Pain during sex: common causes, treatment and when to see a doctor
Quick answer
Pain during or after sex is common and is usually caused by something that can be treated, such as vaginal dryness, an infection, a skin condition, involuntary muscle tightening (vaginismus) or a condition like endometriosis. It is not something you should push through: a GP, gynaecologist or sexual health clinic can help find the cause.
Key points
- Painful sex affects people of every gender and age, and it is a recognised medical symptom, not a personal failing.
- Common causes include vaginal dryness, infections such as thrush or STIs, vaginismus, endometriosis, menopause and anxiety.
- Skin conditions, infections and a tight foreskin can cause pain for people with a penis too.
- Most causes are treatable once they are identified, so it is worth seeing a clinician rather than waiting.
- Stopping when something hurts protects your body and helps avoid a cycle of pain and anxiety.
Is it normal to have pain during sex?
Pain during or after sex is common, but it is not something you simply have to accept. Doctors call it dyspareunia. It can be felt at the entrance of the vagina, deeper in the pelvis, in the penis or testicles, or as soreness afterwards. It can start suddenly or build up over time.
Because many people feel embarrassed, the problem often goes unmentioned for years. Clinicians who work in sexual and reproductive health hear about it regularly, and describing exactly where and when it hurts is the most useful first step towards the right treatment.
What causes pain during sex for women and people with a vagina?
There is often more than one cause, and physical and emotional factors can feed into each other. The most common reasons include:
- Vaginal dryness, which can be linked to not feeling fully aroused, breastfeeding, some medicines, hormonal contraception or lower oestrogen levels.
- Infections, including thrush (a yeast infection) and sexually transmitted infections such as chlamydia, gonorrhoea, trichomoniasis or genital herpes.
- Vaginismus, where the muscles around the vagina tighten involuntarily, making penetration painful or not possible.
- Endometriosis or pelvic inflammatory disease, which more often cause deep pain in the pelvis.
- Menopause and perimenopause, when falling oestrogen can make the vaginal tissues thinner and drier.
- Anxiety, past painful experiences or trauma, which can make the body tense and expect pain.
What can cause painful sex for anyone?
Some causes affect people of any sex. Skin conditions such as eczema, psoriasis or lichen sclerosus can make genital skin sore or prone to splitting. Infections, including STIs and urinary tract infections, can cause burning or pain during and after sex.
People with a penis may also have pain from a tight foreskin (phimosis), inflammation of the head of the penis (balanitis), inflammation of the prostate (prostatitis) or a curve in the penis caused by Peyronie's disease. Allergic reactions to products such as soaps, spermicides or latex can affect anyone.
How is pain during sex treated?
Treatment depends on the cause, which is why an assessment matters. Infections are treated with the appropriate medicine, such as antifungals for thrush or antibiotics for bacterial STIs. Dryness may be helped by a water-based or silicone-based lubricant, a vaginal moisturiser or, around menopause, treatment a clinician can prescribe.
Vaginismus is often helped by a combination of education, pelvic floor physiotherapy and psychosexual therapy. Conditions such as endometriosis are managed by a gynaecologist. Where anxiety or past trauma plays a part, talking therapy can be very effective, either alone or with a partner.
Should you keep going if sex hurts?
No. Continuing through pain can irritate tissues further and can teach the body to expect pain, which tends to increase muscle tension and make the problem worse next time. It is always fine to stop, slow down or choose other ways to be close.
A caring partner will want to know if something hurts. If you feel pressured to continue when you are in pain, that is a consent issue, and support is available.
When to see a doctor
- Get urgent medical help if you have severe pelvic or abdominal pain, especially with a fever, feeling faint or heavy bleeding.
- Seek care promptly if you have pain together with unusual discharge, sores, blisters or a burning feeling when urinating.
- See a GP or sexual health clinic if you bleed after sex or between periods, or after menopause.
- Book an appointment if sex has been painful more than once, or if pain is affecting your relationship or wellbeing.
Frequently asked questions
Who should I see about pain during sex?
A GP or family doctor is a good starting point, and a sexual health clinic can check for infections. Depending on the cause, you may be referred to a gynaecologist, a urologist, a pelvic health physiotherapist or a psychosexual therapist. You can ask to see a clinician of a particular gender if that would help you feel more comfortable.
Can stress or anxiety really cause pain during sex?
Yes. Anxiety can reduce arousal and natural lubrication and make the pelvic muscles tense, both of which can lead to pain. Pain then often increases anxiety about the next time, creating a cycle. A clinician will still check for physical causes first, and treatment often addresses both the body and the worry together.
Is pain during sex a sign of an STI?
It can be. Several sexually transmitted infections, including chlamydia, gonorrhoea, trichomoniasis and herpes, can cause pain during sex, sometimes with discharge or pain when urinating. Many other causes are not infections at all. If there is any chance you have been exposed, a confidential STI test is a sensible step.