Pain during sex is more common than most people realise — research suggests somewhere between 10–20% of women and a smaller but significant percentage of men experience it at some point. It's not something you should just tolerate or assume will go away on its own, because pain during sex almost always has an identifiable cause, and most of those causes are treatable.
If sex has started to hurt when it didn't before, or if it's always been uncomfortable and you've been assuming that's just how it is, this guide walks through what might be behind it and what actually helps.
Types of pain (where and when it happens matters)
Not all pain during sex is the same, and identifying the type helps narrow down the cause:
Entry pain (superficial dyspareunia)
Pain right at the opening of the vagina during initial penetration. This is often sharp or burning and usually signals a problem with the vaginal opening, vulva, or surrounding tissue — dryness, infections, skin conditions, or pelvic floor tension are the most common culprits.
Deep pain (deep dyspareunia)
Pain deeper inside, often felt during deep thrusting or in certain positions. This type can indicate issues with the cervix, uterus, or surrounding organs — endometriosis, ovarian cysts, pelvic inflammatory disease, or fibroids are possible causes.
Pain after sex
Cramping, aching, or soreness that starts after sex has finished. This can be related to orgasm (uterine contractions), an underlying pelvic condition, or prolonged friction without enough lubrication.
If you're trying to work out what's happening, pay attention to when the pain occurs (at entry, during deep penetration, after), what it feels like (sharp, burning, aching, cramping), and whether it happens every time or only in certain positions or situations.
Common causes
Vaginal dryness
This is the most common and most easily fixed cause of entry pain. If there's not enough natural lubrication (whether because of hormones, medications, stress, lack of arousal, or menopause), penetration creates friction that ranges from uncomfortable to genuinely painful. It's a physical issue, not a sign that you're not interested or not doing something right.
A good lubricant solves this immediately. MyNookie carries 148 lubricant options across water-based, silicone, and hybrid formulas — if you've only tried drugstore lube, it's worth upgrading to a dedicated intimate product. Browse Lubricants, and see Vaginal Dryness: Causes, Solutions, and the Role of Lubricants for more on what causes dryness and how to address it beyond just adding lube.
Infections
Yeast infections, bacterial vaginosis, urinary tract infections, and sexually transmitted infections can all cause pain during sex, usually along with other symptoms like itching, unusual discharge, burning during urination, or odour. If pain started suddenly and is paired with any of these, see a doctor — infections need proper treatment, and having sex while you have one usually makes both the infection and the pain worse.
Vaginismus
This is an involuntary tightening of the pelvic floor muscles that makes penetration difficult or impossible. It can be triggered by anxiety (fear of pain, past trauma, first-time nerves), or it can develop after a painful experience (an infection, childbirth, a medical procedure). It's not something you're doing on purpose, and it's not something you can just "relax" through without addressing the underlying cause. Treatment usually involves pelvic floor physiotherapy, gradual desensitisation with dilators, and sometimes therapy to address any anxiety or trauma component.
Pelvic floor tension
Even without full vaginismus, tight or overactive pelvic floor muscles can cause entry pain or a feeling of pressure during sex. This is common in people who hold tension in that area (often without realising it), people who do a lot of high-impact exercise, and people who've been told to "do more Kegels" when their pelvic floor was already too tight. A pelvic floor physiotherapist can assess whether this is the issue and teach you how to relax those muscles rather than strengthen them.
Endometriosis
This condition causes tissue similar to the uterine lining to grow outside the uterus, leading to deep pain during sex (particularly with deep penetration), along with painful periods, chronic pelvic pain, and sometimes bowel or bladder symptoms. If deep pain during sex is paired with very painful periods, see a gynaecologist — endometriosis often takes years to diagnose, but the sooner it's identified the sooner you can start managing it.
Skin conditions
Eczema, lichen sclerosus, and lichen planus can all affect the vulva and vaginal opening, causing pain, itching, and sometimes tearing during sex. These need proper diagnosis and treatment from a doctor (usually a GP or dermatologist), not just over-the-counter creams.
First-time or infrequent sex
If you're new to penetrative sex or haven't had it in a long time, some discomfort as your body adjusts is normal — but it shouldn't be sharp or persist beyond the first few times. If it does, one of the other causes on this list is likely involved. More foreplay, slower penetration, a good lubricant, and starting with smaller toys or fingers before moving to full penetration all help make the adjustment easier. See First Time Having Sex: What to Expect and How to Prepare for more on this.
Menopause and hormonal changes
Declining oestrogen during perimenopause and menopause causes vaginal tissue to become thinner, drier, and less elastic, which leads to pain during sex for many people. This is treatable — vaginal oestrogen (applied locally, not taken systemically) restores tissue health for most people, and lubricants and moisturisers help in the meantime.
Ovarian cysts, fibroids, or pelvic inflammatory disease
These conditions can all cause deep pain during sex, often in specific positions. If you've noticed that certain angles or depths hurt while others don't, and especially if you have other symptoms like irregular bleeding, pelvic pain outside of sex, or pain during bowel movements, see a doctor.
Psychological factors
Anxiety, past trauma, fear of pain, or relationship stress can all make your body tense up in anticipation, which creates real physical pain during sex even when there's no structural cause. This isn't "all in your head" in a dismissive way — the pain is real, and addressing the mental health component (through therapy, particularly trauma-informed therapy or sex therapy) often resolves the physical pain.
When to see a doctor
See a doctor if:
- Pain is new and persistent (more than a couple of occasions)
- Pain is severe or getting worse
- Pain is paired with other symptoms (bleeding, unusual discharge, pelvic pain outside of sex, pain during urination or bowel movements)
- You suspect an infection
- Penetration is impossible or causes sharp, intense pain every time
- Pain is affecting your relationship or quality of life
Don't wait months hoping it will resolve on its own. Most causes of painful sex are treatable, but they need proper diagnosis first.
What actually helps
Start with lubrication
If dryness is even partly involved, a good lubricant removes a lot of the immediate discomfort and gives you better information about whether something else is going on. Use more than you think you need — there's no such thing as too much lube. Water-based formulas work with all toys and condoms; silicone-based formulas last longer and are better for significant dryness. See Lubricants for the full range.
Slow down and add more foreplay
Your body needs time to become aroused and produce natural lubrication (even if you're also using lube). If penetration is happening before you're physically ready, pain is a likely outcome. Communicate with your partner about needing more warm-up time — this isn't about them doing something wrong, it's about your body needing what it needs.
Try different positions
Some positions allow for deeper penetration, which can trigger deep pain if you have endometriosis, cysts, or certain anatomical factors. Positions where you control the depth and angle (like being on top) let you find what's comfortable and avoid what isn't. If certain positions hurt and others don't, that's useful information to bring to a doctor.
Use smaller or graduated toys for gentle exploration
If penetration is difficult or painful, starting with a small dildo or a dilator set lets you explore at your own pace without the pressure of partnered sex. This is particularly helpful if vaginismus or pelvic floor tension is involved. MyNookie carries a range of smaller toys and beginner-friendly options that make this process less intimidating. Browse Beginner Dildos and Anal Toys for graduated sizing options.
See a pelvic floor physiotherapist
If the pain is at entry and you suspect muscle tension (or if a doctor has ruled out infections and structural causes), a pelvic floor physio can assess whether your pelvic floor is too tight and teach you how to relax it. This is standard, evidence-based treatment for vaginismus and pelvic floor dysfunction, not a fringe option.
Talk to your partner
If pain during sex is making you avoid intimacy, not talking about it creates more problems — your partner might not know what's happening, and the silence can make both of you feel disconnected or rejected. A conversation that names the issue, removes blame, and focuses on "what helps right now" makes it easier to navigate together. See How to Talk About Intimacy with Your Partner for more on this.
Focus on other types of intimacy
Penetrative sex isn't the only option, and if it's painful, taking it off the table while you address the cause removes a lot of pressure. External stimulation, oral sex, hands, and toys can all be part of intimacy without requiring penetration. A clitoral vibrator, for example, doesn't require penetration and takes pressure off both partners to make penetration work when it's not comfortable. Browse Clit Stimulators and Vibrators for non-penetrative options.
Treat the underlying cause
If the pain is caused by an infection, a hormonal issue, endometriosis, or another medical condition, treating that condition is what resolves the pain. Lubricants and position changes help in the meantime, but they're not substitutes for proper treatment when a treatable cause exists.
Pain during anal sex
Most of the same principles apply: go slow, use a lot of lubricant (the anus doesn't self-lubricate), start smaller and work up gradually, and stop if it hurts. Pain during anal play is almost always because of too little lube, going too fast, or trying something too large too soon. If pain persists even with proper preparation, see a doctor — haemorrhoids, fissures, and other treatable conditions can cause pain during anal sex.
See Beginner's Guide to Anal Play for a full breakdown of how to start safely, and Anal Douching and Cleaning Before Play for prep guidance.
Where to start if you're unsure
Pick the most likely cause from the list above and address that first. If you're not sure, start with the easiest fix: try a good lubricant and see if that alone makes a difference. If it doesn't, see a doctor for proper diagnosis rather than guessing or trying to manage it indefinitely on your own.
Pain during sex is common, but it's not something you should just live with. Most causes are treatable, and addressing it early makes treatment easier and prevents it from affecting your relationship or mental health long-term.
For related reading, see Vaginal Dryness: Causes, Solutions, and the Role of Lubricants, Understanding Low Libido: Causes and Practical Solutions, and First Time Having Sex: What to Expect and How to Prepare. Browse Lubricants, Beginner Dildos, and Clit Stimulators.