Why Sex May Be Painful, And What To Do About It

Sex should be a pleasurable experience, not a painful one, but for some women (and men) sex isn’t an enjoyable event. Painful intercourse for women is known as dyspareunia, and can be caused by a number of reasons - from the physical to the psychological.

According to a study in the British Journal of Obstetrics and Gynaecology, 1 in 10 women pain during sex lasting 3 months or more. There are many reasons this may happen, and the odd occurrence is pretty normal, but regular pain during or after sex is your body’s way of telling you something isn’t right, and you should never ignore it.  

Let’s take a look at the different reasons you may experience pain during sex, and what you can do to help.

The most common cause? Dryness 💨

Nearly half of women who report pain during sex also notice vaginal dryness. If your vagina is dry as the desert and you try to put something inside, you’ll likely experience discomfort or even feel like you’re getting a friction burn - not fun! It’s particularly common for women going through menopause or post-menopause, though women in their 20s can also experience it.  

The discomfort of dryness aside, it is often associated with times of low oestrogen such as while breastfeeding or after the menopause. The hormone drop can cause an imbalance of good bacteria which can lead to infections that make sex painful.  

If you have experienced vaginal dryness, it might be time to embrace the lube! Try using a small amount of lubricant before sex to make the experience more pleasant and less painful. In between times of intimacy, vaginal moisturisers can also be beneficial and if you don’t want to chat to your doctor about this, you can get them over the counter too!  

Other possible causes 🔬

Besides dryness, there are a number of reasons why sex can hurt during or after, and you may experience pain inside the vagina, or deeper in the pelvic region.

If your pain is in the vagina, it may be caused by:

• Thrush, or an STI (sexually transmitted infection) like chlamydia or genital herpes
• A condition called Vaginismus, which causes muscles in and around the vagina to tightly contract. This makes sex painful, and sometimes impossible
• A condition called Vulvodynia, in which chronic pain affects the external sexual organs, with no known cause
• Irritation due to an allergy to things like latex condoms, soap products or spermicides Issues with the cervix, which can lead to pain when a penis penetrates to this depth
• Intercourse too soon after surgery or childbirth that involved an episiotomy or tear  

If your pain is in the pelvis, it may be caused by conditions such as Pelvic Inflammatory Disease (PID), Endometriosis, Fibroids, Irritable Bowel Syndrome (IBS), or in some cases, even a bout of bad constipation - ouch!

It can be difficult to know which of the above is causing your symptoms, so even more reason to pay your doctor a visit! 

What psychological factors can contribute to pain? 🧠

Some pain originates in the mind, but this makes it no less real, distressing and painful. In the case of Vaginismus, it is thought that the muscles contract due to an underlying fear of pain, preventing penetration partially or completely. This can happen completely involuntarily. 

There are many reasons why your mind could be contributing to pain, such as stress, shame or anxiety related to sex, body image issues, medications such as SSRIs with side effects that suppress sexual desire, other medical problems that affect libido (such as cancer, diabetes or thyroid problems), or a history of trauma.

What to do about pain during sex🤔

Painful sex can be frustrating, but isn’t often linked to medical conditions that require urgent medical attention unless there is also heavy bleeding involved. That said, sex should be an enjoyable experience and shouldn’t have you suffering from chronic pain issues. If pain persists, it’s time to ring up your GP or a healthcare professional at a GUM clinic! They’ll be able to check that everything is fine and recommend treatment depending on any accompanying symptoms. 

This could mean taking medication for an infection, using a special lubricant, stopping use of fragranced body care products, taking estrogen replacement, or treatment for emotional issues at the root of the problem.

It’s also worth noting that, although lubricants can be helpful if the problem is vaginal dryness, it’s important to speak to a GP so they can check everything is A-OK down there. Simply using lubricant could exacerbate undiagnosed problems, for example a tear inside the vagina - noooo, thank you.

Home remedies ✨

While you should always discuss your symptoms with a professional, you may find some home remedies to be effective at reducing pain during sex. Here are a few to try:

• Mindful sexual intercourse - doing it when you and your partner are relaxed
• Talking to your partner - be open about the pain you are experiencing
• Enjoying a warm bath before sex - relax the body and mind
• Using the loo right before having sex - it’s all about the empty bladder!
• If penetration is the source of the pain, consider other forms of sex to help you relax by taking penetration off the table

Don’t let painful sex get in the way of a healthy sex life or your relationship - pain during sex is common, but this doesn’t mean you should accept it as your fate. Talk to your partner about ways you can relieve the pain, and to your GP to find out if they can prescribe anything to help.  Women's health physiotherapists can often be a wealth of helpful information.  

Have you ever experienced pain during sex? What did you do about it? Tell us your story over on Instagram @itsyoppie. Don't forget that our personalised period subscription box can get organic cotton tampons, PMS supplements, and much more, delivered easily and regularly through your letterbox. That's a bit less to worry about while you're getting on with life!

Additional References

Mitchell KR, Geary R, Graham CA, et al. Painful sex (dyspareunia) in women: prevalence and associated factors in a British population probability survey. BJOG An Int J Obstet Gynaecol 2017; 124: 1689–1697.

Gandhi J, Chen A, Dagur G, et al. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. Am J Obstet Gynecol 2016; 215: 704–711.

Crowley T, Goldmeier D, Hiller J. Diagnosing and managing vaginismus. BMJ (Online) 2009; 339: 225–229.

Fact checked by Doctor Brooke Vandermolen.