Many people experience recurrent pain before, during, or after sex – known as dyspareunia – at some point in their lives. Dyspareunia is one of the most common reasons for referrals into sexual health services. It is most common amongst people with a vagina, though people of all genders can suffer.
Anxiety and shame about speaking to a health professional can stop people from asking for help, which can cause worsening of symptoms (including the development of vaginismus in people with a vagina, or erectile dysfunction in people with a penis) longer term problems, or total avoidance of sex.
If you are experiencing pain during sex, it’s probably a good idea to see someone. There is absolutely nothing to be ashamed of, and your healthcare provider will be happy to help.
Your GP is a good starting point, or if you’d feel more comfortable, a sexual health clinic will also be happy to see you. You may be referred for physical support or for mental health support, depending on your unique needs. If you are in the UK, visit NHS.uk/service-search/find-a-sexual-health-clinic/ to find your local sexual health clinic.
Painful sex can happen for several reasons, including:
- not being relaxed or aroused
- not having enough natural lubrication
- poor communication or trust between partners
- allergy to condom or lubricant
- history of sexual abuse or trauma
- emotional trauma, including after an abortion or pregnancy loss
- not enough foreplay
- an sexually-transmitted infection or a vaginal infection, such as thrush
- being a survivor of female genital mutilation
- physical issues, such as vaginal prolapse, scar tissue formation, endometriosis, fibroids, vulval eczema, constipation, IBS, cervical polyp, certain cancers, and more
Good communication is key to understanding and overcoming pain during sex, and Dyspareunia is no exception. Being willing to listen, experiment, and discuss your own needs or your partner’s needs is essential. Often, taking more time to become aroused and using additional lubrication can be enough to solve the issue. Other times, professional support is needed.
Experiencing pain during sex can lead to a vicious circle, whereby the anticipation of pain causes tension, which causes tightening of the vaginal walls and reduced arousal, which leads to further pain.
Painful sex can sometimes develop into vaginismus. Vaginismus is the body's automatic reaction to the fear vaginal penetration. When penetration is attempted, your vaginal muscles tighten up on their own. You have no control over it. Occasionally, you can get vaginismus even if you have previously enjoyed painless penetrative sex.
Please visit your GP if:
- you find it hard inserting a tampon or menstrual cup into your vagina
- you struggle with vaginal penetration during sex, including with a penis, a sex toy, or a finger
- you feel burning or stinging pain during sex
- you fear having sex because it will hurt
Treatment of vaginismus is usually done under the guidance of a specialised therapist, and can involve a combination of psychosexual therapy, relaxation techniques, pelvic floor exercises, sensate focus, and vaginal trainers.
Help is available and the first step is seeking support from your GP.
Some causes of painful sex for people with a penis include:
- infections like thrush
- some STIs
- allergy to condom or lubricant
- a tight foreskin, which can make penetration painful
- small tears in the foreskin that can't be seen but cause soreness and a sharp, stinging pain around the tear
- inflammation of the prostate gland (prostatitis)
- emotional trauma as the result of adult circumcision, sexual assault, or trauma
- testicle pain and swelling which can sometimes be caused by getting sexually aroused but not ejaculating
Some people with a penis have pain during sex just before they orgasm or while they are having an orgasm. This may result in similar anticipation of pain or arousal difficulty cycles as those experienced by those with vaginismus.
Treatment is available along with reassurance and emotional support. Good communication is key to understanding and overcoming pain during sex, and dyspareunia is no exception. Being willing to listen, experiment, and discuss your own needs or your partner’s needs is essential. Often, taking more time to become aroused can be enough to solve the issue. Other times, professional support is needed.
Some sexually transmitted infections (STIs) or skin conditions can cause soreness and pain during sex, and the only way to know for sure if you have an STI is by testing. If you think you might have an STI, visit our STI section for more information on signs, symptoms, testing, and treatment.
STI testing is free of charge via the NHS. If you are in the UK, visit NHS.uk/service-search/find-a-sexual-health-clinic/ to find your local testing clinic. Many areas will provide free online testing, where a sexual health screen will be sent to your home for you to complete and send off by yourself. Other areas still require you to visit a sexual health clinic in person.
Treatment for STIs varies by the infection type, and in some cases, by how advanced the STI has become. You will usually need to visit a sexual health clinic or your GP for treatment. See specific infections for more information on how specific STIs are treated.