Dyspareunia or Painful Sex

What It Means When Sex Hurts: Painful Sex|Causes & Treatment

Is sex supposed to hurt? I’ve received emails and dms from several people about having painful sex. Some ask, “Why does sex hurt?” Others ask, “Why is sex always painful?”

The truth is, sex isn’t supposed to hurt at all. If it hurts, something isn’t right, and until you decipher what exactly is causing the pain, where the pain is happening, what triggers the pain, its nature, how long it lasts, and its intensity, you might never find the right treatment for it. It is also important to determine the exact sexual act that causes or comes with the experience of pain. 

Most of the time, when people complain of painful sex (dyspareunia), they refer to penetrative sex (penis in vagina, penis in anus, finger in vagina, finger in anus, or toy in vagina/anus). It’s possible to experience pain during oral sex too! What’s more, although more people with vaginas complain of painful sex, people with penises experience it too (1% to 5%). They just don’t talk about it as much, partly because of social stigma.

Dyspareunia can affect your sexuality in several ways, including inhibiting sexual desire or causing low libido, because you wouldn’t want to have sex and endure pain. It can make sex unpleasurable when there’s too much pleasure and orgasms to be had. It can also cause relationship issues when one partner wants sex badly but the other(s) can’t have sex because it hurts when they do. 

Whether you are married, in a relationship or single, don’t have sex if you don’t want to. If sex hurts, treat the source of the pain first. 

why does sex hurt?

When Sex Hurts, What is the Pain Like? 

Painful sex or dyspareunia can relate to a burning sensation on the outer part of the genitals during oral sex or manual stimulation (using fingers or hands to stimulate the genitals ). It can also be a stinging sensation in the genitals, a sharp pain in the vaginal opening during the insertion of a penis or object, or an aching thud during deep penetration. Sometimes the pain lasts a short time, and in severe cases, the pain lasts so long that after sex, you might feel it while going about your daily life. 

Why Does Sex Hurt? The Causes of Painful Sex

  1. Vaginal dryness 
  2. Not preparing adequately for anal penetration
  3. First-time penetrative sex
  4. UTI and STIs
  5. Pelvic Inflammatory Disease
  6. Yeast Infections 
  7. Endometriosis
  8. Allergies 
  9. Hormonal imbalance 
  10. Vaginismus
  11. Perimenopause 
  12. Episiotomy scars that haven’t healed properly 
  13. Having penetrative sex up to 6 weeks after childbirth
  14. Oral contraceptives in women who are not breastfeeding after childbirth
  15. During the postpartum period (women who underwent cesarean sections)
  16. Pelvic pain disorders. 
  17. Vulvar pain issues 
  18. Lichen sclerosis
  19. Vulvovaginal atrophy
  20. In the absence of genitourinary infections (infections of the urinary and genital organs), uncircumcised men experience pain during sex more often than circumcised men. 

Painful Sex Caused by Vaginal Dryness 

Without sufficient lubrication, the vagina isn’t capable of accommodating the penis or objects without the experience of pain. That’s just how the vagina was made, just like how the penis needs to be erect before it can be inserted into the vagina or anus. 

Vaginal dryness has a number of causes that include insufficient arousal because of no or rushed foreplay. When a vagina owner is turned on or having a good time, they can lubricate naturally to relax their vaginal walls for easier and pleasurable penetration (if it’s on your menu).

You need to learn to concentrate more on sexual activities outside of penis-in-vagina or penis-in-anus sex that can feel good to all partners in order to elicit arousal and make it easier for the vagina owner to get lubricated. That way, penetrative sex can feel nicer. If you need ideas for what sexual activities to explore for arousal and foreplay, buy my book, Hot Sex Everyday, to access 365 sexual activities for arousal and enhanced pleasure. It has detailed notes on how to go about each activity. 

If you are poorly skilled, you will need the book to learn how to better please your partner(s) in order to avoid dyspareunia or painful sex.

Uncomfortable Sex Positions

During sex, especially penis-in-vagina or penis-in-anus sex, whenever a sex position feels uncomfortable, switch to another sex position. Over 365 sex positions exist. So, explore as many as you can and work with what feels the most comfortable and pleasurable. 

Not Preparing Adequately for Anal Penetration

Anal sex can be very pleasurable. The anus is very tight and doesn’t lubricate naturally like the vagina, so it requires preparation and the use of a generous amount of lubricant for pleasure and no pain. Read this post to learn how to prepare and have the most pleasurable anal sexual experience.

Painful First-Time Penetrative Sex

If the vagina owner has never had penetrative sex, foreplay is important to relax the vaginal muscles for easier and more pleasurable penetration. Preparation before the D-day is also necessary because first-time sex isn’t supposed to hurt, contrary to popular belief. Read this article to learn how to prepare the vagina for the most pleasurable first-time sexual experience. 

Painful Sex Caused by UTI and STIs

Urinary Tract Infections (UTI) and a number of STIs (e.g. chlamydia, HPV, etc.) can cause dyspareunia. Until they are treated, sex will still hurt, so get tested regularly and know the other signs of STIs and UTI. If you notice anything that might be a sign, get tested and start treatment as soon as possible. 

Dyspareunia Caused by Hormonal Imbalance 

Vaginal dryness can also be caused by hormonal imbalance, specifically insufficient estrogen levels, which can result in dryness even when the woman (or vagina owner) is aroused, having a good time, or experiencing orgasms. Unless you are menopausal or perimenopausal, the only way to know if you have low estrogen levels is by going for medical testing. So, see a doctor. 

Hormonal imbalance can be remedied by hormonal creams, suppositories, hormone replacement therapy, or the use of herbs to stimulate libido and the woman’s capacity for lubrication. 

Dyspareunia (Painful Sex) Caused by Allergies 

It is important to know what exactly you are allergic to. It is possible to be allergic to semen, latex in condoms, etc. If you find that you are allergic to semen, talk to your gynecologist about it. If you are allergic to latex, you need to desist from using latex condoms. Work with brands like Skyn or Trojan Bareskin. Glycerin in some water-based lubricants can also cause vaginal irritation and make sex painful. So, check the ingredients in the sexual products you use and avoid using any that contains glycerin and parabens.

What’s more, always do a skin test before using any sexual product on your genitals to ensure that they won’t cause irritation. To do the skin test, apply it to your wrist or elbow crease. If you experience no adverse reactions within a day, you can go ahead and use it on your genitals.

What Helps: Remedies for Painful Sex

  1. Personal lubricants—everyone should own one or more. 
  2. Vaginal moisturizers
  3. Sexual stimulants or homeopathic drugs/herbs that boost libido or enhance arousal
  4. Consumption of foods that are natural aphrodisiacs.   


If dyspareunia or painful sex isn’t caused by vaginal dryness, first-time sex, inadequate preparation for anal sex, or uncomfortable sex positions, you need to see a medical doctor (gynecologist, urologist, or healthcare professional who specializes in the treatment of sexual conditions). They should ask the right questions and do the right tests to figure out what the source of your pain is. That way, they can help you treat the underlying cause and sex won’t hurt anymore.

Remember, sex shouldn’t hurt when there’s too much pleasure to be had. Don’t miss out on the benefits of good sex!

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Ami Shikah is a Certified Sex Coach, clinical sexologist, and radio personality with an Advanced Postgraduate Diploma in Global Sexual and Reproductive Health Management. She loves anything and everything sex as long as it is consensual, pleasurable and free of any form of discrimination, harm or violence. On this blog, her aim is to promote sexual literacy, provide a source of arousal, and promote sexual wellness. If you need to talk to a sex professional about your sexual concerns or issues, she is the one to talk to. She can help you solve your sexual problems. She will help you have the most amazing sexual experiences and live the sex life of your dreams. Sex is a basic need and a natural part of who we are as human beings. Exercise your right to sexual pleasure today! Email her at amishikah@gmail.com for a complimentary sex coaching session.

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