Why It Hurts During Sex

If your time in the sack is more painful than pleasurable, it doesn’t have to be. Here are some things that can help.

woman and man lying in bed, woman is unhappy

Medically reviewed in March 2022

Sex is supposed to be pleasurable and intimate, and yet nearly three out of four women will experience painful intercourse, otherwise known as dyspareunia, at some point in their lives, reports the American College of Obstetricians and Gynecologists. Not all pain is permanent, but it’s important to learn how to deal with it for your sake, and your partner’s. Here are some of the causes of painful sex, how you can prevent it and ways to ease the pain so you can enjoy being intimate again.

The most common causes of painful sex—and what may help
1. Insufficient lubrication: The number one reason women have pain during intercourse is because the area down there isn’t wet enough. A lack of lubrication causes the vagina to be dry.

If you’re feeling dry down there, try using a water-based lubricant to add moisture to the area. You also want to be sure you allow time for arousal and foreplay before penetration. And for women, arousal usually takes a little longer than it does for men, so you'll want to keep that in mind. 

Menopausal women have an especially hard time becoming aroused because their hormones prevent the vagina from lubricating. But, you can talk to your doctor about vaginal estrogen creams that help restore the vagina. 

If you’re still experiencing dryness see your doctor so they can test for yeast infections or vaginosis.

2. Certain health conditions: Certain health problems may make intercourse uncomfortable. If you have any of these conditions and sex is painful, talk to your doctor to discuss how you can make intercourse more enjoyable.

  • Bacterial vaginosis, herpes and gonorrhea may cause irritation and dryness inside or outside of the vulva
  • Bladder infections can cause pelvic pain and discomfort
  • Yeast infections will cause pain inside the vagina
  • Fibroids cause pelvic pain during deep penetration 
  • Endometriosis causes pelvic pain during deep penetration
  • Skin disorders such as contact dermatitis may cause itching, burning and pain
  • If a woman has an episiotomy or tear in the perineum during childbirth, this may cause pain

Depending on the condition, treatments like nonsteroidal anti-inflammatory drugs, antibiotic medications or surgery can improve your symptoms—in some cases, for good.

3. Psychological factors: Women who have experienced traumatic sexual experiences with intercourse, like sexual assault or rape, may have trouble getting into the act again. Negative emotions or anxiety when it comes to sex can make it difficult to feel aroused. 

If these thoughts or feelings—which are nothing to ashamed of—are preventing you from enjoying intercourse, seek the help of a mental health professional. He or she will help you acknowledge what happened and walk you through the ways you can improve your current sex life, despite a previous emotional event.

If it’s not a traumatic event but another fear or anxiety that’s preventing you from enjoying sex, you’ll still want to get expert help. Fear or anxious thoughts can actually cause your vaginal muscles to spasm, or tighten and contract, but Kegel exercises, which are known to strength the pelvic floor, can help relax your pelvic floor in these situations, says Wright.

If you’re not enjoying sex because of psychological factors, then seek professional help first. You might also consider:

  • Picking a good time for sex so it’s a relaxing, not rushed event, for both you and your partner.
  • Massages and warm baths may help get you aroused, and can relax your mind and body.
  • Taking enough time for foreplay like kissing, breast and nipple action and clitoris stimulation will help get you in the mood, too.

4. Relationship problems: Couples who are going through relationship challenges may have problems feeling sexually stimulated. Not all couples have the same sexual drive—one partner may want to have sex more frequently than the other.

And in this case, couples should definitely consider counseling or sex therapy to work through any of those conflicting feelings.

When to see your doctor
It’s not unusual for women to experience some level of pain or discomfort during intercourse, but pain that lingers after sex or anything that feels unusual may yield a trip to your doctor.

Any pain that's not relieved after intercourse should be evaluated. Sometimes, it may be a sign of more serious conditions such as uterine fibroids, endometriosis or ovarian cysts.

If you have abnormal discharge, itching or burning bring those things to your doctor’s attention, too. Lumps and bumps that are painful on the outside of the genitals should also be examined.

Can’t get to your doctor right away? Apply a frozen gel pack wrapped in a towel to the vulva after intercourse to relieve sexual pain.

Practice good vaginal hygiene
Taking care of your sexual organs will help prevent some of the discomfort, too. Proper hygiene will help decrease your risk for things like yeast infections, which can also cause some discomfort during sex. 

When you can, avoid super tight clothing and use cotton underwear instead.

And remember, that vaginal douching, or a washing of the area, can be dangerous because it rids the area of good bacteria that fights infections, and can cause irritation and dryness.

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