You’re not imagining it: sex can hurt, and you’re not alone in feeling confused, frustrated, or even ashamed.
Whether it’s a sharp sting, deep cramping, or burning discomfort, painful sex—called dyspareunia—affects up to 3 in 4 women at some point in life.¹ But many suffer in silence, unsure what’s “normal” or worth getting checked.
The truth? Painful sex is common—but never something you just have to live with.
In this article, you’ll learn:
- What can cause pain during or after sex
- How to know when it’s time to investigate
- Common diagnoses and treatment options
- What to ask your doctor (and what not to ignore)
Let’s talk about what your body’s trying to tell you.
What Is Dyspareunia?
Dyspareunia is the medical term for pain during sexual intercourse. It can happen:
- At the entrance of the vagina
- Deep inside the pelvis
- During penetration or after
- Every time or only in certain positions
The pain can feel:
- Sharp
- Burning
- Achy
- Cramping
- Pulling
Some women only notice pain with initial entry. Others feel deep, lingering discomfort hours later.
Common Causes of Painful Sex
Let’s break down the most common reasons sex might hurt—and what’s happening in your body.
1. Vaginal Dryness or Hormonal Changes
Estrogen keeps the vaginal lining moist, elastic, and lubricated. When estrogen drops (from birth control, breastfeeding, perimenopause, or menopause), the tissues can become dry and fragile.
Symptoms:
- Burning or stinging with penetration
- Post-sex soreness
- Increased UTIs
➡️ Read: What Happens to Estrogen in Perimenopause
2. Pelvic Floor Muscle Tension
Tight or overactive pelvic floor muscles can make it difficult for anything to enter the vagina without pain.
Often linked to:
- Anxiety or trauma
- Childbirth recovery
- Chronic stress or clenching
This type of pain may feel like:
- Hitting a wall
- Sharp internal pressure
- Lasting soreness after sex
Pelvic floor physical therapy is a powerful treatment.
3. Endometriosis or Pelvic Inflammatory Disease (PID)
When tissue grows outside the uterus (endometriosis) or infection causes scarring (PID), deep penetration can trigger sharp or cramping pain.
Clues:
- Pain that worsens during menstruation
- Pain with bowel movements or urination
- Fatigue and infertility
This pain often occurs deep in the pelvis, especially with certain positions.
➡️ Compare: PCOS vs. Endometriosis Symptoms
4. Vaginismus
Vaginismus is an involuntary contraction of the vaginal muscles that makes penetration extremely painful—or impossible.
Often linked to:
- Fear, trauma, or past negative experiences
- Lack of sexual education
- Anxiety about sex or insertion
The good news? It’s highly treatable with desensitization therapy and pelvic floor rehab.
5. Infections or Skin Conditions
- Yeast infections
- Urinary tract infections (UTIs)
- Bacterial vaginosis
- Lichen sclerosus or lichen planus
These conditions can cause:
- Burning
- Itching
- Swelling
- Painful friction
Always check with a doctor before assuming it’s “just a yeast infection.”
6. Psychological or Emotional Stress
Sex is deeply connected to your nervous system. When your body is in fight-or-flight mode, arousal and relaxation are harder to achieve.
Stress, trauma, or relationship strain can make your body tense up during intimacy—leading to pain without a clear physical cause.
That doesn’t make it any less real.
Expert Insight
“Pain with sex is one of the most under-discussed women’s health issues. It’s not just physical—it’s emotional, relational, and hormonal. But with the right care, it’s almost always treatable.”
When Should You See a Doctor?
If any of these sound familiar, it’s time to talk to a provider:
- You dread sex or avoid it because of pain
- Lube doesn’t help
- You’ve had pain for more than a few weeks
- You notice bleeding after sex
- You have other symptoms like discharge, itching, or pelvic pressure
Diagnosis might include:
- Pelvic exam
- STI and infection screening
- Hormone panel
- Referral to a pelvic floor physiotherapist or sexual health counselor
➡️ Book a Care Navigator session for personalized next steps
Real-Life Story
“I used to think painful sex was just something I had to push through. But after one appointment with a pelvic health physio, I realized my muscles were in a constant state of tension. With therapy, communication, and time—I got my body back.”
— Elena, 29
Myth vs Reality
| Myth | Reality |
| “A little pain during sex is normal.” | Pain is your body’s signal—not a requirement. |
| “It’s just in your head.” | Even emotional causes show up physically. All pain is real. |
| “You just need more lube.” | Lube helps, but it doesn’t treat underlying causes. |
| “It will go away on its own.” | Most causes need tailored treatment—and that’s okay. |
Final Thoughts
You deserve intimacy that feels good—not something you brace yourself for.
Painful sex is common but not normal.
With the right diagnosis and care, you can heal—not just physically, but emotionally too.
This is your body. You deserve to feel safe in it.
Call to Action
👉 Wondering what’s behind your pain?
Take our free 5-minute reproductive health quiz to understand your symptoms—and get matched with expert guidance.
👉 https://zorahealth.co/quiz/reproductive-health
Sources
- Mayo Clinic – Painful Sex (Dyspareunia)
- Cleveland Clinic – Vaginal Dryness
- ACOG – Pain During Sex
- NHS – Vaginismus
- NIH – Endometriosis Overview
Anna Haotanto is the Founder of Zora Health and a passionate advocate for women’s empowerment. Anna’s personal experiences with egg-freezing, PCOS, perimenopause and the challenges of fertility have fueled her mission to provide high-quality information, financing, and support to help women and couples navigate their fertility journeys with confidence. She is also recognised for her achievements in finance, entrepreneurship, and women’s empowerment, and has been featured in various media outlets. You can also follow her on Linkedin or Instagram.
