7 most common causes of painful sex

7 most common causes of painful sex

What causes painful sex?

Different physiological or psychological factors can cause pain or discomfort during sex. Changes in hormones, lack of sexual arousal or infections can cause pain in different ways. Both men and women can experience painful sex, but it is more common in women. 

Did you know that 1 in 13 British women experience pain during sex? If you’re one of these women, then painful sex could be your body’s way of telling you something is wrong. You shouldn’t feel ashamed or embarrassed as many people can experience this at some point in their lives and there is almost always a solution when you find the cause. 

Take a look at these 7 possible causes of painful sex and what to do to help you enjoy pleasurable sex again. 

1. Thrush

Thrush is a common yeast infection of the vagina, but it can also affect the penis, mouth, and less commonly the armpits, groin or in between fingers. 

Thrush is caused by an imbalance of bacteria which allows the normally harmless fungus known as candida to grow in places that are warm and moist such as the vagina. 

Thrush of the vagina and penis has a range of symptoms that can make sex uncomfortable. For men, thrush can cause difficulty pulling back the foreskin of the penis, and for women it can cause irritation, burning, soreness and stinging of the vagina during sex. 

Painful intercourse should always be investigated, particularly If the pain is accompanied by unusual discharge. Most of the time, it’s nothing to worry about and could be a common infection such as thrush which is treatable. 

Although thrush is not an STI it can be triggered or made worse by sex. It’s wise to avoid sexual activity until your or your partner’s thrush has cleared which is usually in 7-14 days when treated with antifungal medicines. 

2. Sexually transmitted infections (STIs)

Another possible infection that could make sex unpleasant is one that is transmitted through sex. STIs are spread through the penis and vaginal fluids and are often symptomless unless left untreated long enough to cause problems. 

Symptoms of STIs range from unusual discharge with or without an unpleasant smell or colour, to pain when peeing or bleeding after sex. Regular STI testing and barrier protection such as condoms prevent STIs, and early diagnosis and treatment can help prevent complications. 

Unusual discharge, pain, discomfort or bleeding during or after sex could be a sign of infection and should prompt you to get tested by your GP or your local sexual health clinic

3. Vaginismus

Vaginismus is a condition that can make sex nearly impossible. Not only can it be painful, but it can also be emotionally distressing. With vaginismus, the vaginal muscles tighten up when any penetration is attempted. You may find sex or inserting a tampon difficult, and it can happen despite previously enjoying sex.

In most cases, the cause of vaginismus is psychological. A history of bad sexual experiences, unpleasant medical examinations and feeling self-conscious about your body can sometimes develop into this condition. 

Psychological support to help you overcome any fears associated with penetration, plus physical exercises to help the vaginal muscles relax are the treatment types for vaginismus. 

If you’re comfortable, you can also try vaginal dilators which are objects shaped like a tampon that come in various sizes. The idea is that starting off with smaller sizes and gradually increasing the size at your own pace can help you get used to penetration. In preparation for this, try relaxation techniques such as controlled breathing. 

4. Vaginal dryness

Sex without adequate lubrication can cause pain, tears in and around the vagina and irritation. The vagina is naturally lubricated with discharge or fluids but sometimes it can become dry due to hormonal changes. Menopause, breastfeeding, and certain medications such as the contraceptive pill and antidepressants are all common causes of vaginal dryness due to their effect on hormone levels. 

Alternatively, not being sexually aroused can mean a lack of lubrication, making sex uncomfortable rather than pleasurable. Although, there are things you can do to help this. 

Take care of the health of your vagina; this means avoiding anything that could disrupt the pH balance. Whilst cleanliness is important, cleaning your vagina with perfumed soaps can be harmful and lead to vaginal dryness or even infections such as thrush. 

Are you suffering from vaginal dryness? Fake it until you make it by using water-based lubricant gels during foreplay and sex; these also help even if you don’t have vaginal dryness. 



5. Lack of sexual arousal

Not being sexually aroused can happen due to a number of reasons. Medications, medical conditions, or simply not connecting with your partner sexually can leave you feeling uninterested in sex. When your body isn’t prepared for sex, penetration can be far from pleasurable.

Vaginal dryness and even vaginismus are some of the complications of this, and for men, the complication could be erectile dysfunction

6. Menopause

Sexual intercourse can be particularly difficult during menopause, both physically and emotionally.

The hormonal changes during menopause (in this case, the reduction in oestrogen levels) can affect the vagina. A tight, dry and sore feeling is how the vagina is described during and after sex when menopausal. The lack of oestrogen causes the vaginal tissues to thin and reduces vaginal lubrication. All of this makes penetration quite sore and uncomfortable. 

Vaginal dryness increases the risk of tears in the vagina when attempting penetration, and this makes it easier for bacteria and viruses to enter the body causing infection. 

Fortunately, there are things you can do to not only treat vaginal dryness but particularly vaginal dryness caused by menopause. As we mentioned earlier, lubes are your friend but in the case of menopause, hormone replacement therapy (HRT) can help to combat vaginal dryness. 

Local vaginal hormone replacement therapies such as Gina contain a type of oestrogen known as estradiol and it directly targets vaginal dryness by replacing lost oestrogen. It comes in the form of a tablet which is inserted into the vagina. Find out more about Gina, here

7. Allergies

We’re specifically talking about allergies to condoms or lubes here and in rare cases allergies to semen.

The latex material that makes condoms, ingredients that form lubricants, and seminal fluids can cause allergic symptoms when some people are exposed to them. Symptoms include itching, burning, swelling, rash and in extreme cases, anaphylaxis (severe allergic reaction). As you can imagine, these symptoms can make sex really uncomfortable and may lead to a lack of desire for sex. 

Non-latex condoms are available, and if you have an allergy to semen, condoms can help prevent a reaction by blocking contact with this fluid. 

Durex Latex Free - 12 Condoms
Limited Time Offer

Pelvic pain when having sex

If you feel pain deeper in the pelvis during intercourse this could be a sign of a more chronic condition such as endometriosis or irritable bowel syndrome (IBS), or possibly ovarian cysts. Infections such as pelvic inflammatory disease (PID) and urinary tract infection (UTI) can also make sex uncomfortable. 

Any pain during or after sex should be investigated straight away. There is always a cause of the pain, and with tests and examinations, your GP can come to a diagnosis and treatment can begin to allow you to enjoy pain-free sex.

Laura Shillcock -
James O'Loan - CEO & Prescribing Pharmacist
James O'Loan , CEO & Prescribing Pharmacist on 18 November 2022
i
How we ensure accuracy in our content