When Sex is Painful: 5 Possible Causes

Health Writer

Sex is supposed to feel good. It is supposed to foster a deep sense of intimacy between you and your partner. When sex is painful, the opposite can happen. You might find yourself avoiding close encounters. You might find it awkward to talk to your partner and instead start distancing yourself. When sex hurts, called dyspareunia, it can cause not only rifts in your relationship but can cause lower sex drive, a fear of sex and a sense of loneliness. If sex is painful for you, you are not alone. Around 75 percent of women experience pain during intercourse at some time in their life according to the American College of Obstetricians and Gynecologists.

There are a number of different reasons you might be experiencing pain during sex, many of which are treatable. The following are some of the more common reasons that sex can hurt:

Vaginal atrophy

Vaginal atrophy is the most common cause of painful sex in postmenopausal women. When estrogen levels decrease, you can experience vaginal dryness. Your vagina and vulva shrink, or atrophy, because of diminished blood flow to this area. It can cause soreness and burning. Estrogen treatments help. If you prefer not to undergo hormone treatment, use a water based lubricant when having sex. Because the act of sex increases blood flow, the more you have sex, the less your vagina and vulva will atrophy.


Vaginismus is when the muscles in the pelvic floor involuntarily tighten, causing pain. Muscle contraction can also occur when inserting a tampon or getting a gynecologic exam. You might feel that you are too small and that your partner’s penis doesn’t fit. It might feel like the inside of your vagina is being torn or beaten. Vaginismus is treated through specialized exercises that can help you learn to control and relax the muscles.

Infection or inflammation

Infections, such as yeast infections, urinary tract infections or sexually transmitted infections (STIs), can cause you to have pain during intercourse. Inflammation from infections or injuries to the wall of the vagina (for example, from inserting or taking out a diaphragm), can also result in pain during sex. You might also have inflammation or infection in the uterus , ovaries or pelvic area, such as cysts, pelvic inflammatory disease or endometriosis. These infections can result in pain that feels like it is deep within your pelvis.

Previous negative experiences

While your pain is real, it is sometimes caused by negative attitudes toward sex. You may have experienced sexual assault or be fearful of sex because of religious reasons or misinformation. If you have previously experienced pain during intercourse, you might associate sex with pain and worry that having sex is going to hurt. Your pain might be caused by your fear.

Allergies or skin conditions

Skin conditions, such as eczema, can occur in your genital area causing itching, burning and pain. The rubbing that occurs during intercourse can aggravate the skin condition, causing pain. You might also have allergies which cause itching and rash. Some people are allergic to latex, which is found in many condoms. If you have an allergy to latex, there are other types of condoms available, however, keep in mind they are not as effective.

While sexual pain is common, it doesn’t have to be part of your life. Talk to your doctor about what you are experiencing. Most conditions that cause pain during intercourse are easily treatable.

See more helpful articles:

Half of Postmenopausal Women Face Challenge of Vaginal Atrophy

Making Vaginal Health a Priority During Menopause


“When Sex Hurts,” Date Unknown, Staff Writer, HealthyWomen.org

“When Sex Hurts: Vaginismus,” Date Unknown, Staff Writer, The Society of Obstetricians and Gynaecologists of Canada

“When Sex is Painful,” May 2011, Staff Writer, The American College of Obstetricians and Gynecologists