Why is sex painful?

Pain during sex can be brought on by so many different things, which is why it’s important to try and figure out what could be causing it. Just talking about sex can make us feel vulnerable, but when it comes to your health and happiness it’s important to be open about any discomfort you may be experiencing. In this article, we mainly focus on why sex can be painful for women and what you can do about it.

Skip to: Causes of painful sex | What to do | Related issues | Management tips

As we’ve mentioned already, there are a variety of different reasons why sex can be causing you pain. To help give you an idea of the sorts of things that can cause it, we’ve listed some potential reasons for painful sex below…

Dryness

This is one of the most common reasons for experiencing discomfort during sex, as intercourse may bring about a burning or itching sensation.^1,2

Menopause

Leading on from the last point, many people experience pain during sex when menopausal, as the hormone fluctuations can lead to vaginal dryness or atrophy.³

Constipation or bloating

The symptoms of IBS may have a knock-on effect on your sex life, as many women experience a deep pain within the pelvis during intercourse.⁴

Scar tissue

Injury, trauma or previous surgeries can cause scar tissue, which can increase tension in the pelvic floor muscles.⁵  

Intact hymen

This is a membrane in the vaginal opening, which has a small hole in it from birth which becomes stretched with use of tampons or by having sex. However, during your first time you may feel pain as the hymen is forced open during intercourse.⁶

Vaginismus

This is when the muscles in the vagina tighten up when you try to insert something into it, which makes sex painful or even impossible.⁷

Inflammation

Sometimes the glands in the vagina can become inflamed and tender, triggering something called Bartholinitis which can cause to painful sex.⁶

Infection

There are a range of infections that can cause pain during sex, some sexually transmitted, some not. For example, it could be bacterial like thrush or viral like with herpes. Either way, it’s best to speak to a healthcare professional so that they can give you the best advice.⁶

Endometriosis

This is a condition that affects the lining of the womb, where similar tissue grows in the ovaries and fallopian tubes. This causes pain during and after sex among many other symptoms.⁸

Undiagnosed conditions or issues

There are also other issues that may be causing pain during sex, like ovarian cysts, fibroids, pelvic inflammatory disease or interstitial cystitis. So it’s recommended to speak to a medical professional to find out the cause of your pain.⁶

If you experience pain during or after sex, it’s best to get some advice from a GP or a healthcare professional at a GUM clinic. They’ll help to try and find the cause of your pain and guide you on your treatment options.⁹

It’s important to acknowledge that painful sex can have a knock-on effect on other areas of your life. As well as discomfort during sex, you may also experience:

• Emotional distress
• Not feeling connected with your partner
• Low self-esteem
• Frustration
• Mental health distress

Opening up about your emotional wellbeing to your partner, a loved one or health care professional may help you to process your thoughts and feelings. Plus, this is also a big step in finding a solution to the problem.

Of course, the first thing to do when experiencing pain during or after sex is to get some advice from your GP or a GUM clinic. This is so they can work with you to find the cause and offer the right treatment. Here’s what they might recommend:⁹

• If you have unusual discharge, itchiness or soreness around your genitals as well as pain, they may offer you treatment for thrush or an STI test.
• If you experience vaginal dryness, they might suggest using a lubricant – but remember to use a water-based lube if you're using condoms, because oil-based versions can damage them and make them ineffective.
• If you have an allergy or irritation around your genitals, they may recommend that you avoid using products that could be causing it.
• If there's an emotional reason or anxiety contributing to the issue, a counsellor or sex therapist may be able to help – either your GP or sexual health clinic can refer you.

You shouldn’t put up with painful sex. It is something to be enjoyed and if it’s a distressing experience for you, it may have an impact on your overall wellness and potentially your relationships too. Don’t be afraid to reach out for help, as lot of the causes have a simple solution.⁶