Painful sex

There are lots of reasons why sex may become painful, and even when the problem has been sorted out, it can take a long time before sex becomes enjoyable again. You definitely need help from your doctor for this symptom – it is not something you can sort out on your own.

Before you see your doctor, try to be clear in your mind whether the pain occurs:

when your partner attempts to put his penis into your vagina (superficial pain)
when the erect penis is fully inserted and during thrusting (deep pain)
in the hours after sex
in another part of the body, such as the hip joints.

Causes of pain at the entrance of the vagina during sex

Lack of arousal and a dry vagina is one of the most common reasons (look at sex and ageing).

After childbirth, some women experience pain when they start having sex again. It is more likely after the first baby. Sometimes it is due to an episiotomy (that is the cut made during the delivery) that has not healed properly. The pain almost always goes away after about 3 months.

Infections, such as thrush or herpes, cause soreness of the vulva (the lips round the opening of the vagina). Vaginal discharge causes chafing of the skin, which makes the problem worse.

Blocked Bartholin’s glands. Bartholin’s glands are just inside the opening of the vagina, one on each side. They help produce lubrication for sex. If the opening of a Bartholin’s gland becomes blocked, it swells up into a cyst. Bacteria may enter the cyst, turning it into a painful abscess.

Skin irritants such as perfumed soaps, bubble baths, biological (which means that they contain enzymes) washing powders, ‘intimate’ deodorants and spermicides can all make the vulva sore.

When sex causes pain deep inside

Pelvic inflammatory disease is an infection of the Fallopian tubes (the tubes, one on each side, that carry the egg from the ovaries to the uterus). These tubes lie close to the top of the vagina, so sex causes a deep pain.

Endometriosis is a peculiar condition, in which some of the tissue that normally lines the uterus (the womb) lies outside the uterus, in the pelvic cavity. No one knows why it occurs, though it seems to be quite common. Many women have no symptoms from it, but if the tissue is lying behind the uterus it can cause painful sex, especially on deep thrusting. A sign of endometriosis is bad period pains – especially if they last throughout the period.

Pelvic pain syndrome. For 2 out of every 3 women with deep pain during sex, no cause can be found; you may have to accept that you have pelvic pain syndrome. This syndrome is not fully understood, but it is related to stress. One possible, but not proven, explanation is that, in some women, chronic stress alters the flow of blood in the veins of the pelvis, so that the pelvis becomes congested. If you are easily aroused during sex, but have difficulty reaching orgasm, the problem becomes worse because the pelvic congestion is not relieved. You may then experience a pain that persists after sex for some hours.

Lack of arousal. Intercourse will be uncomfortable if penetration occurs before you are aroused. This is partly because of lack of lubrication, but also because with sexual arousal the upper part of the vagina balloons open. This helps to lift the womb up and away from the thrusts of the penis. If penetration occurs too early, there may be a pain or discomfort felt deep in the middle of the pelvis with each thrust.

Other causes include irritable bowel syndrome (IBS) and cystitis – both the bladder and bowel lie close to the vagina.

Dr Phil Hammond discusses painful sex, vaginal dryness and urinary tract infections in his Expert guide to After the menopause

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Thursday, June 10th 2010

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Comments on this article

Posted by Optional on 21/02/2012 at 05:37

Hi I have policistic overys had it since 16 years off age I'm now 35 and sex hurts and I'm left with pain in the bottom off my lower left side of my stomach do u no what is coursing it

Posted by katy on 26/09/2011 at 10:52

when i have sex i cant explain it well but it hurts when my boyfriend tries to thrust into me like it did the first time i ever had sex. ever since the last time we had sex i cant wear tampons and it hurts to have intercourse

Posted by Daisy on 08/09/2011 at 02:51

During orgasm I have terrible stinging pain deep inside, on release of sperm (whilst trying for a baby) the stinging was so intense I have to hold still and my husband has to cease sexual activity. I often bleed and the orgasm spasms are really painful. I have been checked for STI/STD'S but always come back clear. I regularly have thrush to the point of bleeding and suffer from cystitis resulting in antibiotics for relief. I have two children and my partner has also been checked whilst we have been together with clear results.My smears always come back normal too. Please help, I am REALLY concerned.

Posted by Britt on 08/08/2011 at 05:46

I am 18 years old. Everytime me and my fiance have sex, I start off really wet and then get dry. It feels like the folds of my vaginia are entering my body and is rubbing me raw. If you have any suggestions please help me.

Posted by ann81153 on 21/07/2011 at 12:18

I will soon be 58yrs old and I noticed using a mirror that my clitoris is very very small compared to years ago. It first scared and dI figured as long as I am able to urinate I'm ok. I have not been sexually active for over 10 years, I take over 15 medications for my lupus, kidneys, and diabeties.

Posted by Optional on 20/02/2011 at 08:24

well for starters, on the top very top where the lips first seperate i have 2 bumps with little holes in them. they dont hurt or anything just embarrassing and on the very bottom before the anus i have 2 large pimple type things. do i have herpes or something?

Posted by Optional on 02/12/2010 at 02:28

Vagina too tight intercourse too painful, cannot take penis even with lubrication.

Posted by Optional on 10/11/2010 at 09:21

The first time i had sex was so painful we had to stop as i also started bleeding, i went to my doctor who carried out an exam on me and that was painful too, i just want to know whats wrong with me so i can enjoy sex. any ideas?

Posted by Optional on 14/06/2010 at 04:15

Since menopause sex too painful, although wanted. Have tried lubricants, but do not seem to work. What next?????

Posted by Optional on 28/04/2010 at 10:04

I have extreme pain during sex. It is on the inside front part of my vagina and it starts when my fiance is climaxing. I nor my doctor's can find what is causing this pain but it is very frustrating because I am the kind of person that loves sex and I mean I love sex...please help me.

Posted by lucy on 01/12/2009 at 10:08

i was having sexual intercourse and as he was thrusting he missed and penetrated my anus and the pan was crippling. its been two days and i experienced a tear and some bleedind and find it hard to sit and stand easily. i dont engage in anal activities nd dont wish to ever do so please tell me how i can heal physically. I have been cleaning with dettol disinfectant what else should i do. Please help

Posted by Anonymous on 10/11/2009 at 04:26

talking on behalf of my partner. we have been together ten years and he is sore when the forskin is pulled back-he has been to doctor and clinics but the viagra they prescribed didnt make that much diffrence-he missed a few appointments due to his work and has now been signed off the clinic but it hasnt got better

Posted by Anonymous on 20/10/2009 at 06:41

It hurts while having sex and after having had sex it then hurts/burns around the vagina too. I think it's thrush, just need some more advice about it?

Posted by ma on 19/03/2009 at 07:21

Is it harmful to want and have anul sex If so how