Woman waking up ready to start hormone therapy

Painful sex is discomfort that may occur immediately before, during, or after sex. It is a common issue in women, with many experiencing pain during sex at some point in their lives. 

If you are experiencing pain with intercourse, identifying the cause is important as it may be treatable or indicate an underlying condition. At Advantia Health, our women’s health providers are available to provide diagnoses, treatments, and support.

Pain During Sex: Common Symptoms 


Pain with sex can occur at the time of entry, thrusting, or throughout. The pain may be brief or long-lasting, and it may continue after sex. Women have described the pain as: 


  • Burning 
  • Sharp 
  • Cramping 
  • Throbbing
  • Aching 
  • Or other types of pain


The pain you experience might be experienced deep in the pelvic area, as general vaginal discomfort, or only on the outside of the genital area. 


Pain may occur in many different areas, such as your vulva, vagina, perineum, uterus, bladder, lower back, or anywhere in the general area of your pelvis. 

Common Causes of Painful Sex

The pain you experience from sex may have many causes, from physical to psychological sources.


Not enough lubrication: Vaginal dryness is the most common reason and can occur due to not enough foreplay, childbirth, or breastfeeding. Additionally, certain medications like antidepressants, antihistamines, and birth control pills can decrease natural lubrication. 


Irritation and skin disorders: Spermicides, condoms, soaps, and shampoos may cause irritation and thus lead to pain with entry. Skin disorders such as eczema in the genital area can also lead to painful intercourse. 


Infections: Yeast infections and sexually transmitted infections (STI) such as herpes may cause pain with sex. Often you will experience discharge as an additional symptom.


Medical Conditions: Women with endometriosis, pelvic inflammatory disease may have pain during intercourse. Also included in the list of medical conditions are fibroids, irritable bowel syndrome, cystitis, and hemorrhoids. 


Surgery: Pain with sex after hysterectomy surgery and other gynecological surgeries can be common. These can be the result of scarring, and/or other issues that require medical attention from your trained OB/GYN or gynecologist. 


Hormonal Changes: During menopause and perimenopause decreases in estrogen can lead to vaginal dryness. Vaginal atrophy, a loss of normal moisture and thickness leading to inflammation, may also be caused by hormonal changes. Menstruating women may experience pain with sex before their period. This may be due to menstrual cramps or irritation of the bladder or urinary tract due to hormonal changes.


Physical problems: Vaginismus, spasming of the pelvic muscles, may cause painful penetration. Painful sex can be a result of other physical ailments such as organ prolapse or malformations of the vagina. Low back pain has also been reported to inhibit sexual activity due to pain. 


Psychological Causes: Issues such as anxiety and depression can cause a lack of arousal leading to pain. Stress may cause the pelvic floor muscles to tighten leading to discomfort during sex. Some women with a history of sexual abuse may also experience pain during intercourse. 


Treatments for psychological causes can be more complicated than traditional physical ailments, and many women seek the help of licensed mental health professionals in addition to their medical providers.


However, it’s an important first step to reach out to your OB/GYN or Gynecologist. Many women’s health providers are trained and experienced with the common psychological issues that may cause you to experience pain during sex.


Pregnancy and Postpartum: Pregnancy may contribute to painful sex. Additionally, having sex too soon after birth may cause intercourse to be uncomfortable.


IUD: It is unusual to experience pain during or after sex due to an IUD. If you are experiencing pain with your IUD during sex, this may be an indication that the IUD is out of place. However, some people just don’t tolerate the presence of an IUD in their uterus. Regardless, It’s important to contact your trained medical provider if you are experiencing these symptoms. 


PCOS: PCOS can cause a variety of health issues in women. If you are experiencing pain with sex with PCOS, you should contact your women’s healthcare provider.

Pain During Sex: Potential Treatments

There are some potential treatments that can help alleviate your pain during sex. Keep in mind—it’s essential that you seek the guidance of your women’s health provider to ensure there are no serious medical issues causing your symptoms.


Use Lubricants: If your pain is due to vaginal dryness, over-the-counter water-based lubrication or vaginal moisturizers may help. It’s important to avoid skin irritating products which may exacerbate your symptoms—or cause new ones to develop.


Prescription Medications and/or Hormone Treatments: In many instances, your licensed women’s health provider can prescribe the medicine you need to alleviate and treat your symptoms. 


Physical and/or Mental Therapy: Some women find relief from their symptoms with pelvic floor therapy. Mental health therapy can play a key role in helping treat underlying psychological causes that may be responsible for the pain you are experiencing during sex.


Wait at Least 6 Weeks after Birth/Surgery to Have Sex: Scar tissue and other results of surgical trauma take time to heal. It’s essential to relay your symptoms to your women’s health care provider as you recover from birth or surgeries.


Try Different Sexual Positions: When pain is muscular, some women find the best sex position for lower back pain is either doggy-style or side-by-side spooning. Ultimately, what feels most comfortable for you is likely your best option.  


Establish Good Sex Practices: There are numerous sexual best practices you and your partner can enact to help minimize potential causes for your pain during sex. Some include:

  • Setting aside time for sex when neither you or your partner feel anxious or tired. 
  • Talking with your partner if you feel that your foreplay does not allow you to become properly prepared for sex. 
  • Emptying your bladder prior to intercourse. 

Sex is Not Supposed to Hurt | Contact Your Women’s Health Provider

It can be hard to tell the cause of painful intercourse. Whatever the cause of the pain, it is important to prioritize your sexual health. Though it may feel embarrassing, it is important to discuss your symptoms with a doctor. These are common issues, and your women’s healthcare provider is here to help.


To schedule an appointment with Advantia’s women’s health practitioners, find a provider below.