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Why Does Sex Hurt? Common Causes of Pain During Sex & Treatment

Emily Carter · 9 July 2026 · 8 min read · 597 views

Medically Reviewed by: Pelvic Health Physiotherapist

Pain during sex is more common than many people realise, yet it's still a topic that many find difficult to discuss. Whether the discomfort happens before, during, or after intercourse, it should never be ignored. While occasional discomfort can happen, persistent pain is not considered a normal part of a healthy sex life.

Painful sex, medically known as dyspareunia, can affect women and men of all ages. It may be linked to pelvic floor muscle problems, hormonal changes, infections, medical conditions, previous surgery, childbirth, or emotional factors such as stress or past trauma. The good news is that many causes can be successfully treated once the underlying reason is identified.

In this guide, we'll explain the most common causes of pain during sex, how it's diagnosed, and the treatment options that may help you regain comfort and confidence.

If you're recovering from pelvic pain or painful intercourse, explore our Medical Grade Silicone Vaginal Dilators and Pelvic Floor Therapy Products.

Pain During Sex at a Glance

Pain during sex is medically known as dyspareunia.
It can affect both women and men.
Persistent pain is not normal and should be assessed.
Pelvic floor dysfunction is a common but often overlooked cause.
Many people improve with conservative treatments such as pelvic floor physiotherapy.
Early diagnosis often leads to better outcomes.

What Is Pain During Sex?

Dyspareunia is the medical term used to describe persistent or recurring pain before, during, or after sexual intercourse.

The pain may be felt:

At the entrance of the vagina
Deep inside the pelvis
Around the vulva
Inside the penis
In the lower abdomen
Around the pelvic floor muscles

For some people, the discomfort is mild and occasional. For others, it can make intimacy difficult, affect relationships, and reduce overall quality of life.

Is Pain During Sex Normal?

The simple answer is no.

Although temporary discomfort can sometimes occur, especially after childbirth, surgery, or during hormonal changes, ongoing pain should never be accepted as something you simply have to live with.

Many people delay seeking help because they feel embarrassed or assume nothing can be done. In reality, there are many effective treatments available, and identifying the cause is the first step towards recovery.

Common Symptoms

Pain during sex doesn't feel the same for everyone.

Symptoms may include:

Pain at the start of penetration
Deep pelvic pain during intercourse
Burning or stinging sensations
Sharp or stabbing pain
Muscle tightness
Throbbing after intercourse
Pain that continues after sex
Difficulty inserting tampons or vaginal dilators
Reduced sexual enjoyment due to discomfort

If these symptoms continue for several weeks or become worse over time, it's important to seek medical advice.

What Causes Pain During Sex?

Painful intercourse can have many different causes. Sometimes there is one clear reason, while in other cases several factors may contribute.

The most common causes include:

Pelvic floor dysfunction
Vaginismus
Vaginal dryness
Hormonal changes
Endometriosis
Vulvodynia
Pelvic inflammatory disease (PID)
Urinary tract or vaginal infections
Sexually transmitted infections (STIs)
Previous pelvic surgery
Childbirth recovery
Emotional trauma, anxiety, or stress

A proper diagnosis helps determine the most appropriate treatment.

Pelvic Floor Dysfunction

One of the most common causes of painful sex is pelvic floor dysfunction.

The pelvic floor muscles support the bladder, bowel, and reproductive organs. These muscles should relax during intercourse. If they become too tight, overactive, or painful, penetration may become uncomfortable or even impossible.

Symptoms often include:

Pain during penetration
Pelvic pressure
Bladder urgency
Constipation
Pain after intercourse
Ongoing pelvic pain

Many people benefit from pelvic floor physiotherapy, relaxation techniques, and home rehabilitation exercises.

Vaginismus

Vaginismus is a condition where the muscles around the vaginal opening tighten involuntarily, making penetration painful or difficult.

Some women may experience discomfort during:

Sexual intercourse
Pelvic examinations
Tampon insertion
Vaginal dilator therapy

Treatment usually focuses on gradually relaxing the pelvic floor muscles and reducing fear associated with penetration.

Depending on individual circumstances, treatment may include pelvic floor physiotherapy, counselling, breathing exercises, and graduated vaginal dilator therapy.

Vaginal Dryness

Insufficient natural lubrication can also cause pain during sex.

Common causes include:

Menopause
Breastfeeding
Hormonal changes
Certain medications
Cancer treatments
Reduced arousal

Vaginal dryness increases friction during intercourse, making penetration uncomfortable.

Lubricants, moisturisers, hormone therapy (where appropriate), and pelvic floor rehabilitation may help improve symptoms.

Endometriosis

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus, often affecting the ovaries, fallopian tubes, or pelvic tissues.

Many women with endometriosis experience:

Deep pelvic pain during intercourse
Painful periods
Chronic pelvic pain
Pain when opening the bowels
Fertility difficulties

Treatment depends on the severity of symptoms and may include medication, physiotherapy, or surgery.

Vulvodynia

Another possible cause of painful sex is vulvodynia, a long-term pain condition affecting the vulva. The discomfort may be constant or triggered by touch, pressure, or penetration.

People with vulvodynia often describe:

Burning sensations
Stinging pain
Sharp discomfort
Irritation
Tenderness around the vaginal opening

The exact cause isn't always known, but contributing factors may include nerve irritation, previous infections, hormonal changes, pelvic floor muscle tension, or past injury.

Treatment varies depending on the individual and may include pelvic floor physiotherapy, medication, lifestyle changes, and pain management techniques.

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease is an infection affecting the female reproductive organs. It is often caused by untreated bacterial infections, including certain sexually transmitted infections.

Symptoms may include:

Deep pelvic pain during sex
Lower abdominal pain
Fever
Unusual vaginal discharge
Pain when urinating
Irregular bleeding

Early treatment with antibiotics is important to reduce the risk of long-term complications.

Infections and Sexually Transmitted Infections

Some infections can make sexual intercourse uncomfortable or painful.

Examples include:

Vaginal thrush
Urinary tract infections (UTIs)
Chlamydia
Gonorrhoea
Genital herpes

Alongside pain during sex, symptoms may include itching, burning, unusual discharge, or pain when passing urine.

These conditions usually require medical assessment and appropriate treatment.

Can Emotional Trauma Cause Pain During Sex?

Yes.

Emotional wellbeing and physical health are closely connected.

Past trauma, anxiety, stress, depression, relationship difficulties, or fear of pain can all influence how the body responds during intimacy.

For some people, emotional stress causes the pelvic floor muscles to tighten automatically, making penetration uncomfortable or painful.

This does not mean the pain is "all in your head." The pain is real, and addressing both the physical and emotional aspects of recovery is often the most effective approach.

How Is Pain During Sex Diagnosed?

A healthcare professional will usually begin by discussing:

Your symptoms
When the pain occurs
Your medical history
Previous pregnancies or surgery
Current medications
Bladder and bowel symptoms

Depending on your symptoms, further assessment may include:

A pelvic examination
Swab tests
Urine tests
Ultrasound scans
Blood tests
Assessment of the pelvic floor muscles

These investigations help identify the underlying cause and guide treatment.

Treatment Options

Treatment depends entirely on the underlying cause.

Common treatment options include:

Pelvic floor physiotherapy
Vaginal dilator therapy
Pelvic floor trigger point therapy
Water-based lubricants
Hormonal treatment where appropriate
Treatment for infections
Counselling or psychological support
Relaxation and breathing techniques

Many people experience significant improvement once the correct diagnosis has been made.

Can Pelvic Floor Therapy Help?

For many people, yes.

Pelvic floor physiotherapy is often recommended when pain is caused by muscle tension, poor muscle coordination, or pelvic floor dysfunction.

Treatment may include:

Muscle relaxation techniques
Gentle stretching
Breathing exercises
Trigger point release
Home exercise programmes
Education about pelvic health

Your physiotherapist may also recommend home therapy products to support your rehabilitation.

Frequently Asked Questions

Can painful sex go away?

Yes. Many causes of painful sex are treatable. Recovery depends on identifying the underlying cause and following the recommended treatment plan.

Can pelvic floor therapy help painful intercourse?

Yes. Pelvic floor physiotherapy may improve muscle relaxation, flexibility, and coordination when pelvic floor dysfunction contributes to pain.

Can stress make sex painful?

Yes. Stress and anxiety may increase muscle tension, including in the pelvic floor, which can contribute to discomfort during intimacy.

Can vaginal dilators help?

For some people, yes. Under professional guidance, vaginal dilators may help improve flexibility, reduce muscle guarding, and make penetration more comfortable.

Should I ignore pain during sex?

No. Persistent pain is not considered normal and should always be assessed by a healthcare professional.

Final Thoughts

Pain during sex can be distressing, but it is important to remember that it is not something you simply have to live with. Whether the cause is physical, hormonal, muscular, or emotional, many effective treatments are available.

Seeking help early can make a significant difference. With the right diagnosis and a personalised treatment plan, many people are able to reduce pain, improve pelvic floor function, and enjoy intimacy with greater comfort and confidence.

If you're managing pelvic pain or recovering from conditions such as vaginismus or pelvic floor dysfunction, your healthcare professional may recommend pelvic floor physiotherapy alongside products such as medical-grade vaginal dilators or a pelvic floor wand as part of your rehabilitation programme.

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