Sex is meant to be a pleasurable and intimate experience, but for some people, it can be uncomfortable or even painful. If you have been Googling, “Why does it hurt when I have sex?”, you are not alone; around 7.5% of sexually active British women have reported painful intercourse for three or more months in the past year. Though painful sex (also known as dyspareunia) should not be considered normal, it does not necessarily mean that there is a serious problem. There are many reasons why sex can hurt, including vaginal dryness, vaginismus, and other issues that we will explore in this article.
Mr A. Steshenko, Consultant Gynaecologist at The Gynae Centre, says, “While painful intercourse can be distressing, it’s important to remember that it’s not something you have to endure in silence. The cause of the pain is unlikely to be serious, though seeking medical help can put your mind at ease. A gynaecologist can help identify the root cause and provide tailored treatments to improve your comfort and quality of life, and regain confidence in your intimate relationships.”
Unfortunately, painful sex is a taboo topic in many circles, and we understand how the thought of consulting your GP with your symptoms can feel a little awkward or embarrassing. However, at The Gynae Centre, we are specialists in gynaecological healthcare, which means that there’s nothing you can tell us that we haven’t already heard. We are compassionate, discreet, and have years of experience in effectively treating or managing gynaecological conditions.
Why does it hurt when I have sex?
Painful sex can stem from several factors. Some of the most common include:
Vaginismus
This is a condition characterised by involuntary tightening of the vaginal muscles, which can make penetration extremely painful or impossible. This is sometimes tied to psychological factors, past trauma or heightened anxiety, creating a physical response that makes sex uncomfortable. However, the condition does not have a confirmed cause.
Vaginismus treatment involves using Botox to temporarily and partially paralyse the muscles around the vaginal opening, making penetration easier. Small dilators can then be introduced by the patient, eventually leading to penetrative sex.
Vaginal dryness
Vaginal dryness, often linked to hormonal changes (such as during menopause or after childbirth), is another common cause of uncomfortable or painful sex. Inadequate lubrication results in friction during intercourse, leading to burning pain and itching.
To relieve vaginal dryness in the short term, you can use a good quality, body-safe lubricant, and don’t be afraid to reapply as needed. However, if vaginal dryness persists, it’s important to consult a specialist to get to the root cause, and alleviate your discomfort. If the cause is linked to menopause, for example, hormone therapy can be instrumental in dealing with vaginal dryness. Localised treatments, such as oestrogen creams, can deliver the hormones directly to the vaginal tissues, improving lubrication, elasticity and overall comfort.
For those experiencing additional menopausal symptoms, systemic hormone therapy may provide broader relief, addressing issues such as hot flushes, mood swings and sleep disturbances while also alleviating vaginal dryness.
Sexually Transmitted Infections (STI)
Some STIs are symptomless, while others can cause pain during sex, and other symptoms. Chlamydia, gonorrhea and trichomoniasis can cause inflammation in the vagina, cervix or urethra. This inflammation can make the genital tissues more sensitive or swollen, and often leads to discomfort, burning or pain during intercourse.
The herpes simplex virus can cause painful sores in the genital area, which may be aggravated by friction during sex. Likewise, the human papillomavirus (HPV) can cause genital warts, which are usually not painful, but can result in bleeding and pain if exposed to friction.
Pelvic inflammatory disease, though not an STI itself, can be caused by STIs. This condition causes inflammation and scarring of the reproductive organs, leading to deep pelvic pain during intercourse.
If you are sexually active, it is important to use barrier methods, such as condoms, to reduce the risk of contracting an STI (though it is important to note that some STIs, like HPV, can still spread with the use of barrier protection). It is also important to book a regular sexual health check – once per year, or every time you have sex with someone new. Diagnosing STIs early through STI tests can help you get the treatment you need, and prevent the disease from causing further damage.
How to make sex more comfortable
If you have ruled out or sought treatment for the above causes of painful sex, but you are still experiencing pain or discomfort during intercourse, here are some things you can try to make sex more comfortable and enjoyable for you and your partner.
Get comfortable with your body
Sometimes, lack of self-confidence – particularly body confidence – can cause anxiety, which can make sex difficult and uncomfortable, both mentally and physically. If this is something you struggle with, then it’s important to note that confidence is not built overnight. Your journey to becoming more comfortable with your own body will take time, and may involve:
- Counselling
- Practising self-care and gratitude
- Engaging in healthy habits, such as regular exercise and healthy eating
- Using masturbation as a way to understand what you do and don’t enjoy during sex
Communicate with your partner
Talk with your partner about what feels good and what doesn’t. Setting boundaries and discussing preferences can help reduce anxiety and discomfort. If you can, share any concerns about pain or discomfort so that adjustments can be made to suit your needs.
You may also want to try taking intercourse slowly, with more emphasis on sexual stimulation before penetrative sex (i.e. foreplay). It may also help to focus on creating emotional intimacy with your partner to help you form a stronger connection and trust between one another.
Experiment with positions
Certain positions can reduce pressure on sensitive areas or provide better control over depth and angle, which can help minimise discomfort. Consider positions where you or your partner can easily adjust movement if anything feels painful.
Understand your right to stop
If pain or discomfort occurs during sex, don’t feel like you have to continue. You have a right to say ‘no’ to anything that you don’t want to try, or to stop being intimate at any time. Make your partner aware that you are no longer comfortable with the current situation, and engage in self-care to ease any discomfort, pain or anxiety.
Are you experiencing painful sex?
If you are worried about feelings of pain or discomfort during sex, and are unsure of the cause, The Gynae Centre can conduct a consultation and investigations to help get to the bottom of the issue.
Call our friendly, experienced team on 020 7580 8090, or book online.
