Major causes of pain during se.x?

   To be able to make lo.ve without pain, there must be sufficient desire to make lo.ve and sufficient a.rousal
. The woman must have relaxed pelvic floor muscles and there shouldn't be any irritated body parts e.g a bladder infection, venereal diseases, insufficient lubrication of the va.gina, oedema, a tight foreskin etc.
It is important to look at the problem from different points of view. There may be a biological cause. This may be a s.exually transmitted disease, a va.ginal infection, a disorder of the uterus or the large intestine, an infection of the vaginal mucous membrane, a snip or a tear during childbirth and insufficient lubrication of the va.gina. Men may have infections on skin anomalies to the pe.nis, infections of the glans and the foreskin due to fungi or bacteria, a tight foreskin, prostatitis, or a low testosterone level (hormones). In women, vestibulit (an inflammation in the .v.agina) can be a cause of s.ex pain.

A medical investigation is an important step in the treatment process. The pain may be due to social causes like relational problems. Communication problems between the partners may play a role. Many people are afraid to indicate what they like in the se.xual field.

 Psychological causes may also play a role. Since many women can't relax sufficiently, the vagina doesn't get w.et enough the penis rubs against the side of the va.gina, which leads to irritation. Due to the fear of pain the pelvic floor muscles are tensed too much, which causes the lo.ve play to hurt.

 The woman gets into a vicious circle of fear of pain, which leads to tension, the tension to extra pain and no more ar.ousal, which leads to a dry va.gina, which leads to more irritation, etc. There may also be negative thoughts and feelings about sex.uality and certain harmful events may play a role. 

Vestibulitus and va.ginismus are other possible causes of pain during se.x.
For men who can ma.sturbate without pain, physical causes may often be excluded. Fear of pain may lead to the avoidance of the pain by not wanting to make love anymore.