Women's Health

The surprisingly common cause of painful sex

 (AndreyPopov)

Most of the discussion around sex focuses on how to do it safely and, of course, how good it can feel. But painful intercourse deserves some time in the sexual spotlight as well. As terrible as it can be, not talking about it doesn't solve anything—because, yes, in many cases, painful sex can be treated. That's especially true if it's caused by cervicitis, or inflammation of the cervix, the lower part of the uterus that leads to the vagina. Cervicitis affects over half of women at some point in their lives, according to the U.S. National Library of Medicine, and sex that makes you say "yowza," but not in a good way, is one common tip-off of the condition.

Cervicitis has many potential causes, but it often happens due to an infection of some sort.

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Infections like gonorrhea and chlamydia can lead to an angry cervix, board-certified ob/gyn Antonio Pizarro, M.D., tells SELF. He notes that "the cervix is a very delicate part of the body." Other common culprits: herpes, HPV, and the little-known, very common STD trichomoniasis. "[Cervicitis] can also come from bacterial vaginosis and an overgrowth of yeast," says Pizarro.

"You can also see chemical cervicitis, which is almost like an allergic reaction when the cervix comes into contact with something that irritates the tissue and stimulates an immune system response," Jamil Abdur-Rahman, M.D., board-certified ob/gyn and chairman of obstetrics and gynecology at Vista East Medical Center in Waukegan, Illinois, tells SELF.This can occur because of a latex allergy, sensitivity to spermicide, douching, or even scented body washes and feminine hygiene products.

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In addition, pelvic trauma like childbirth and pre-cancerous or cancerous lesions on the cervix can lead to cervicitis, says Abdur-Rahman.

And since your cervix can't speak, if it's in trouble, it might make that known via painful sex.

It makes sense when you think about how roughed up your cervix can get during penetration. The act can make a completely healthy cervix sore, so if yours is inflamed, normal sexual contact can become intensely painful because of "damage [cervicitis] is doing to the tissue," says Pizarro. In addition to pain, you might also experience bleeding during sex if you have cervicitis.

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More generally, cervicitis can cause generalized pelvic pain that gets worse during your period, says Abdur-Rahman. If the inflammation spreads through your vagina, you might also notice painful urination, increased discharge, itching, or other signs of vaginal irritation.

At that point, it's time to see a doctor, who will run tests to figure out the reason for your cervicitis.

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Treatment for cervicitis usually targets the root cause, which often requires some investigation. "I do targeted testing for gonorrhea, chlamydia, trichomoniasis, and a group of other things," says Pizarro. "If there's nothing there, then [I'll do] a Pap smear, because bleeding and pain during intercourse can be signs of cervical cancer." This process of elimination helps avoid unnecessary antibiotic treatment, says Pizarro (especially important since antibiotic-resistant STDs are on the rise, according to the World Health Organization).

If the issue is something like herpes, your doctor will probably recommend an antiviral treatment, like Valtrex, and if it's chemical cervicitis, avoiding exposure to latex, douches, spermicide, or whatever irritated you is the best course of action. PH-balancing gels might also help, depending on the situation, Pizarro adds

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There are also ways of treating symptoms—namely pain—while waiting for the cause to clear up. "There's lidocaine jelly, which is local anesthetic in jelly form, and you can place it anywhere with mucous membranes to diminish discomfort," says Abdur-Rahman.

The good news is that cervicitis is easy to clear up, and when caught early, is really NBD.

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There's only one caveat, but it's an important one. "Cervicitis is benign for the most part, but it can be problematic," says Abdur-Rahman. When left untreated, STDs like gonorrhea and chlamydia can cause cervicitis that leads to pelvic inflammatory disease, an infection of the reproductive organs that can increase your risk of infertility, ectopic pregnancy, preterm labor, and miscarriage, says Abdur-Rahman. "Cervicitis can lead to some larger issues, so it's important to nip it in the bud," he explains.

But, "when treated early, cervicitis shouldn't affect your fertility," says Pizarro. So, if you think you have cervicitis, there's no need to freak out, but there is a need to go see a doctor.