In movies, TV, and mainstream pornography, sex is typically portrayed as an intensely pleasurable activity every single time it happens. 

But in real life, it’s rarely so simple. 

Many people experience pain or discomfort that affects their ability to relax and feel pleasure during sex. For some, the pain is a fleeting nuisance. For others, it makes some types of sex nearly impossible. 

Painful intercourse — or “dyspareunia” in the medical community — is more common than you might think. The prevalence of dyspareunia falls between 3-18% worldwide, and it can affect up to 28% of the population in a lifetime.

Experiencing pain during sex can be jarring, particularly if this is a new occurrence. It can affect both your body and mind, impacting your self-confidence and your ability to be intimate with your partner(s). But as unpleasant as it may be, it’s nothing to feel ashamed of. 

Whether it's a new sensation or a recurring issue, understanding what causes painful intercourse and how a medical professional can help is an important step toward reclaiming a pain-free sex life.  

What’s dyspareunia?

Dyspareunia is recurring genital pain experienced just before, during, or after sexual intercourse. It's more common in people with vaginas, and the dysfunction can be so severe that it disrupts one’s ability to fully enjoy intimacy. 

Pain from dyspareunia can feel like stabbing, burning, throbbing, or cramping. It can be pretty intense, and the discomfort has many possible causes. 

How common is dyspareunia? 

According to the American College of Obstetricians and Gynecologists (ACOG), approximately three in four people with vaginas experience painful intercourse at some point in time throughout their lives. While it may be a short-term problem for some, it can also be a long-lasting issue that persists for weeks, months, or years. 

Symptoms of dyspareunia 

Dyspareunia symptoms are varied, and no two people will have the exact same experience with the condition. However, recognizing the signs is crucial to understanding and addressing the pain. Here's an overview of some common symptoms — if this sounds like you, you should schedule an appointment with your doctor. 

• Pain during sexual penetration: If you consistently feel pain when your partner penetrates you or when you penetrate yourself with a sex toy, this may indicate dyspareunia.

• Pain using tampons: Inserting a tampon shouldn’t be painful. If it is, you may be experiencing dyspareunia. 

• Pain during thrusting: Some people with dyspareunia feel pain at the point of penetration, while others feel it during thrusting. 

• Burning or aching pain: Not all dyspareunia pain feels the same. Note that your genitals shouldn’t burn or ache during sex, either. 

• Stabbing pain or pain deep in the pelvis: These types of pain are also associated with dyspareunia, and can make penetrative sex extremely uncomfortable. 

Painful intercourse causes

A number of factors can cause or contribute to sexual pain. It can be challenging to pinpoint the underlying issue due to the intricacy of the potential physical and psychological causes. 

Painful intercourse may be caused by:

• Vaginal dryness: Painful intercourse, particularly after menopause, can sometimes be attributed to low estrogen levels, which can cause vaginal dryness. Vaginal dryness is also linked to some medications, childbirth, breastfeeding, and a lack of sexual arousal before intimacy. 

• Medical conditions: Ovarian cysts, endometriosis, fibroids, pelvic inflammatory disease, and other medical conditions can cause soreness during intercourse.

• Vaginismus: This condition causes the pelvic floor muscles to contract during attempted penetration, resulting in pain and discomfort.

• Vulvodynia: Vulvodynia, chronic pain that affects the vulva and vaginal opening with no cause, can contribute to painful intercourse.  

• Vaginitis: Vaginitis causes the vagina to become inflamed, and can result in uncomfortable or painful intercourse. 

• Infections: Vaginal infections such as yeast infections, sexually transmitted infections (STIs), and urinary tract infections can cause inflammation that leads to pain during intercourse.

• Injury or trauma: Vulvar or vaginal damage due to childbirth, surgery, an accident, an episiotomy, or trauma can cause sexual pain.

• Irritable bowel syndrome (IBS): IBS can impact the pelvic muscles, contributing to painful sex. 

• Stress: Elevated stress levels can tighten pelvic floor muscles, making penetration painful.

• Emotional factors: Feelings of fear, guilt, or shame about sex can manifest as physical discomfort during intercourse.

• Self-image or body issues: If you have low self-esteem or don't feel comfortable with yourself and your body, it may cause you to feel uncomfortable engaging in sex with your partner(s), leading to pain. 

• Relationship problems: Emotional distance, unresolved conflicts, sexual issues, or a lack of trust within a relationship can negatively impact physical intimacy in the same way anxiety does. 

Does dyspareunia cause bleeding?

Approximately 15% of patients with vaginas who experience bleeding after sex have dyspareunia. In some cases, the underlying issue causing the pain might also cause bleeding, as is the case with endometriosis, fibroids, vaginitis, and certain types of infections.

Injury to the vaginal tissues — whether it's from childbirth, rough intercourse, or trauma — can also cause bleeding. If you experience dyspareunia and bleeding, seek medical attention to stay safe and get to the bottom of the issue.

How is dyspareunia diagnosed?

Because many different underlying conditions can cause painful intercourse, diagnosing dyspareunia requires a comprehensive approach from your doctor. When you schedule an appointment with your healthcare provider, you can expect: 

• Physical exam: The doctor will likely conduct a pelvic exam. They'll evaluate your genital area for abnormalities, infection, and potential causes of pain, and they may use a speculum to open your cervix. 

• Ultrasound: A pelvic ultrasound can provide useful images of the internal structures of the pelvis. It helps your doctor detect cysts, fibroids, and other abnormalities that cause pain. 

• Laparoscopy: A laparoscopy may also be required in more complex cases that are harder to diagnose. This minimally invasive surgery involves the insertion of a tiny camera into the abdomen to inspect the pelvis area. 

How long does it take to cure dyspareunia?

Dyspareunia treatment options include medication and counseling aimed at resolving the underlying issue causing the pain. Some people benefit from faster-acting solutions, such as topical estrogen creams that help the body produce more vaginal lubrication, which is often recommended for postmenopausal women. Others require more prolonged treatment, particularly when the pain is a symptom of a serious condition like endometriosis or pelvic inflammatory disease. And while dyspareunia is usually treatable, it can become a chronic condition.

Because psychological issues can cause dyspareunia, your healthcare provider may recommend therapy. Counseling sessions can span several weeks, months, or even years and can benefit both individuals and couples as they navigate dyspareunia. 

Your doctor may also recommend desensitization therapy or Kegel exercises. Other advice may include scheduling regular check-ups with your healthcare provider and switching up sex positions to be more comfortable. 

Tips to reduce pain during sex

Painful intercourse may prevent you from getting and staying in the mood — and that’s completely normal. If you experience dyspareunia and you want to ease back into sex, these tips may help: 

• Use lubricant: Choose a water-based lubricant to reduce friction and enhance pleasure during sexual activities. Lube is always an excellent addition, but it's particularly beneficial for dyspareunia caused by vaginal dryness. 

• Get in the mood for sex: Foreplay is fun, and it helps prepare your body for sex. Try long periods of foreplay before escalating to other forms of intimacy to reduce the chances of discomfort.

• Communicate with your partner: Communication is vital to a healthy sex life. Discuss your feelings, fears, and pain with your partner to help them understand what you’re going through and how they can best support you. 

• Try relaxing nonsexual activities: Indulging in things like massages and cuddling can boost intimacy and trust with your partner, potentially smoothing the transition to sexual intercourse.

• Seek therapy: If the cause of your dyspareunia is psychological, book an appointment with a counselor or sex therapist to address the issue's root. They can provide feedback, guidance, and valuable strategies for your healing journey. 

Get comfortable with Quinn 

If you have trouble achieving arousal, try Quinn. Our sexual sounds and stories are great for setting the mood and engaging in sexual play with or without a partner — no penetration required. 

Quinn is an audio erotica app created by women for the world. We have a wide range of erotic content to explore, including thousands of guided masturbation sessions and narrated sex stories across diverse kinks and preferences. To access our library, download the Quinn app for iOS or Android.