Pain during sex? Here are the causes and proven solutions

Pain during sex is more common than people realize. Yet many women continue to put up with it, either out of embarrassment or because they think it’s “just part of it.” The medical term for pain during sex is dyspareunia. It refers to persistent or recurring pain before, during, or after vaginal penetration.

How common is painful intercourse?

Research shows that 10 to 20% of women experience pain during intercourse at some point in their lives. During menopause, this percentage rises to more than 50%, primarily due to hormonal changes that affect vaginal health.^1,2

What causes pain during sex?

Painful intercourse rarely has a single cause. It is often the result of a combination of physical, hormonal, and psychological factors.

Vaginal dryness

Vaginal dryness is one of the most common causes of pain during intercourse. A decrease in estrogen—for example, during menopause, while breastfeeding, or as a result of certain hormonal treatments—can cause the vaginal lining to become thinner, drier, and more sensitive.³

This can lead to:

• burning sensation;
• irritation;
• a pulling sensation;
• pain during or after penetration.

Genitourinary Syndrome of Menopause (GSM)

In women during and after menopause, vaginal dryness can be part of the genitourinary syndrome of menopause, abbreviated as GSM. This includes both vaginal and urinary symptoms, such as dryness, pain during intercourse, itching, irritation, and a more frequent urge to urinate.⁴

Hypersensitivity, infections, or skin conditions

Recurrent infections, an altered vaginal microbiome, or skin conditions such as lichen sclerosus can make the intimate area more sensitive. As a result, touch or penetration can become painful.

Pelvic floor muscle tone

An overactive or tense pelvic floor can make penetration difficult or painful. This tension sometimes develops unconsciously, for example, after previous experiences of pain, stress, childbirth, or out of fear that the pain will recur.

Psychological and Relationship Factors

Fear of pain, stress, fatigue, or negative sexual experiences can intensify or perpetuate pain. That doesn’t mean the pain is “all in your head”: physical tension, emotions, and pain influence one another.

What can help with painful intercourse?

The right approach depends on the cause. Sometimes simple, non-hormonal measures can help. If the pain is persistent, severe, or unexplained, it is important to consult a doctor or gynecologist.

1. Use a suitable lubricant

If you experience pain due to vaginal dryness, a lubricant can be an important first step. A lubricant reduces friction during sex and can thus provide immediate relief.^4,5

A suitable lubricant:

• reduces friction during penetration;
• increases comfort;
• can help prevent minor damage caused by friction;
• Works immediately upon use.

What should you look for when choosing a lubricant?

• long-lasting glide performance;
• a pH level suitable for the intimate area;
• a formula that is fragrance-free and free of sugar alcohols;
• ingredients that support hydration;
• Compatibility with condoms and sex toys;
• a formula that is suitable for the sensitive intimate area.

Aqua Glide versus a traditional water-based lubricant

Not all water-based lubricants have the same composition. The table below shows how Aqua Glide differs from a traditional water-based lubricant. Always check the ingredient list and instructions for use for other products, as formulas vary by brand.

“Classic water-based lubricant” refers here to common product formulas and not to every lubricant on the market. The exact properties vary by brand and product.

2. Take care of your intimate skin even outside of sexual moments

A lubricant is used during intimate contact and works immediately. In cases of persistent dryness, a daily care product that moisturizes and helps protect the external intimate skin may also be recommended.

So, a lubricant and a daily intimate care product don’t serve exactly the same purpose and can complement each other.

3. Consider pelvic floor therapy

When muscle tension is a factor, working with a specialized pelvic floor physical therapist can help. You’ll learn to consciously feel your pelvic floor, relax it, and rebuild your confidence.

4. Talk to your doctor about local hormonal treatments

If you experience severe symptoms during or after menopause, a doctor may consider prescribing local estrogen therapy. This can help restore the vaginal lining and reduce dryness and pain. This treatment is always prescribed for medical reasons and administered under medical supervision.⁴

5. Talk about it

Talking about pain—with your partner and with a healthcare provider—can relieve some of the pressure and help prevent you from putting up with your symptoms for too long. Take your time, don’t push yourself, and stop if something hurts.

When should you see a doctor?

Have pain during sex medically evaluated if:

• the pain persists or recurs regularly;
• the symptoms appear suddenly;
• you also experience vaginal bleeding, abnormal discharge, itching, or a burning sensation;
• you notice any changes in your skin, cuts, or cracks;
• penetration becomes difficult or impossible;
• the pain has a negative impact on your well-being or your relationship.

In conclusion

Painful intercourse is neither a taboo nor an inevitable fate. It’s a signal from your body that deserves attention. With the right knowledge, an appropriate lubricant, proper care, and professional guidance, intimacy can become more comfortable again.

Would you like to learn more about a lubricant that was specifically developed with the sensitive intimate area in mind? Visit Aqua Glide .

Sources

1. Harlow BL et al. Prevalence of symptoms consistent with vulvodynia. American Journal of Obstetrics and Gynecology, 2014.
2. Laumann EO et al. Sexual dysfunction in the United States. JAMA, 1999.
3. Kingsberg SA et al. Vulvar and vaginal atrophy in postmenopausal women. Menopause, 2013.
4. North American Menopause Society. Management of genitourinary syndrome of menopause. Menopause, 2020.
5. World Health Organization. Guidelines on vaginal practices and the use of lubricants.