Are you experiencing pain during sex and wondering why it hurts? WUKA experts discuss the potential causes, when to seek help, and what you can try at home to make it all a little easier.
Does Sex Hurt?
Sex is not supposed to hurt. Sex is supposed to bring pleasure, and feelings of euphoria, so when you experience pain during intercourse, it’s most likely your body’s way of telling you that something isn’t quite right.
The technical name for what you might be experiencing is ‘dyspareunia’. Dr. Fiona MacRae, expert in woman’s health and bioidentical hormonal replacement therapy for the Marion Gluck Clinic, explains more: 'Dyspareunia means painful sexual intercourse. It is multifactorial and does not always signify disease.'
Thankfully, there is also usually a really quick and simple fix that will get you back on track and enjoying sex again too.
Saurabh Phadnis, consultant gynaecologist and gynaecological oncologist at London Gynaecology, told us: 'Painful intercourse is a common problem, affecting almost 3 out of 4 women during their lifetime.'
He goes on to say that, 'If pain during intercourse persists, one should seek medical advice for investigations of common gynaecological conditions which may require appropriate treatment.'
And, yes, we get it. It can be embarrassing to talk to your doctor about sex, but rest assured that it is probably nothing new to them, and nothing they haven’t heard before.
Why Does It Hurt When I Have Sex?
There can be a number of reasons why some women experience painful sex, and most likely you will be able to easily remedy them yourself. That said, it is always a good idea to rule out any potential issues that might need medical attention by visiting your healthcare provider.
Vaginal dryness is the one of the most common reasons for pain during sex.
As Dr. MacRae points out, 'pain during penetration may simply be due to a lack of lubrication, which can be resolved with enhanced foreplay or external lubricants.'
A major cause of vaginal dryness can be put down to hormonal changes, as our experts highlight.
'During perimenopause and menopause, decreasing levels of the hormone oestrogen may cause vaginal dryness,' says Mr. Phadnis.
So, some vaginal dryness is normal, and probably to be expected at certain points in a woman’s life, but it doesn’t just occur during the menopause or pre-menopausal phase. Other causes of vaginal dryness include breastfeeding, some types of contraceptive pill, some antidepressants, and some cancer treatments.
If you do experience dryness and it is causing pain during intercourse, vaginal lubricants are a great idea and easily accessible.
Existing Vaginal Pain
Sometimes pain during sex can be down to pre-existing vaginal pain that is associated with an illness or condition you may or may not already be aware of.
'Thrush or sexually transmitted infections such as chlamydia, gonorrhoea and herpes can cause painful intercourse,' explains Mr. Phadnis, adding that there are some skin disorders that can also cause pain, especially if you experience ulcers or abrasions in the vulva.
He goes on to add, 'Contact dermatitis is a common skin disorder that affects the vulva. It is a reaction to an irritating substance, such as perfumed soaps, douches or lubricants. It may cause itching, burning and pain, especially during sex.' Yet another reason why you should be avoiding perfumed soaps and other irritants when you take a shower.
Interestingly, some women also find that having sex during their period can cause pain, while others find that sex can actually help with menstrual cramps. If you want to know more, read our 5 facts about period sex here. You might also want to read more about relationships and periods too.
The vulva is the outer part of your genitals, including the labia, clitoris, vaginal opening and urethra. Sometimes, pain can be felt in the vulva during sex, and this can be due to a disorder called ‘vulvodynia’.
According to the NHS, common signs of vulvodynia include a burning or stinging sensation that’s triggered by touch – and this is why it tends to occur during sex. Some women find that the pain gets worse when they sit down, and although it is usually limited to the vulva, sometimes it can spread across the whole genital area.
Saurabh Phadnis told us:
'When pain is confined to the vestibule (the area around the opening of the vagina), it is known as vulvar vestibulitis syndrome (VVS). There are many treatments available for vulvodynia, including self-care measures. Medication or surgery may be needed in some cases.'
If you’re concerned about vulvadynia, speak to your doctor about possible treatments.
Some women may experience deeper pain during sex and, again, there can be more than one reason why.
Pelvic Inflammatory Disease (PID) is a common condition and symptoms are often mild, so you might not know that you have it. Signs that you could have PID include pain around the pelvis, pain during sex, pain when urinating, bleeding after sex and in between your period, heavy and painful periods and a change in vaginal discharge.
Pelvic pain experienced during intercourse might also be due to endometriosis, irritable bowel syndrome, fibroids or constipation too.
Dr. MacRae adds: 'Emotional factors, such as stress causing tensing of pelvic floor muscles, may also cause pain.'
If you are feeling stressed or upset, this could also explain why you are finding sex a little difficult or painful.
Read more about the different causes of pelvic pain here.
Pain During Sex For Women
Although both men and women can experience pain during sex, there are specific conditions that affect only women, and should be discussed with your doctor. An example of this is Vaginismus, a condition that can sometimes make sex impossible.
Saurabh Phadnis explains more:
'Vaginismus is a reflex contraction (tightening) of the muscles at the opening of the vagina, and it can cause pain during sex for women. It can be treated with different forms of counselling and cognitive therapy.'
Childbirth can also be the cause of pain, as Mr. Phadnis points out that 'women who have had an episiotomy or tears in the perineum during childbirth may have pain during sex that can last for several months'.
Coping With Pain During Sex
Experiencing pain during sex can be emotionally draining and can cause problems in relationships if the causes are not dealt with.
Some women might feel an array of emotions that can further exacerbate the problem too, as Mr. Phadnis explains:
'Emotions such as fear, guilt, shame, embarrassment or awkwardness about having sex may make it hard to relax. If one cannot relax, arousal is difficult, and pain may result. Stress and fatigue can also affect desire to have sex.'
If you or your partner is experiencing pain during sex, don’t suffer in silence. Talk to your partner and let them know, so that you can find a solution together. For example, changing positions or finding other ways to be intimate can help hugely.
As mentioned previously, vaginal dryness is one of the main reasons why women experience pain during intercourse, but luckily this is also one of the easiest problems to solve.
Dr. MacRae explains:
'Pain during penetration may simply be due to a lack of lubrication, which can be resolved with enhanced foreplay or external lubricants.'
Lubricants are readily available online or in shops and are relatively inexpensive to buy too.
Consult a Doctor
If you are concerned about pain during sex and you are not experiencing vaginal dryness, it’s important to seek medical advice so that your doctor can rule out any other underlying issue.
You can make an appointment with your own GP – or, if you prefer, you can visit a sexual health clinic to discuss the potential causes and treatments available. Your doctor might ask you a few questions, such as how long you have been experiencing the pain, where you feel it and how intense it is too.
You may be referred to a gynaecologist who can rule out specific conditions and help you to understand why you are experiencing pain and what can be done to overcome it.