A number of physical, hormonal and psychological conditions can cause sexual pain. Causes of sexual pain in women include:

• Surgery or childbirth. Women who have intercourse too soon after surgery or childbirth may experience pain. Women who develop a laceration during childbirth, or undergo an episiotomy (a procedure in which some of the skin between the vagina and anus is cut) may also experience pain during intercourse for a period of time after delivery.
  
  
• Inadequate lubrication. Vaginal dryness resulting from a lack of lubrication can cause sexual pain. Causes of inadequate lubrication include menopause and insufficient stimulation.
  
  
• Vaginal infection. Bacterial and yeast infections are common causes of sexual pain. Vulvovaginitis, a condition in which the vagina or vulva is inflamed or infected, may also cause sexual pain.
  
  
• Genital irritation. A variety of soaps, detergents, douches and other feminine hygiene products can irritate the genitals and trigger sexual pain.
  
  
• Endometriosis. A condition in which cells that make up the lining of the uterus (endometrium) are found outside the uterine cavity.
  
  
• Vaginismus. A condition in which the vaginal muscles involuntarily contract.  
  
  
• Poorly fitting diaphragm. A diaphragm that does not fit properly can cause sexual pain.
  
  
• Allergic reaction. Allergic reactions triggered by the latex in a condom or diaphragm can cause sexual pain. Seminal plasma hypersensitivity (semen allergy) can also cause sexual pain.
  
  
• Sexual assault. Sexual abuse or rape can cause vaginal injury or psychological trauma, either of which can trigger sexual pain.
  
  
• Ovarian cyst. A fluid-filled structure located within or on an ovary.
  
  
• Vulvodynia. Chronic discomfort or pain of the vulva (the external genitalia composed of the labia, clitoris and vaginal opening), especially burning, stinging, irritation, or rawness.
  
  
• Uterine fibroids. A condition in which tumors grow within the wall of the uterus (womb).
  
  
• Vulvar vestibulodynia. A condition in which a woman experiences pain in the vulvar vestibule (the folds of skin around the vagina) on contact.
  
  
• Adenomyosis. A condition in which the cells that make up the lining of the uterus (endometrium) grow into the muscle wall of the uterus (myometrium).
  
  
• Gynecologic cancers, such as vaginal or cervical cancer.
  
  
• Retroversion of the uterus. A condition in which the uterus is tipped back instead of forward.
  
  

Causes of sexual pain in men include:

• Urethritis. Inflammation of the urethra, the canal that carries urine and semen out of the body.
  
  
• Benign prostatic hyperplasia (BPH, also called benign prostatic hypertrophy). Noncancerous enlargement of the prostate gland. The prostate, which surrounds the upper part of the urethra, grows as men age. This can constrict the urethra, causing pain during urination (dysuria) and during ejaculation (dyspermia). BPH affects more than half of men after age 50, according to the U.S. National Institutes of Health (NIH).
  
  
• Prostatitis. A common acute or chronic condition in which the prostate gland becomes inflamed, usually because of bacterial infection. Prostatitis can lead to chronic pelvic pain syndrome.
  
  
• Prostatodynia. A painful condition that resembles prostatitis except there is no evidence of inflammation or infection by microorganisms.
  
  
• Prostate cancer. Malignant tumors in the prostate, one of the most common kinds of cancer, can impinge on the urethra, making urination and ejaculation painful.
  
  
• Trauma, including testicular and scrotal pain.
  
  
• Reiter’s syndrome. A condition involving urethritis, arthritis and conjunctivitis (an inflammation of the eyelids), seen mainly in young men and often caused by chlamydia.
  
  
• Peyronie’s disease. A condition in which a hard lump forms on the penis and can cause the penis to bend painfully during an erection. One percent of men may have Peyronie’s disease, according to the NIH.
  
  
• Penile cancer. Cancer of the penis is rare in the United States but more common in Africa and other developing regions.
  
  
• Balanitis and balanoposthitis. Inflammations affecting the skin over the tip of the penis.
  
  
• Phimosis and paraphimosis. Conditions involving the tightening of the foreskin.

In addition, men can experience priapism, a painful erection lasting four hours or more. Causes of priapism include sickle cell anemia, spinal cord disorders, neuritis, sexually transmitted diseases (STDs), leukemia (cancer of the blood), trauma, drug abuse, carbon monoxide poisoning and the bite of a black widow spider.

According to the NIH, about 10 to 40 percent of men with sickle cell anemia experience priapism, which can cause impotence. Certain medications, including treatments for erectile dysfunction, some antidepressants and some antipsychotic drugs, can also cause priapism.

Additional causes of sexual pain in women or men include:

• Sexually transmitted diseases. Herpes sores, genital warts and other signs and symptoms of sexually transmitted disease can cause sexual pain. 
  
  
• Urinary tract infections. An infection that develops along the urinary tract, which includes the kidneys, ureters (tubes from the kidneys to the bladder), bladder and urethra.
  
  
• Psychological issues. Psychological and mental disorders are one of the most common triggers of sexual pain. Causes of psychogenic dyspareunia include anxiety, guilt, hostility, aversion to sexuality, anger toward the sexual partner and unresolved issues with past abuse.
  
  
• Hemorrhoids. Sexual pain may result from the presence of swollen veins in the lower portion of the rectum or anus.
  
  
• Interstitial cystis. A chronic inflammation of the bladder that can cause pain and the need to urinate frequently.
  
  
• Urethral diverticulum. A condition in which an outpouching (or pocket) of tissue forms from the urethra.
  
  
• Pelvic adhesions. Bands of fibrous tissue that form between two surfaces inside the body. They may result from inflammation, surgery or injury.
  
  
• Pelvic floor tension myalgia. A spasm of the pelvic floor muscles.

In addition, a number of medications have been linked to sexual pain, including antibiotics, antidepressants, antihistamines and low-estrogen oral contraceptives (birth control pills).