Pain During Sex? These Are the Causes and Proven Solutions

Pain During Sex? These Are the Causes and Proven Solutions

Pain during intercourse is more common than you might think.
Many women struggle with it due to embarrassment or because they assume it’s “normal.” The medical term for pain during sex is dyspareunia — recurring or persistent pain before, during, or after vaginal penetration. But pain is never normal, and there are evidence-based solutions.

How Common Is Pain During Sex?

Research shows that 10–20% of women experience pain during sex at some point in their lives.
During menopause, the proportion rises to more than 50% — mainly due to hormonal changes that affect vaginal health.¹²

What Causes Pain During Sex?

Painful intercourse usually isn’t caused by just one thing. Often, it’s a mix of physical and psychological factors.

1. Vaginal Dryness

One of the most common causes is vaginal dryness, often due to a drop in estrogen — for example during:

• menopause

• breastfeeding

• use of hormonal contraception

This can make the vaginal lining thinner, less moist, and more sensitive.³

This dryness can lead to:

• burning

• irritation

• a painful or pulling sensation during penetration.

2. Genitourinary Syndrome of Menopause (GSM)

In menopausal women, vaginal dryness can be part of GSM — which also includes:

• urinary complaints

• itchiness

• frequent urge to urinate

• pain during sex.⁴

3. Sensitivity, Infections & Skin Conditions

Recurrent infections, a disrupted vaginal flora, or skin issues such as lichen sclerosus make the vagina more sensitive — which can cause pain on contact or penetration.

4. Pelvic Floor Muscle Tension

If the pelvic floor muscles are tense or overactive, penetration can feel difficult or painful.
This tension can develop unconsciously, for example after previous painful experiences, stress, or childbirth.

5. Psychological Factors

Anxiety about pain, stress, fatigue, or negative sexual experiences can make pain worse or even cause it.
Body and mind influence each other more than many people realize.

What Can Help With Pain During Sex?

The good news: painful intercourse is treatable. In many cases, simple non‑hormonal solutions can significantly help.

1. Lubricant — Essential First Step

Medical guidelines recommend using a lubricant as the first step when vaginal dryness plays a role in pain.⁴⁵

A good lubricant :

• reduces friction

• increases comfort

• helps prevent micro‑tears

• works immediately.

What to look for in a lubricant :

• long‑lasting glide

• pH‑neutral and microbiome‑safe

• free from irritating ingredients such as perfume

• includes hydrating components like ectoin or hyaluronic acid

• water‑ or silicone‑based lubricants are generally recommended.⁵
  

2. Vaginal Hydration and Care

If dryness persists, products that hydrate and support the intimate mucosa over time may be helpful alongside lubricant use.

3. Pelvic Floor Therapy

If muscle tension is part of the problem, guidance by a specialized pelvic floor physiotherapist can help you learn to relax the muscles and regain confidence in your body.

4. Local Hormonal Treatment

For severe menopausal symptoms, a doctor may consider local estrogen therapy — always on medical indication and under supervision.

5. Open Communication

Talking about pain — with your partner and a healthcare provider — lowers the threshold to seek help and prevents problems from getting worse.

In Summary

Painful intercourse is not normal and does not need to be endured in silence. With the right knowledge, appropriate products, and professional support, intimacy can become comfortable and enjoyable again.

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 lubricant use.