We’ve all heard about bleeding when someone “loses their virginity,” or vaginal dryness when a woman gets older, but we often neglect discussing pain during sex as an issue at large – something that 75% of women will experience at one point in their lives. 

The Basics
Pain during sex is called “dyspareunia,” and it can occur before, during, or after sex. It isn’t limited to people with vaginas, but that’s what we’ll be talking about today. For some dyspareunia manifests as burning, while for others it might feel more like aching or throbbing. It can be brief, or it can last hours. The pain might be limited to sex, or it could occur during other kinds of penetration, such as inserting a tampon. This is all to say that pain during sex, like most things relating to our bodies, isn’t the same across the board. 

Entry vs. Deep Pain
One of the easiest ways to better understand the causes of pain during sex is by distinguishing between pain that occurs during entry versus pain that occurs during deep penetration, inside of the canal. Let’s go through the potential causes for both types:

Why am I experiencing entry pain during sex?

• Not enough lube: If you’re experiencing a drop in estrogen, such as during menopause, after childbirth, and on certain medications, such as antidepressants, you might experience increased vaginal dryness, which can be alleviated with more lube. 
• Injury 
• Infections, such as UTIs
• Vaginismus (for more information on vaginismus, see our article on the topic)
• Developmental difficulties: sometimes the vagina isn’t fully formed or develops with a block, which can cause pain. 
• Irritation from spermicides, latex condoms, or soaps.
• You’re just not aroused enough.

Why am I experiencing deep penetration pain during sex?

• Endometriosis 
• Fibroids 
• Cystitis 
• Irritable bowel syndrome (IBS)
• Pelvic floor issues 
• Ovarian cysts
• Hemorrhoids 
• Surgeries 
• Constipation 

Outside of these two types, your emotional well being may also contribute to pain during sex. Anxiety, depression, feelings of insecurity, and fear can all lower arousal, making sex more painful. Stress may cause the pelvic muscles to become tense, causing pain. If you have experienced sexual abuse, you may experience these symptoms as well.

While most women will experience pain during sex at some point in their lives, that doesn’t mean it has to be accepted as “normal.” If you continue to experience pain when you have penetrative sex, tell your doctor, even if it feels awkward or embarrassing.