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Sex should be good. Like, really, really good.

It definitely shouldn’t be painful or uncomfortable, and yet, for far too many people, it is.

According to the American College of Obstetricians and Gynecologists (ACOG), nearly 3 out of every 4 vulva owners will experience pain during intercourse at some point in their lives. And one of the most common types of pain is a burning sensation.

If this has happened to you, know that it isn’t “normal” and you don’t have to “put up with it.”

“There’s this big stigma that’s associated with sex that it should somehow be painful or that it’s OK if it’s painful,” says pelvic pain specialist Sonia Bahlani, OB-GYN. “That’s not true at all.”

It is possible to figure out what’s going on and to get treatment so that you can enjoy sex again, sans pain.

The truth is, there are a lot of different things that could be causing a burning sensation during and after sex.

That’s why, if you see a doctor or other healthcare professional, there are many factors they’ll consider to arrive at a diagnosis.

This includes:

  • your age
  • your sexual history
  • your medical history
  • the location of the burning
  • how often it occurs
  • when it occurs

Let’s break down the possibilities.

There are a few things it could be, including:

Lack of arousal

Vulva owners produce varying levels of natural lubrication when they’re aroused. But if you’re not in the mood or not turned on enough — and you don’t use added lube — sex can be painful due to the lack of lubrication.

The reasons why you’re not into it, of course, can vary.

It’s possible that there are issues in your relationship that are impacting your desire for sex. Or maybe your partner just isn’t turning you on or paying attention to your needs.

Your mental health can play a part, too. Depression, stress, and anxiety can affect your libido.

Past trauma, especially if it was sexual in nature, can affect your desire for sex too.

Vaginal dryness

Hormonal changes during the different stages of your menstrual cycle can cause vaginal dryness. When this occurs, it can cause a burning or stinging sensation during intercourse because of friction.

“Any kind of continuous or forceful penetration can cause burning, which would be similar to the burning sensation you would feel if you continuously rub the skin on your arm,” says Kim Langdon, OB-GYN.

There are lots of different things can cause this kind of vaginal dryness, including:

Your menstrual cycle

“During certain days of a [menstrual] cycle, like right before menstruation, the vaginal tissue may be drier due to the rise of the hormone progesterone,” explains Langdon.

Hormonal contraception

If you’ve been on birth control for over 5 years, says Bahlani, it can change the amount of testosterone produced by your ovaries. Testosterone contributes to vaginal lubrication, so if your levels drop too low, it can lead to vaginal dryness and a burning sensation.

Childbirth and nursing

Your hormones postpartum, especially if you’re breastfeeding, can also decrease your estrogen levels, lessening blood to your genitals and decreasing vaginal lubrication.

In fact, one study found that 43 percent of folks postpartum had vaginal dryness 6 months after giving birth.

Menopause

Perimenopause (the transition to menopause) and menopause can also inhibit your body’s ability to naturally lubricate itself, causing this kind of burning feeling.

“During menopause, you have a decreased amount of estrogen, progesterone, and testosterone,” explains Bahlani.

“Those changes in the hormones within the vestibule can also lead to vaginal atrophy,” which is the thinning, drying, and inflammation of the vaginal walls.

While this generally affects vulva owners after the age of 40, chemotherapy, radiation, and certain medications can cause menopause to begin early. Hormone therapy treatments for menopause generally can help with this kind of dryness.

Hormonal disorders

Polycystic ovary syndrome (PCOS) and hypopituitarism, for example, can cause lower estrogen levels, leading to dryness.

Allergy medications

Some allergy medications can also affect the fluids in your vagina.

“Allergy medications essentially dry you up,” explains Heather Jeffcoat, a Los Angeles doctor of physical therapy who specializes in treating pelvic health conditions, and author of the book “Sex Without Pain: A Self Treatment Guide to the Sex Life You Deserve.”

“This can mean less moisture in your vagina tissue too, which can contribute to pain.”

Irritation

Any kind of irritation in the vagina or the vulvar vestibule (the area at the entrance to your vagina) can cause an inflammatory reaction, which feels like a burning or stinging pain — and that pain is only exacerbated by the friction that comes with penetrative sex.

Sometimes, this inflammation develops because people’s immune systems are hypersensitive to certain substances, which triggers this kind of irritation or inflammatory reaction when they come into contact with it.

“Sometimes, it’s something as simple as lubricants,” says Bahlani, “because some lubricants in drugstores contain parabens, sulfates, and endocrine disruptors or ingredients that alter the pH of the vagina.”

That’s why, says Sara Reardon, a pelvic floor therapist based in New Orleans, Louisiana, says “anything that glitters, sparkles, tingles, or smells shouldn’t go into your vagina.”

And if you’re sensitive to latex, latex condoms can cause irritation, too.

In fact, Bahlani says that sometimes the condom itself can cause irritation, regardless of the material.

“Condoms are good for a lot of things — they keep us protected from STIs — but they can have irritative components too,” she says.

Fissures

Fissures are small tears or cracks in the skin on the vulva, in the vagina, or anus. These can occur during or after intercourse or other sexual activity.

They are also more likely to occur if you aren’t well lubricated, either due to lack of arousal or dryness.

While fissures are generally superficial and heal on their own, they can cause a burning sensation during intercourse because of the excess friction.

However, some rare dermatological conditions, like lichen sclerosus, can result in more frequent vaginal fissures.

“This medical diagnosis needs treatment to preserve sexual function,” says Jeffcoat. “[It] causes scarring and narrowing of the vaginal canal and, if untreated, can make penetrative intercourse very painful or impossible.”

Infection

Yeast infection, bacterial vaginal infections, and urinary tract infections can all cause vaginal burning,” says Reardon.

Yeast infections generally cause itchiness and redness, as well as a thick white discharge. But when the infection causes inflammation, it can cause burning too.

Bacterial vaginosis has similar symptoms and is caused by an imbalance of the pH in the vagina. However, if you have this kind of infection, sex won’t be the only time you feel this kind of burning.

Sexually transmitted infections (STIs), such as trichomoniasis, can also cause burning sensations.

“Trichomoniasis is the third most common reason for vaginitis,” says Langdon. “It’s a parasite that infects humans and can be found in the bladder, vagina, uterus, fallopian tubes, and urethra of the penis.”

Only around 30 percent of people with this STI show symptoms, which is partly why it’s the most common curable STI in the United States.

Other STIs that can cause vaginal pain include gonorrhea, chlamydia, and genital herpes.

Most infections can be resolved with treatment.

Vaginismus

Vaginismus is a condition that causes the muscles of the outer third of the pelvic floor to constrict or spasm, resulting in dryness, pain, and burning.

This “prevents pain-free penetration into the vaginal canal by a finger, tampon, speculum or penis during vaginal intercourse,” explains Reardon, and it generally requires intervention with a pelvic floor therapist.

Vestibulodynia

Vestibulodynia, also sometimes called vulvodynia, is a condition that causes pain or burning at the opening of the vagina during sex. The pain occurs because the nerve endings in the vagina are hypersensitive.

Oral contraceptives may trigger this condition, too.

Intercourse can aggravate this burning sensation so you may notice pain more frequently.

Interstitial cystitis

Interstitial cystitis, otherwise known as bladder pain syndrome, can cause bladder pressure, bladder pain, and pelvic pain.

“You feel like you have an UTI,” says Bahlani. “And every time you have sex, you can have burning pain, or what feels like vaginal burning pain even though it’s actually coming from the bladder.”

It could be caused by a semen allergy.

“A semen allergy is characterized as local and systemic,” says Langdon.

“After exposure to the ejaculate, you may experience itching and swelling at points of contact, while systematically, it may also lead to generalized hives, swelling, or anaphylaxis.”

However, semen allergies are very rare. You’re more likely to be experiencing burning for another reason.

It could be microtears or soreness from pelvic floor dysfunction that you don’t notice until after the fact.

However, it’s also very likely that it could be irritation caused by something other than sex.

Lack of cleanup

“Chronic moisture can cause irritation and chafing, which could lead to a yeast infection,” explains Langdon.

That’s why, she continues, it’s “always best to get up and go to the bathroom after sex and make sure the excess semen is wiped away.”

You can also shower quickly after sex to clean up and pat the area dry.

Douching or other vaginal hygiene products

While cleanup is important, certain vaginal products, including scented tampons or pads, as well as douching products, can irritate your vagina and make things worse.

“The vagina is a self-cleaning oven,” says Bahlani. “You don’t need to douche the vagina at all or ever.”

It’s far safer for you to just spread the labia and let water roll over it when you want to clean the area, she continues.

“Scrubbing harsh soaps in the area can alter the pH of the vagina,” which can lead to inflammation, changes in the skin, and, yes, burning.

In fact, some people even have allergic reactions to scented products or douching products, causing them to have even more severe reactions.

Underwear

The wrong kind of underwear can also cause irritation or infection. That’s why it’s best not to wear thongs or tight underwear that doesn’t breathe.

Also be careful with what you wash your underwear with, because certain detergents and fabric softeners can cause irritation or allergic reactions.

Unless the burning was a one-off, it’s probably best you talk to a doctor right away.

“A burning sensation during sex should always be evaluated by a medical provider or pelvic floor physical therapist,” says Reardon.

“When the pain isn’t accurately diagnosed and goes untreated, [vulva owners] continue to unnecessarily suffer, experience pain, and avoid intercourse altogether.”

There’s no one-size-fits-all treatment, she adds, so it’s unlikely that you’ll be able to stop the burning on your own. In order to stop it, you’ll need to be evaluated so that a doctor can get to the bottom of what’s going on and treat it.

Plus, says Jeffcoat, “the longer you wait, the longer it may take to treat.”

But if you experience green or foul smelling discharge, swelling, itching, fever, and chills, seek medical attention right away. These are all signs of a severe infection.

Sex is supposed to be hot, but it isn’t supposed to burn or hurt.

It’s surprisingly common for people to experience pain or burning during penetrative sex, but that doesn’t mean it’s normal.

If you experience this kind of pain, know that there’s help available. Talk to a healthcare professional to figure out exactly what’s going on and get back to… well, getting it on.


Simone M. Scully is a writer who loves writing about all things health and science. Find Simone on her website, Facebook, and Twitter.