Pain During Sex? Why Your Body Is Reacting & Medical Next Steps

Pain during sex is more common than many people realize. It can happen at any age, in any type of relationship, and for many different reasons. While occasional discomfort may not signal a serious issue, ongoing or severe pain during sex is your body's way of saying something needs attention.

The good news: most causes are treatable. Understanding why sex hurts is the first step toward feeling better.

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What Is Pain During Sex?

The medical term for painful sex is dyspareunia. It can feel different depending on the cause. Some people describe:

• Burning or stinging
• Sharp or stabbing pain
• Deep pelvic pressure
• Aching after sex
• Tightness that makes penetration difficult or impossible

Pain can occur:

• At the entrance of the vagina
• Deep in the pelvis
• In the penis
• In the testicles
• During thrusting
• After sex ends

Pain is never "just in your head," but emotional and physical factors often work together. Both deserve attention.

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Common Physical Causes of Pain During Sex

1. Vaginal Dryness

One of the most common causes of painful sex is not enough lubrication. This may happen due to:

• Menopause or perimenopause
• Breastfeeding
• Certain medications (like antidepressants or antihistamines)
• Not enough foreplay
• Hormonal birth control

When there isn't enough natural lubrication, friction increases, leading to burning or tearing sensations.

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2. Infections

Infections can cause inflammation and make sex painful. These include:

• Yeast infections
• Bacterial vaginosis
• Urinary tract infections (UTIs)
• Sexually transmitted infections (STIs)

Symptoms may include itching, discharge changes, odor, pelvic pain, or burning with urination. Infections usually require medical treatment.

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3. Pelvic Floor Muscle Tension

The pelvic floor muscles support the bladder, uterus, and rectum. If they become too tight or spasm, penetration can be painful or impossible. This condition is sometimes called vaginismus.

You may notice:

• Difficulty inserting tampons
• Pain during gynecologic exams
• Tightness that feels involuntary

Pelvic floor physical therapy can be very effective.

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4. Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. It can cause:

• Deep pain during sex
• Severe menstrual cramps
• Chronic pelvic pain
• Infertility

Pain during deep penetration is a common symptom. Diagnosis often requires imaging or surgery.

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5. Ovarian Cysts or Fibroids

Growths in or around the uterus and ovaries can cause pressure or deep pelvic pain during sex. These are often benign but may need monitoring or treatment.

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6. Skin Conditions or Irritation

Conditions like eczema, lichen sclerosus, allergic reactions, or even reactions to soaps and lubricants can irritate sensitive genital tissue.

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7. Prostatitis (In People with a Prostate)

Pain during sex or ejaculation in men may be caused by inflammation of the prostate gland. Symptoms can include:

• Pelvic pain
• Painful urination
• Discomfort in the lower back

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Emotional and Psychological Factors

Sex is both physical and emotional. Stress, trauma, and mental health conditions can affect how your body responds.

Common contributors include:

• Past sexual trauma
• Anxiety about sex
• Relationship stress
• Depression
• Body image concerns

The body can physically tense in response to emotional stress, leading to real pain.

In some cases, dissociation (feeling disconnected from your body during sex) may be a factor, especially for people with trauma histories. If you're experiencing feelings of detachment or disconnection during intimate moments, take a free Dissociative Disorder symptom assessment to explore whether this might be contributing to your experience.

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When Is Pain During Sex Serious?

Pain during sex can sometimes signal a more serious medical condition. You should speak to a doctor promptly if you experience:

• Severe pelvic or abdominal pain
• Fever along with pelvic pain
• Unusual or foul-smelling discharge
• Bleeding after sex (especially after menopause)
• Sudden, sharp pain that doesn't improve
• Pain combined with unexplained weight loss

These could indicate infections, ectopic pregnancy, pelvic inflammatory disease, or other urgent conditions. If pain is severe or accompanied by concerning symptoms, seek immediate medical care.

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What to Expect at a Doctor's Visit

Talking about sex can feel uncomfortable, but doctors are trained to discuss it professionally and without judgment.

Your appointment may include:

• A detailed symptom history
• Questions about when the pain started
• Discussion of medications and medical history
• A pelvic or genital exam
• Swabs or urine tests
• Ultrasound imaging if needed

Being honest about your symptoms helps your doctor identify the cause more quickly.

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Treatment Options for Pain During Sex

Treatment depends on the underlying cause. Many cases improve significantly with proper care.

Possible treatments include:

• Lubricants or vaginal moisturizers
• Hormone therapy (for menopause-related dryness)
• Antibiotics or antifungal medications
• Pelvic floor physical therapy
• Pain management strategies
• Treatment for endometriosis or fibroids
• Counseling or sex therapy
• Adjusting medications

If anxiety or trauma contributes to pain, therapy with a licensed mental health professional can be life-changing.

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Practical Steps You Can Try Now

While medical evaluation is important, some immediate strategies may help reduce discomfort:

• Use a high-quality water- or silicone-based lubricant
• Spend more time on foreplay to increase natural arousal
• Communicate openly with your partner
• Avoid harsh soaps or scented products in the genital area
• Try different positions to control depth and pressure
• Practice relaxation breathing before sex

However, these steps should not replace medical care if pain continues.

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Why You Shouldn't Ignore Pain During Sex

Pain during sex is not something you simply have to "live with." Ignoring it can lead to:

• Avoidance of intimacy
• Relationship strain
• Worsening anxiety
• Chronic pelvic pain
• Delayed diagnosis of treatable conditions

Early evaluation usually leads to simpler treatment and better outcomes.

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The Mind-Body Connection

It's important to understand that sexual pain is often multifactorial. You can have:

• Mild physical irritation combined with anxiety
• Hormonal dryness plus pelvic muscle tension
• A past traumatic experience affecting current physical response

Treating only one piece may not fully solve the problem. A comprehensive approach works best.

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Speak to a Doctor

If you are experiencing ongoing or severe pain during sex, speak to a doctor. Some causes can be serious or even life-threatening if left untreated. Prompt evaluation ensures that infections, reproductive conditions, or other medical issues are properly diagnosed.

You deserve sex that is comfortable, consensual, and pleasurable—not painful.

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Final Thoughts

Pain during sex is common, but it is not normal to suffer in silence. Your body reacts for a reason. Whether the cause is hormonal, muscular, infectious, structural, or emotional, solutions are available.

Start by:

• Noticing your symptoms
• Tracking when pain occurs
• Speaking openly with your healthcare provider
• Exploring both physical and emotional factors

Relief is possible. The first step is taking your symptoms seriously—and getting the right medical support.