Pain during sex is common and can feel like burning, stinging, tightness or deep pelvic discomfort. It may be caused by vaginal dryness, infections, hormonal changes or underlying medical conditions. Understanding the possible causes can help you find the right treatment.
What Are the Different Types of Pain During Sex?
Pain during sex, medically known as dyspareunia, generally falls into two categories:
Entry pain: Pain around the vaginal opening during penetration, often caused by dryness, irritation, infections or muscle tension.
Deep pain: Discomfort deeper inside the vagina or pelvis, sometimes associated with endometriosis, ovarian cysts or other pelvic conditions.
Some women also experience soreness, burning or cramps after sex.
9 Common Causes of Pain During Sex in Females
1. Vaginal Dryness
Insufficient lubrication can cause friction, irritation and burning during penetration. Common triggers include hormonal changes, breastfeeding, menopause, certain medications and insufficient arousal.
Using a water-based or silicone-based lubricant may help reduce discomfort.
2. Vaginal Infections and STIs
Yeast infections, bacterial vaginosis and sexually transmitted infections (STIs) can cause inflammation and painful intercourse.
Other symptoms may include itching, unusual discharge, unpleasant odour or burning when urinating. Testing can help identify the cause and appropriate treatment.
3. Endometriosis
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. It can cause deep pelvic pain during sex, painful periods and ongoing pelvic discomfort.
Symptoms vary, and a medical assessment may be needed for diagnosis.
4. Vaginismus and Pelvic Floor Tension
Vaginismus involves involuntary tightening of muscles around the vaginal opening, making penetration painful or difficult.
Pelvic floor tension can also cause discomfort during sex or tampon insertion. Pelvic floor physiotherapy and psychosexual therapy may help.
5. Hormonal Changes and Menopause
Declining oestrogen levels during perimenopause and menopause can make vaginal tissues thinner, drier and more sensitive.
Lubricants, vaginal moisturisers and prescribed vaginal oestrogen treatments may help relieve symptoms.
6. Vulvodynia and Skin Conditions
Vulvodynia causes persistent vulvar pain, often described as burning, stinging or soreness.
Skin conditions such as eczema and lichen sclerosus can also cause irritation and discomfort during intercourse.
Treatment depends on the underlying condition.
7. Ovarian Cysts and Other Pelvic Conditions
Ovarian cysts, uterine fibroids, adenomyosis and pelvic inflammatory disease may cause pain during deep penetration.
Persistent pelvic discomfort, particularly alongside other symptoms, should be assessed by a healthcare professional.
8. Childbirth or Previous Surgery
Vaginal tearing, scar tissue and pelvic floor changes after childbirth can make intercourse uncomfortable.
Breastfeeding-related hormonal changes may also contribute to vaginal dryness. Pelvic floor physiotherapy and medical treatment can support recovery.
9. Stress, Anxiety and Emotional Factors
Stress, anxiety, relationship difficulties and previous painful experiences can affect arousal and increase pelvic floor tension.
Anticipating pain may also cause involuntary muscle tightening, making intercourse more uncomfortable.
Psychosexual therapy can help address these emotional and physical responses.
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Why Does Sex Suddenly Hurt When It Didn't Before?
Pain during sex can develop even if intercourse was previously comfortable.
Possible reasons include:
Hormonal changes or vaginal dryness
New infections or inflammation
Changes in medication
Pregnancy, childbirth or breastfeeding
Pelvic conditions such as endometriosis
Increased stress or pelvic floor tension
If the pain is new, recurring or worsening, seek medical advice.
How to Reduce Pain During Sex
The right approach depends on the cause, but several strategies may improve comfort:
Use lubricant: Reduce friction and irritation during penetration.
Allow more time for arousal: Avoid rushing into penetration.
Adjust sexual positions: Choose positions that allow control over depth and movement.
Communicate openly: Let your partner know what feels comfortable.
Avoid irritants: Use gentle, fragrance-free intimate care products.
Seek professional support: Medical treatment, pelvic floor physiotherapy or psychosexual therapy may help.
Avoid continuing penetration when it causes pain.
When Should You See a Doctor?
Speak with a healthcare professional if pain during sex is persistent, recurring or affecting your wellbeing.
You should also seek advice if you experience unusual discharge, bleeding after intercourse or ongoing pelvic discomfort.
Sudden severe pelvic pain, particularly with fever, fainting or possible pregnancy, requires urgent medical assessment.
Frequently Asked Questions
Is pain during sex normal?
Pain during sex is common, but persistent or significant discomfort shouldn't be ignored. Many causes are treatable.
Can anxiety cause painful sex?
Yes. Anxiety can affect arousal and contribute to pelvic floor muscle tension, although physical causes should also be considered.
Why does deep penetration hurt?
Deep pain may be associated with endometriosis, ovarian cysts, pelvic inflammatory disease or pelvic floor dysfunction.
Can pain during sex be treated?
Yes. Treatment may include lubricants, medication, hormonal therapy, pelvic floor physiotherapy or psychosexual counselling, depending on the cause.
