If you feel pain at the start of intercourse, the culprit may be vaginal dryness, which usually stems from lowered estrogen levels after childbirth and during breastfeeding. Your doctor may prescribe an estrogen cream or suggest that you use a vaginal lubricant, such as KY Jelly. But if the real reason is lack of arousal, the cause may be a problem in your relationship, which can best be handled by spending more time together or perhaps even seeking couples therapy.
Another common reason for discomfort is a yeast infection, which can cause irritation and pain during sex. Over-the-counter antifungal medications are effective, but see your doctor for an accurate diagnosis first.
If you've recently had a baby and you underwent an episiotomy, you'll heal in one to two months, but you may still feel pain and tenderness, especially during the beginning of sex, for three months to a year.
Pain that comes later in the act of sex, however, may mean something else entirely. "If the start of intercourse goes smoothly, but pain occurs upon deep penetration or thrusting during intercourse, the most common reason is endometriosis growth of uterine tissue outside the uterus or cysts or tumors, benign or malignant, in the vagina or uterus or on the ovaries," says Donna Sweet, M.D., professor of internal medicine at the University of Kansas School of Medicine, in Wichita.
Such problems can be detected during pelvic exams or through a vaginal ultrasound (a noninvasive procedure) or a laparoscopy (a minimally invasive surgical technique in which a tiny endoscopic tube is inserted through a small incision in the pelvic area).
Be sure to tell your doctor if pain during sex tends to be worse right before your period -- that could be a sign of endometriosis.