Painful Intercourse: Causes and What Really Helps

Pain during sex is more common than people think. Yet many women continue to live 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.

Important to know: Pain is never normal, and there are scientifically proven solutions.

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 over 50%, mainly due to hormonal changes that affect vaginal health¹².

What causes pain during sex?

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

Vaginal dryness

Vaginal dryness is one of the most common causes of pain during intercourse. A drop in estrogen—for example, during menopause, breastfeeding, or when using hormonal birth control—causes the vaginal lining to become thinner, drier, and more sensitive³.

This can lead to:

• burning sensation

• irritation

• a pulling or painful sensation during penetration

Genitourinary Syndrome of Menopause (GSM)

In women during and after menopause, vaginal dryness can be a symptom of GSM. This syndrome includes both vaginal and urinary symptoms such as dryness, pain during intercourse, itching, and a more frequent urge to urinate⁴.

Hypersensitivity, infections, or skin problems

Recurrent infections, an imbalance in the vaginal flora, or skin conditions such as lichen sclerosus can make the vagina more sensitive and cause pain during touch or penetration.

Pelvic floor muscle tone

An overactive or tense pelvic floor can make penetration difficult or painful. This tension sometimes develops unconsciously, for example, following previous painful experiences, stress, or childbirth.

Psychological factors

Fear of pain, stress, fatigue, or negative sexual experiences can intensify or perpetuate pain. The body and mind influence each other more strongly than is often realized.

What can help with painful intercourse?

The good news is that pain during sex can be treated. In many cases, simple, non-hormonal measures are sufficient.

Lubricant: an essential first step

Medical guidelines recommend the use of a lubricant as the first step in treating painful intercourse caused by vaginal dryness⁴⁵.

A suitable lubricant:

• reduces friction

• increases comfort

• helps prevent micro-damage

• works immediately

What should you look for when choosing a lubricant?

• Long-lasting glide
• pH-neutral and microbiome-safe

• free of irritants such as perfume

• with moisturizing properties (thanks to ectoine or hyaluronic acid)

• without sugar alcohols such as glycerin (to reduce the risk of infection)

• Water-based and silicone-based lubricants are most commonly recommended in the medical literature⁵.

Vaginal hydration and care

If dryness persists, it may be helpful to use products that provide long-lasting hydration and support for the intimate mucous membranes, in addition to a lubricant.

Pelvic Floor Therapy

When muscle tension is a factor, working with a specialized pelvic floor physical therapist can help you learn to relax your muscles and regain confidence in your body.

Local hormonal therapy

In cases of severe menopausal symptoms, a doctor may consider local estrogen therapy. This is always done on medical advice and under medical supervision⁴.

Open communication

Talking about pain—with your partner and with a healthcare provider—makes it easier to seek help and prevents symptoms from getting worse.

In conclusion

Painful intercourse is neither a taboo nor an inevitable fate. It is a signal from your body that deserves attention. With the right knowledge, appropriate products, and professional guidance, intimacy can once again become comfortable and enjoyable.

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 (NAMS). Management of genitourinary syndrome of menopause. Menopause, 2020.

5. World Health Organization (WHO). Guidelines on vaginal practices and the use of lubricants.