often women blame vaginal burning on a urinary tract infection (UTI). It's true that you may experience burning down there when you pee if you have a UTI, and it could seem like that's related to sex if you pee right after intercourse. But pain from a UTI is generally not caused or amplified by sex.
Here’s a list of all possible reasons you may be experiencing burning or pain during or after sex—and ways to treat them.
Meet the experts: Lauren Streitcher, MD, is a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and the founder and medical director of the Northwestern Medicine Center for Sexual Health.
Mary Jacobson, MD, has 20 years of experience in gynecology and women's health issues. She is the chief medical officer of Alpha Medical, a telehealth platform.
1. Yeast infection
If you’ve ever had one, you know yeast infections aren't the most comfortable experience. Typically, Dr. Streicher says, you’ll feel itchiness, and may have redness at the opening of the vagina, along with a thick white discharge. But, there’s a chance it may burn during sex too. “There can be burning from the inflammation of the tissue,” explains Dr. Streicher.
Symptoms of a yeast infection might be similar to a bacterial infection called bacterial vaginosis, or BV, which is caused by an imbalance of pH in the vagina. It causes vaginal irritation, but not necessarily added irritation during or after sex.
You probably won’t have the redness that you would with a yeast infection either. You may notice a foul odor, thin white discharge, and pain (that doesn’t get worse with intercourse, necessarily), says Dr. Streicher. You can get an antibiotic from your doctor to treat BV.
Treatment: Yeast infections are typically treated with an antifungal. There are over-the-counter versions you can get, but if you haven't had a yeast infection before, you should definitely see your doctor so they can make sure that's what you're dealing with, says Dr. Streicher. They'll be able to prescribe stronger antifungal medications as well.
2. Vestibulodynia
This condition is common in young women and often causes pain or burning at the opening of the vagina during sex. (It's also sometimes referred to as vulvodynia, but technically, that only refers to generalized vulvar pain, whereas vestibulodynia is limited to pain at the entry of the vagina.)
“This is essentially caused by hypersensitivity on the nerve endings in the vagina,” Dr. Streicher says. Vestibulodynia can be hormonal too, and potentially triggered by low-dose birth control pills, which may contribute to vaginal dryness by lowering testosterone levels (which is a huge factor in your sex drive!), she adds.
Treatment: If you confirm with your gyno that you're experiencing vestibulodynia and you think the reason is your BC, speak with your doctor about potentially changing the prescription or using a different method, such as an IUD.
3. Vaginismus
Vaginismus is a different condition from vestibulodynia, though there is sometimes an overlap in symptoms, Dr. Streicher says. Basically, with vaginismus, the muscles surrounding the vaginal opening constrict, and this can also result in dryness and burning when you have penetrative sex.
Treatment: Patients with vaginismus may benefit from working with a pelvic floor physical therapist, who use a variety of techniques to release muscle tension.
4. An inflammatory reaction
Some women are sensitive to certain personal care products, such as scented vulvar washes and soaps, and it can cause an inflammatory reaction that may feel like burning or stinging pain, Dr. Streicher says. The same goes for some water-based lubricants, which ironically, many women use to combat dryness.
Treatment: To prevent irritation, it’s a good idea to skip feminine washes and just gently clean the outside areas of your vulva with unscented soap and warm water, steering clear of the vagina. When it comes to lube, you don’t need to stop using it, but it’s best to go with a silicone-based lube to minimize inflammation, Dr. Streicher suggests.
5. Perimenopause or menopause
The average age women in the U.S. enter menopause is 51, says Dr. Streicher. But women can start perimenopause, the transition period into menopause, any time after 40. Some women start menopause even earlier as a result of chemotherapy, radiation treatments, or certain medications. Perimenopause and menopause inhibit the body's ability to naturally lubricate itself, which can lead to dryness and a burning or stinging sensation during intercourse.
Treatment: A couple of options for treating menopause-related dryness are prescription local vaginal estrogen pills, creams, or rings. There are also non-hormonal options such as DHEA and the CO2 laser.
6. Hormonal changes
Aside from menopause, other hormonal changes can contribute to vaginal dryness and that burning sensation during penetration. During the postpartum period, for example, your body may be low in estrogen, especially if you’re breastfeeding, and that means your body won't be able to lubricate itself as it naturally would. Also, some women (even those who don’t have vestibulodynia) may have lack of lubrication and pain during sex due to hormonal changes from low-dose birth control.
Treatment: Again, there are treatment options to make sure your hormones are regulated and helping you stay lubricated. It may be as simple as changing your birth control method. But there isn’t just one correct solution, and it varies from person to person. So, it’s best to contact your doctor, who can either prescribe something for your specific case or can put you in touch with another expert.
7. Lack of arousal
Last but not least, the vaginal dryness and burning you’re feeling may arise from lack of arousal. There often isn’t one singular cause, though; there could be issues within your relationship or with your partner that are interfering with your ability to get turned on.
Your mental health could also be a factor: Depression and anxiety can impact your desire and lubrication. Your body could also be reacting to certain triggers and having a trauma response during sex that results in physical pain. This can cause the vaginal and pelvic floor muscles to become overly tense and difficult to relax during sex, says Kyle Bukowski, MD, an ob-gyn and the chief medical officer at Planned Parenthood of Maryland. “This can cause pain and burning just like tense shoulder and neck muscles can cause a tension headache,” he adds.
Treatment: Dr. Streicher points out that there are many potential treatments, including medications you can take for low libido and vaginal dryness. Start by bringing up what you're feeling to your healthcare provider. They may be able to offer solutions, or can send you to a medical sex specialist or a mental health professional, depending on your needs.
8. Allergy to sperm or condoms
Chemicals found in condoms, spermicide, vaginal lubricants, and moisturizers can irritate the sensitive skin of the vagina and cause burning. This is due to a change in pH of the body’s normal secretions, explains Mary Jacobson, MD, an ob-gyn and the chief medical officer at Alpha Medical.
And while not as common, it is possible to develop a sperm allergy, sometimes called semen allergy, that is a rare allergic reaction to proteins found in semen.
Treatment: As a precaution, people with sperm allergy are prescribed an epinephrine auto-injector (Epi-Pen) in the event of anaphylaxis, a life-threatening allergic reaction, Dr. Jacobson says. Using a condom every time you have sex if you think you’re allergic to semen can help. And if you think you’re having a reaction to condoms, she recommends using a fragrance-free or non-latex condom.
9. Sexually transmitted infections
STIs like chlamydia, gonorrhea, trichomoniasis, and Mycoplasma genitalium can all cause inflammation and irritation of the vagina and cervix, Dr. Bukowski notes. Herpes blisters can cause ulcers on the skin that can be incredibly painful and often cause a burning sensation.
Treatment: Getting tested regularly after having sex with a new partner or once a year if you’re 25 or younger are important ways to identify and treat STIs before symptoms appear. But if you’re already developed an STI, they can be easily treated with a short course of antibiotics, says Dr. Bukowski.
10. Endometriosis
Pain during or after sex is common in people with endometriosis have sexual dysfunction, per Mayo Clinic. The condition occurs when endometrial tissue (which lines the inside of the uterus) grows outside of the uterus.
“This tissue is responsive to a woman's normal hormonal cycle and thus grows and bleeds just like the uterine lining, which over time causes inflammation and scarring of pelvic tissues. When this tissue implants along the spaces between the vagina and surrounding organs, namely the bladder and rectum, they can cause pain, inflammation, and burning in the vaginal canal,” Dr. Bukowski says.
Treatment: Your doctor can diagnose the disease through a pelvic exam, ultrasound, MRI, or a minor surgical procedure called a laparoscopy. Treatment varies depending on the severity of the patient’s symptoms and medications, from birth control to surgery to remove the displaced endometrial tissue.
11. Contraception
While an unlikely cause, your birth control could be lowering the estrogen levels in your body, says Dr. Jacobson. This could lead to dryness and decreased lubrication, causing thinning of the vaginal wall and ultimately irritation, pain, and discomfort during intercourse.
Treatment: Speak to your doctor and let them know what you’re experiencing. They might suggest changing your contraceptive method or recommend a topical hormone to reduce that burning pain, according to Dr. Jacobson.
How to Prevent Burning after Sex
No matter what you’re feeling before, during or after sex, be open with your partner, your doctor, and yourself about any discomfort or pain. Diagnosing and treating the source of the problem as soon as possible is the first and best step.
“The longer you wait, the more difficult the pain during and after intercourse is to treat,” says Dr. Jacobson. “And foreplay strongly affects sexual desire, arousal, and orgasm.” So, let your partner know what you need, and make sure you’re fully ready and in the mood before having sex. This will make it more enjoyable and less painful.
If you’re experiencing pain during sex, it could be the position you’re in. Try placing a pillow under you or your partner to elevate the hips and open the pelvis. Or you could try spooning, where you're both lying side by side, as this allows for more natural penetration.
Dr. Jacobson also recommends using lubricants and moisturizers that are physiologically most similar to natural secretions. As always, speaking with your health care provider is the best way to find the right care and treatment for you.
Bottom line: No matter which of the conditions above you're dealing with, there are solutions that can get rid of the burning sensation you're feeling during sex and make the experience more pleasurable (which you deserve!). Talk to your doctor so they can help you find the right fix.
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