What Causes Painful Sex?

There are multiple reasons why someone might experience painful sex. Before getting into what those are, just to be very clear – when I say painful sex, right now I’m referring to pain with insertion during vaginal intercourse. This pain can be deep in the vagina or more at the entrance. Sometimes it can prevent intercourse from happening completely.

A little disclaimer: This is not medical advice and you should always discuss your symptoms with a medical provider. That being said, I know there are many barriers to doing so. 

Now let’s briefly review some common causes: 

1. Vaginal Dryness 

   If things feel dry, irritated, scratchy, it’s possible you have dryness in the vagina or vulva. This can happen from lack of lubrication, low estrogen levels in the tissue, medication side effects, or side effects from certain medical conditions. 

2. Infections 

   If there’s a urinary tract infection, sexually transmitted disease, bacterial infection, yeast infection, you may experience a side effect of pain with intercourse. 

3. Irritation/Reaction 

   Similar to dryness, sometimes the tissue is having a reaction to something and is feeling irritated. For example, if you’re using a highly scented soap this can irritate the vulva. 

4. Other Medical Causes 

   Things like fibroids, ovarian cysts, endometriosis, or adenomyosis can cause pain with intercourse. Additionally if you have any scar tissue from previous injuries, this can make the tissue more sensitive or tight. 

5. Trauma 

   This can be a physical trauma like a car accident if the body was injured in a way affecting the pelvic floor (the whole body is connected, so it’s often involved even when you don’t realize it!). However pain with intercourse or even limited ability to insert anything, can also be from sexual, emotional, physical, or verbal abuse/trauma.

6. Shame 

   When we feel shame around our genitals or sexuality, our body internalizes that. Sometimes that can present as closing off that area, making insertion painful or very limited. This can even happen as a result of lack of education around sexuality or anatomy. 

7. Chronic Stress and Anxiety 

   When the body is in a state of chronic stress and anxiety, it can put the body into a chronic state of tension. Muscles that are more tense, can become tender or painful. This can especially cause discomfort when this tension happens at the vaginal walls or around the entrance to the vagina, making it difficult to insert anything. Learn more about anxiety and the pelvic floor here. 

Now we could dive deeper into all of these, but I just wanted to give you a quick list so that you can better understand possible causes behind your pain. This is a non exhaustive list, as in you might have a reason not listed here. It’s also possible to have a combination of the above. Once you have a better idea of what’s behind your pain, you can more easily address it. 

If you’re having painful sex, you can check my Starter Guide to Less Pain, More Pleasure for more guidance on getting started towards more enjoyable intercourse!