GUIDE
Painful Sex (Dyspareunia): Causes and Solutions
Pain during sex is something many people silently endure, but it's something you shouldn't have to. Pain is an important message from the body. This guide covers why painful sex (dyspareunia) happens, how it differs from vaginismus, and what helps toward recovery.
What is dyspareunia?
Dyspareunia is the name for recurrent pain felt before, during, or after sex. The pain may be at the entrance or deeper, and may feel like burning, stinging, or stretching. It can affect both women and men, though it's more common in women.
Dyspareunia is the name for recurrent pain felt before, during, or after sex. The pain may be at the entrance or deeper, and may feel like burning, stinging, or stretching. It can affect both women and men, though it's more common in women.
Why does it happen?
Physical factors
Insufficient arousal and related dryness, infections, skin and tissue sensitivities, hormonal changes (such as menopause or postpartum), and certain health conditions can cause pain.
Psychological and relational factors
Anxiety, stress, anticipation of pain, past negative experiences, and relationship tension can trigger or intensify pain. Pain and anxiety often form a cycle that feeds each other.
How is it different from vaginismus?
These two are often confused but aren't the same. Vaginismus is the involuntary tightening of the pelvic floor muscles, making penetration difficult or impossible. Dyspareunia is the broader term for pain during sex where penetration is possible.
Vaginismus can cause dyspareunia, but not all painful sex is vaginismus.
A professional can make the right distinction. You may also want to read our vaginismus guide.
What helps recovery?
- Understanding the cause: Addressing any physical factor first.
- Allowing time for arousal: Adequate arousal and lubrication markedly reduce pain; using a lubricant when needed.
- Reducing anxiety: Breathing and mindfulness work that breaks the pain-anxiety cycle.
- Moving gradually and without pressure: Giving the body safety instead of forcing it.
- Communicating with a partner: Sharing the pain and progressing together, without pressure.
When should you see a professional?
If pain during sex is persistent, be sure to see a professional (first a gynecologist or urologist). Once physical causes are ruled out, support from a clinical psychologist is very valuable for working with the anxiety-pain cycle.
Frequently asked questions
Why does sex hurt?
Painful sex (dyspareunia) can have physical and psychological causes: insufficient arousal and dryness, infections, skin or tissue sensitivities, hormonal changes; as well as anxiety, stress, and anticipation of pain. Often several factors combine, and a professional evaluation is important to identify the right cause.
Does painful sex go away?
In most cases, yes. When the underlying cause is identified and addressed, pain usually decreases or resolves. Adequate arousal and lubrication, reducing anxiety, a gradual and pressure-free approach, and medical support when needed all aid recovery.
Is painful sex the same as vaginismus?
No, but they're related. Vaginismus is the involuntary tightening of the pelvic floor muscles that makes penetration difficult or impossible. Dyspareunia is a broader term for pain during sex where penetration is possible. Vaginismus can lead to dyspareunia, but not all painful sex is vaginismus.
What should you do about painful sex?
First, don't ignore the pain and try to understand its cause. Allowing time for arousal, using a lubricant, reducing anxiety, and moving gradually without pressure all help. If pain persists, you should see a gynecologist or other professional.
Is pain during sex normal?
Persistent pain is not normal and shouldn’t be ignored. Pain is the body’s way of pointing to something. Rather than shame or "putting up with it," trying to understand the cause is important for both your sex life and your overall health.
References
- ACOG. When Sex Is Painful. www.acog.org opens in a new tab
- StatPearls (NCBI Bookshelf). Dyspareunia. www.ncbi.nlm.nih.gov opens in a new tab
- NHS. Vaginismus. www.nhs.uk opens in a new tab
- World Health Organization. Sexual health. www.who.int opens in a new tab