Sex is meant to feel good — nourishing, playful, and deeply connecting. Yet when pain shows up, everything can shift. You might start anticipating discomfort before intimacy even begins, or feel a mix of confusion, frustration, or even guilt. Many people quietly wonder, “Is it just me?”
You’re far from alone. Painful sex — known medically as dyspareunia — affects around one in five women at some point. And while anyone can experience it, women are more commonly affected, often carrying the emotional and relational weight quietly.
If this is something you’ve been dealing with, here’s the most important truth: your pain is valid, and it deserves care.
What is dyspareunia, really?
Dyspareunia means pain during or around sexual activity. It can show up before penetration, during it, or even afterwards — sometimes lingering longer than expected. It can be occasional or constant. Mild or intense. And it’s always worth exploring.
Two main patterns tend to appear:
- Superficial dyspareunia — pain at the vaginal opening. It can feel like burning, stinging, or sharp discomfort at the start of penetration.
Deep dyspareunia — pain deeper in the pelvis, often appearing with certain positions or deeper penetration. For many, this kind is linked with conditions like endometriosis.
Why does painful sex happen?
There’s no single story here; everybody has their own reasons. Some of the more common ones include:
- Vaginal dryness — sometimes caused by hormones, medication, or simply a drop in arousal. When lubrication is low, it can feel like friction rather than pleasure.
- Vaginismus — involuntary tightening of the pelvic floor muscles that can make penetration feel impossible.
- Vulvodynia — chronic pain around the vulva that can feel like burning, irritation, or rawness.
- Menopause — a natural shift, but one that can thin vaginal tissues and reduce elasticity.
- Infections — such as bacterial vaginosis or yeast infections, which often come with itching, burning, or discharge.
- Endometriosis — where tissue similar to the womb lining grows outside the uterus, causing deep pelvic pain and painful sex.
- Pelvic floor dysfunction or pelvic inflammatory disease (PID) — both can affect comfort during intimacy.
Stress and anxiety — emotional tension can make sex feel tense instead of relaxing, and your muscles respond accordingly.
Many people don’t realise how closely the body and mind are intertwined here. If sex has hurt in the past, your body may brace the next time — even before you’re fully aware of it.
How is dyspareunia diagnosed?
Talking to a doctor can feel daunting — especially about something so personal — but it’s the key to understanding what’s going on.
A clinician will gently explore:
- your symptoms
- your medical and sexual history
- a physical or pelvic examination
- any tests that help uncover underlying causes
This isn’t about judgment. It’s about clarity and relief.
What can help?
Treatment depends on the root cause, but several approaches can make a meaningful difference:
- Topical oestrogen or vaginal moisturisers: These can support lubrication and restore comfort, especially if hormones are playing a role.
- Pain relief when needed: Over-the-counter options, such as ibuprofen or paracetamol, can help ease acute discomfort.
- Pelvic floor physiotherapy: Learning how to relax, not just strengthen, the pelvic floor can be transformative.
- Relaxation and breathwork: Techniques that help soften muscle tension and rebuild a sense of safety in the body.
- Treatment for infections: If bacterial or fungal infections are involved, targeted medication is essential.
Surgery in specific cases: For conditions like endometriosis, surgical treatment may be recommended.
What matters most is not pushing through the pain or trying to “fix it” alone. You deserve support, and the proper care can make sex feel safe and pleasurable again.
The bottom line
Painful sex isn’t something you have to accept or work around. It’s a sign your body is asking for attention — and responding to that message can be the beginning of real healing.
If you’re experiencing discomfort that keeps recurring, consult your doctor. With the right diagnosis, guidance, and gentle steps, intimacy can become something you look forward to again, rather than something you fear
