Pain during sex is more common than many people realise, but it is not something you should feel you have to live with.

Pain may occur before, during or after sex and can have a range of physical and psychological causes. Sometimes the discomfort is temporary, while in other cases it may continue or worsen over time.

Although occasional discomfort does not always indicate a serious problem, persistent or recurrent pain during sex should be assessed by a healthcare professional. Identifying the underlying cause is the first step towards finding appropriate treatment and improving your quality of life.

Key takeaways

Pain during sex can have many possible causes.
Pain may occur before, during or after intercourse.
Ongoing or worsening symptoms should not be ignored.
A medical assessment can help identify the underlying cause.
Treatment depends on the reason for the pain.

What is painful intercourse?

Painful intercourse, also known as dyspareunia, describes persistent or recurrent pain experienced before, during or after sexual activity.

The pain may affect the entrance to the vagina, occur deeper within the pelvis or continue after intercourse has finished.

Some people experience discomfort only occasionally, while others find that pain affects every attempt at penetrative sex.

Painful intercourse is a symptom rather than a condition itself, so understanding what is causing it is important.

What causes pain during sex?

There are many possible causes of pain during sex.

These include:

Vaginal dryness
Hormonal changes
Infections
Skin conditions affecting the genital area
Pelvic floor muscle problems
Endometriosis
Ovarian cysts
Fibroids
Pelvic inflammatory disease
Psychological factors such as anxiety or previous trauma

Sometimes more than one factor contributes to painful intercourse.

A healthcare professional will consider your symptoms, medical history and any associated symptoms before determining the most likely cause.

Pain during sex from vaginal dryness

One of the most common causes of painful intercourse is vaginal dryness.

Reduced natural lubrication can increase friction during sex, making penetration uncomfortable or painful.

Vaginal dryness may occur because of:

Hormonal changes
Breastfeeding
Perimenopause or menopause
Certain medications
Some medical treatments

Simple treatments may help, but persistent symptoms should still be assessed to rule out other causes.

Pelvic pain during sex

Pain felt deeper within the pelvis during intercourse may have a different cause from pain around the vaginal opening.

Deep pelvic pain may be associated with conditions including:

Endometriosis
Fibroids
Ovarian cysts
Pelvic inflammatory disease
Pelvic adhesions

The location, timing and severity of the pain can provide useful clues during a medical assessment.

Pain after sex

Some people experience pain only after intercourse has finished.

This may involve pelvic discomfort, cramping or soreness.

Pain after sex can have many possible causes, including irritation, infections, pelvic floor muscle tension or underlying gynaecological conditions.

If symptoms occur repeatedly or are becoming more severe, it is advisable to seek medical advice.

Could an infection be causing the pain?

Yes.

Certain infections may cause pain during or after sex.

These include urinary tract infections, vaginal infections and some sexually transmitted infections.

Additional symptoms may include:

Unusual vaginal discharge
Burning when passing urine
Itching or irritation
Bleeding after sex
Pelvic discomfort

Prompt assessment can help identify whether an infection is present and whether treatment is required.

When should you speak to a doctor?

Occasional discomfort may not always indicate a serious problem.

However, you should arrange a medical assessment if:

Pain happens regularly during sex
The pain is severe
Symptoms are becoming worse
You notice bleeding after sex
You have unusual vaginal discharge
You experience ongoing pelvic pain
Pain is affecting your relationships or quality of life

Persistent pain should never be accepted as normal.

What happens during a medical assessment?

A clinician will usually begin by asking about your symptoms.

This may include questions about:

When the pain occurs
Where the pain is felt
How long symptoms have been present
Your menstrual history
Current contraception
Previous medical conditions
Any associated symptoms

Depending on your symptoms, further assessment may be appropriate.

This could include , urine tests, swabs or referral for additional investigations where clinically indicated.

How is dyspareunia treated?

Dyspareunia treatment depends entirely on the underlying cause.

Treatment may involve:

Treating an infection
Managing vaginal dryness
Addressing hormonal changes
Pelvic floor physiotherapy
Treatment for underlying gynaecological conditions
Referral to an appropriate specialist where required

Because treatment varies significantly, obtaining an accurate diagnosis is important before symptoms are managed.

Why you should not ignore painful intercourse

Pain during sex can affect physical health, emotional wellbeing and intimate relationships.

Many people delay seeking help because they feel embarrassed or assume discomfort is something they must tolerate.

In reality, persistent pain deserves medical assessment.

Early assessment may help identify treatable conditions and prevent symptoms from continuing unnecessarily.

Final points

Pain during sex is never something you should simply put up with.

Although many causes are not serious, persistent or recurrent pain should be assessed to identify the underlying reason and determine the most appropriate treatment.

If painful intercourse is affecting your wellbeing or your relationships, speaking to a healthcare professional can help you understand what is causing your symptoms and what treatment options may be available.

FAQs

Is pain during sex normal?

Occasional discomfort can happen for several reasons, but persistent or recurrent pain during sex is not considered normal and should be assessed.

What is dyspareunia?

Dyspareunia is the medical term for persistent or recurrent pain experienced before, during or after sexual intercourse.

What causes painful intercourse?

Painful intercourse can be caused by vaginal dryness, infections, pelvic floor problems, endometriosis, fibroids, ovarian cysts, hormonal changes and several other conditions.

When should I see a doctor for pain during sex?

You should seek medical advice if pain is persistent, worsening, severe or accompanied by symptoms such as bleeding after sex, unusual discharge or ongoing pelvic pain.

Can painful sex be treated?

Yes. Treatment depends on the underlying cause and may involve medication, treating infections, managing hormonal changes or addressing underlying gynaecological conditions.

Can anxiety cause pain during sex?

Psychological factors, including anxiety, can contribute to painful intercourse in some people, although physical causes should also be considered during a medical assessment.

Pain during sex: When should you speak to a doctor?