Why does sex hurt? 14 common reasons why intercourse is painful, plus how to prevent it

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  • Expert advice from those in the know.

    So, why does sex hurt? Good question – and, sadly, not one that there’s a straightforward answer to.

    Putting on some pretty lingerie, selecting one of the best sex toys for couples, and pouring a glass of wine for yourself and your partner, only to then feel a stabbing, burning or, well, any kind of pain down there can be a bit of a mood killer, to put it mildly. Not to mention a worry.

    Sex can hurt for a number of reasons, from underlying infections to hidden health conditions. Let’s be honest, you

    That highlighted, it’s definitely better to deal with it sooner rather than later – no point gritting your teeth and hoping it will go away.

    Known medically as dyspareunia, as obstetrician, gynaecologist and consulting doctor for Wellbeing Sisters Larisa Corda explains, painful sex affects one in ten British women, as per an International Journal of Obstetrics and Gynaecology study.

    And, according to doctor Shree Datta, gynaecologist for intimate wellbeing brand INTIMINA, there are two main types. Superficial dyspareunia – pain at the entrance to the vagina or within it at the point of penetration – or deep dyspareunia – which occurs deep in the pelvis. “Remember that pain can range from a mild irritation to debilitating pain, meaning sex can’t be tolerated, and it may be temporary, intermittent or a long term problem,” she explains.

    Both female experts stress that it’s important to discover it sooner rather than later why you may be suffering from pain during sex. Keep reading to decode why does sex hurt, once and for all.

    Why does sex hurt? 14 common reasons

    1. Too little lubrication

    FYI, one of the most common reasons you’re having to Google, ‘why does sex hurt?’, is because you have too little vaginal lubrication during sex. This is totally normal – a lot of women experience vaginal dryness.

    Your vagina lacking moisture can be down to the amount of foreplay before penetration, or even a lack of hormones such as oestrogen around the time of menopause, explains Datta. “If you suffer from medical conditions such as diabetes or depression, this can also affect your sexual libido and enjoyment,” she shares.

    Bottom line: many women simply do not produce enough vaginal lubrication, including younger women, adds Samantha Evans, sexual health expert, former nurse and co founder of luxury sex toy retailer Jo Divine.

    Try this: Rather than keep Googling why does sex hurt, Evans shares that the use of lubricants can really help. Often GPs will prescribe a hormonal cream or pessary, but many gynaecologists advocate using vaginal lubricants to help nourish the delicate tissues of the vagina. Read out guide to the best lubes to buy over the counter, while you’re here.

    Why does sex hurt: Detail of woman in lingerie lying in her bed

    2. You may be suffering from a skin condition

    Did you know? Underlying skin conditions can actually cause irritation during sex, and condoms may also cause discomfort or burning, particularly if you have an allergy, explains Datta. If your vagina burns after sex, you may have eczema and other genital skin conditions, such as lichen sclerosis.

    Try this: Make sure you visit your GP to get your skin condition defined, if you think you may be suffering. From there, they can help you decide the best course of action, explains Corda.

    3. You may have vaginismus

    Ever heard of vaginismus? If you haven’t, it’s the tightening of your vaginal muscles automatically at the time of penetration, explains Datta. But why does this happen? “It can be caused by a combination of physical and psychological issues,” explains Corda. “Physical causes can include urinary tract infections, sexually transmitted diseases, vulvodynia, skin conditions such as psoriasis or eczema, menopause, and birth trauma.”

    Psychological problems, on the other hand, can be caused by emotional or sexual trauma. “A previous painful experience with sex might make it harder to feel aroused and enjoy touch,” explains a spokesperson from Brook Advisory. “It can also make the muscles around the vagina and anus clench (to protect you from the pain you’re worried about) and make penetration difficult and more painful.”

    Try this: With the appropriate medical intervention and counselling, the experts share that the problem can be alleviated to enable penetrative sex. Treatment usually involves specialist counselling, pelvic floor exercises, biofeedback training with a women’s health physiotherapist and use of medical dilators or a vibrator or dildo to slowly encourage the vagina to relax and open.

    4. You may have an STD

    Pain during or after sex can also be a sign of a sexually transmitted disease (STI) or vaginal infection, like a urinary tract infection like cystitis.

    “Stinging or burning during sex may be as a result of a sexually transmitted infection, especially if you also experience an unusual vaginal discharge, or an unusual odour,” says Professor Ellis Downes, consultant obstetrician and gynaecologist and spokesperson for vSculpt. “If you have a new sexual partner and have had unprotected sex with him, and are experiencing these symptoms it would be a good idea to have it diagnosed and treated by your GP or at a sexual health clinic.”

    Try this: STIs such as Chlamydia or gonorrhoea can have little to no symptoms but vaginal itching or burning, as well as painful sex, might be a sign that you are infected. Visit your GP or GUM clinic for a test. Treatments usually involve antibiotics but your doctor can recommend the next course of action.

    Why does sex hurt? A woman and man kissing on a bed

    5. You might have thrush

    Three out of four women will suffer with thrush at some point in their lives, although it’s other infections, such as bacterial vaginosis. As above, UTI’s are also a common reason as to why sex is likely to hurt. Vaginal thrush, in particular, is a common yeast infection, and the main symptoms include painful sex, itching, soreness, stinging, burning when peeing and an odourless discharge.

    Try this: You can pick up a DIY test in most pharmacies to determine whether you have thrush or BV, and your pharmacist will be able to recommend the best course of action. It’s usually treated with anti-fungal cream, pessaries, pills or a combination.

    6. You could be going through the menopause 

    According to Corda, during the menopause, women experience a reduction in sex hormones which can lead to both vaginal dryness and sexual pain.

    Do note here: Don’t feel embarrassed about this or suffer in silence – as Datta points out, lots of people experience sexual problems at different stages of life. “There is a lot of help out there, so there is no need to deal with this difficulty alone,” she shares. Do book an appointment with your GP if you think your painful sex may be because of menopausal symptoms.

    Why does sex hurt? Cropped Image Of Couple Doing Sex On Bed At Home

    7. Your vagina may be irritated

    You’ll likely know that genital irritation can be caused by spermicides, latex or vaginal douching. Some women are allergic to certain products or even their partner’s sperm. Latex products, such as condoms or sex toys, can also cause an allergic reaction, so if you’ve ever experienced an itching or burning sensation when trying new products, then you might’ve had an irritation or allergic reaction which can, in turn, lead to painful sex.

    Try this: do be aware of what you are applying to the delicate skin of your genitals. Glycerin – which is often found in flavoured lubes – as well as parabens and aspartame, can cause irritation. Similarly, alkali or acidic lubes can mess with the pH balance of your vagina and cause dryness and itching. Instead, switch to a water-based (not silicon-based) lube, such as Pjur. Another alternative is Sliquid, which is also glycerin- and paraben-free.

    Similarly, opt for latex-free condoms and, when using a sex toy, make sure you clean if after use (read how to clean your sex toys, here), recommends Downes. “Some cleaning substances can irritate the vaginal lining, though, so do note that it’s best just to use hot water and natural soap.”

    8. You may just not be aroused

    “If you’re not physically aroused, touch of any kind can be uncomfortable, especially if it’s somewhere sensitive, like your clitoris or the tip of your penis,” says a spokesperson from the Brook Advisory Clinic. “Being well-lubricated, relaxed and with lots of blood flow in the area (you want either an erect penis or a vulva swell) helps with this, so put plenty of focus on foreplay,” they recommend.

    FYI, women especially need warming up before penetrative sex, both physically and emotionally. “If you’re not feeling turned on – that is, if you’re not mentally aroused – touch can be unpleasant. For example, being tickled when you’re feeling playful and silly is usually more fun than when you’re tired or angry,” adds the Brook spokesperson.

    Try this: The sexpert suggests spending time enjoying foreplay to significantly improve your sexual pleasure. “There may be times when penetrative sex is not possible, but you can still have great sex without intercourse,” they share.

    Corda also adds that, if you’re worried about your lack of libido, counselling could be key to treating these factors and reviving the pain associated with sex. But in the first instance, it’s important to see your doctor to rule out medical causes first and provide the correct treatment.

    Why does sex hurt? Woman being kissed by her man - Romantic couple

    9. You may be injured

    Did you know? “Painful sex can be a sign of damage from previous sex, such as tearing or soreness,” explains a spokesperson from the Brook Advisory Clinic.

    Think about it – you wouldn’t go running if you’d twisted your ankle, so try not to have sex super quickly after a particularly enthusiastic session, as it may have resulted in friction that has left you sore.

    10. He may be too big

    “Even if you’re well lubricated and fully aroused, you may experience pain if a man inserts his penis too quickly or deeply,” says Evans. “The vagina relaxes as you warm up to having sex, and will open more comfortably if the penis enters slowly. Guiding your partner in at your own pace can really help avoid any pain.”

    Try this: She explains that often, having sex doggy style can be painful, so try backing onto the penis at your own pace. The same can be said when going on top. Don’t let your partner to pull you down onto their penis if you suffer from painful sex: instead, she recommends slowly lower yourself, controlling the speed and depth of insertion that is comfortable. Got it?

    Why does sex hurt? Close-up of couple's legs in bed together

    11. You may have a female health condition like endometriosis

    Painful sex is a common symptom for women with endometriosis symptoms, which affect two million women in the UK, making many avoid sex altogether. Up to 50% of women with endometriosis have cited painful intercourse, ranging from sharp, stabbing, needle-like pain to a deep ache. It can feel mild to intense, either during sexual intercourse or up to 24 to 48 hours post-coitally, or both.

    As well as endometriosis (when the lining of the uterus grows outside the uterus or is thicker than normal), painful sex can also be caused by fibroids (growths of muscle and tissue inside the uterus) growing close to your vagina or cervix, irritable bowel syndrome and constipation.

    Try this: Endometriosis – and its flare ups – are unpredictable, so often it feels like there’s no knowing when they may occur. Some women experience pain throughout the month whereas others only experience it at certain times, likely – but not definitely – related to their menstrual cycle. There is no cure for endometriosis but there are treatments that can help with the pain – do visit your doctor if you fear you may have it.

    12. If you’ve just given birth, your vagina may be recovering

    Wondering why does sex hurt after just giving birth? FYI, giving birth is a beautiful and emotional thing – but also an emotional and physical challenge, too, and you’ll need to take time to recover afterwards. “Childbirth is a formative experience for any woman, and for some it can be traumatic,” says Dr Becky Spelman, psychologist and We-Vibe‘s relationship expert. “Insensitive care practitioners or a difficult or dangerous birth can give rise to a heightened fear of birth, pregnancy, and even sexuality itself. Women who have experienced a traumatic birth often struggle to re-engage with their sexual selves, even when they have recovered physically, and can experience pain with no obvious physical cause,” she explains.

    So why exactly is sex painful after giving birth? A number of reasons, from bruising to the vaginal wall is a common reason, explains Downes. “You may also have experienced a tear which will need time to heal completely before you have sex again – doctors recommend at least six weeks but it often takes longer,” she shares.

    Why is sex painful? Woman with Legs Raised wearing white shorts lying on bed

    13. Your relationship might be under strain

    Arguing a lot or working through a stressful patch in your relationship? Ill feeling can actually totally cause painful sex, FYI – it’s a vicious cycle.

    “Experiencing emotional pain as a result of conflict within your relationship could lead to painful sex,” says Evans. “Many couples go through an emotional disconnect if one of them is unable to have sex, which in turn can increase the pain levels, thus creating a vicious circle.”

    Try this: The sexpert advises that consulting a couples’ counsellor or sex therapist may help – and remember, you are not alone.

    14. You could have a hidden health condition

    Often painful sex is a sign of a more unusual, difficult to diagnose health issue, explains Evans. Some of the lesser known conditions that could be causing you discomfort during sex include:

    • Lichen Schlerosus – a common condition generally affecting postmenopausal women thought to be linked to an overactive immune system.
    • Vestibulodynia – a condition that makes you feel a burning pain thought to affect 12-15% of women.
    • Vulvodynia – spontaneous burning without an itching sensation.

    If you’re worried you have any of the above, do see a doctor.

    Is painful sex normal? 

    Now you’ve read the expert answer to why does sex hurt, we’re sure you’re keen to know if pain during intercourse is actually common. Short answer: yes, but it’s important to see your doctor if sex is painful repeatedly. “It can stop you from enjoying sex or lead to you avoiding sex altogether,” shares Datta – which is not good.

    “This can be isolating, affect your mood and cause distress,” she shares. “It could also cause problems in your relationship over time. You may be referred to see a Gynaecologist and we may need to examine and exclude both physical and psychological problems.

    Bottom line: pain during sex can be down to a number of different causes. “That’s why sometimes a multi-disciplinary approach is needed to reach an adequate diagnosis and to offer appropriate support,” explains Corda. “This may include psychologists, urologists, gynaecologists, and even dermatologists.”

    They’ll be able to allow you to explore the various issues affecting your ability to have or enjoy sex, and your relationship with your partner.

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