What causes pain during sex?

Having sex is an experience that should be enjoyable, and if you are experiencing pain when having sex it can be a way of your body telling you that something isn’t quite right. Sometimes experiencing pain can be a sign that your body was not ready to be touched or penetrated in a certain way, and using lube and having oral sex can be a way to stop sex from hurting. At other times experiencing pain may be due to a medical condition, having an injury or infection, or from trauma. In this case, speaking to a doctor or sexual health professional about what is causing you pain can be a way to get support and find a solution to the problem. 

There can be many reasons you may experience pain during sex, and this is nothing to feel embarrassed or ashamed about. You can always stop if sex is painful, and no one should ever make you feel afraid or under pressure to continue having sex. Experiencing pain during sex can be upsetting so try to be kind to yourself and allow yourself time to understand your body and what works for you. 

What can cause pain during sex?

There are a lot of different causes and reasons why someone experiences pain during sex. If you are experiencing pain it is important to be kind to yourself and give yourself time to figure out why sex hurts. Sexual pleasure is important for both your physical and mental health and you deserve to have it in your life if it is something that you want. 

Anal and vaginal dryness during sex 

When having sex with a penis, fingers or when using sex toys it is extremely important that the person being penetrated is wet and relaxed. Being wet can allow for the penis, fingers or sex toy to go inside someone without them experiencing friction, which can cause pain. Having oral sex, before penetrative sex, can be a great way to make a person relaxed and wet, and ready to put something inside them. Using lube is also a great way to reduce anal and vaginal dryness and make penetration pain-free. Checking in with your partner, by asking them if something feels good, if they are enjoying themselves or if they want to try something else, is a way to make sure it is an enjoyable experience for everyone involved. If sex begins to become uncomfortable or dry at any stage, using more lube can be a great way to make it feel good again. If you are using condoms, make sure to use a water-based lube.

Thrush

Thrush is a common yeast infection that can affect the vagina and penis. Symptoms of thrush can include white discharge, itching and irritation around the genital area and soreness and stinging during sex and when you pee. Thrush can be caused by using soaps, perfumes and shower gels on your genitals. You can help to reduce the pain from thrush and avoid getting it again by only using a gentle soap substitute to wash the area, by drying the area properly after washing, wearing loose clothing and avoiding having sex until the thrush has cleared up. You can also speak to a pharmacist about the infection and they will be able to recommend the best treatment for thrush, such as an antifungal medicine.  

Sexually Transmitted Infections

Many sexually transmitted infections (STIs) can cause pain during sex. If you are sexually active, it’s important to get regular checkups at an STI clinic and ask your partner(s) to get tested too. Always use protection like a condom or a dental dam during sex to protect from STIs. Find a list of free STI clinics in Ireland here.

Urinary Tract Infection (UTI)

Urinary Tract Infections (UTIs) affect your urinary tract, which can cause Cystitis, a common infection of the bladder, urethritis, or a kidney infection. Symptoms of a UTI can include pain or burning sensation when you pee, feeling the need to constantly pee, blood in your pee and pain in your lower back or stomach. Having a UTI can also cause pain during sex. If you think you have a UTI contact your GP and they will be able to decide if you need to be treated with an antibiotic. 

It is important to always pee after sex as this helps to reduce the risk of getting a UTI.  

Vaginismus

Vaginismus is a medical condition whereby the vagina suddenly tightens up when you try to insert something into it. Vaginismus is the body’s automatic reaction to the fear of some or all types of vaginal penetration, such as putting a penis, finger, sex toy or medical apparatus inside the vagina. Vaginismus can be caused by many things such as internalised stigma around sex, previous negative experiences when having sex, trauma and stress and anxiety. It is something that a person does not have control over as the vaginal muscles tighten up on their own. 

Signs that you may be experiencing vaginismus can include not being able to insert a tampon into your vagina, struggling to put a penis, finger or sex toys into your vagina and experiencing pain during sex. Although having vaginismus can be painful and upsetting, it can be treated so that you can have pain-free penetration with time.

If you think you may have vaginismus, speaking to your GP or a sexual health professional can help. They will be able to offer you support and treatment options for vaginismus. Treatment options can include vaginal trainers to help you get used to having something inside your vagina, and accessing therapy or using relaxation techniques to help you understand and manage your feelings around penetration. 

Ovarian cysts

Ovarian cysts are small fluid-filled cysts that develop in the ovary. The ovaries are two almond-shaped organs that are part of the biological female reproductive system. There’s one on each side of the womb (uterus). Most ovarian cysts occur naturally and go away in a few months without needing any treatment. An ovarian cyst usually only causes symptoms if it splits (ruptures), is very large or blocks the blood supply to the ovaries. Some of the symptoms of ovarian cysts include pelvic pain, pain during sex and heavy or irregular periods. If you have any of these symptoms it is important to contact your GP for advice.

A tight foreskin

Having a tight foreskin, also known as phimosis, can cause significant pain during sex, because of the difficulty in pulling the foreskin over the head of the penis. If you’re experiencing this problem, speak to your GP and they will be able to advise you on the best treatment options available to you.

A tear in the foreskin

Small tears in the foreskin that can’t be seen but cause soreness and sharp, stinging pain around the tear can also be a cause of pain during sex. Using lube during sex can help to avoid this problem. If you are experiencing any of these symptoms visit your GP or visit a sexual health clinic for advice and treatment for the problem.

Endometriosis

Endometriosis is a condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes. Symptoms of endometriosis can include high levels of pain during your period, pain during or after sex, pain during your period when going to the bathroom, feeling sick, constipation, diarrhoea, or blood in your pee. If you have symptoms like these it can help to keep track of them before visiting your GP. Endometriosis can often be difficult to diagnose as it can vary from person to person and have the same symptoms as other conditions. Visiting your GP is the best way to find out if you have endometriosis or if something else is causing you pain. 

Size compatibility during sex

A common issue that can cause pain during sex is when a penis is too big or long to comfortably penetrate the vagina or anus. During vaginal sex with a penis, if one person has a slightly short or neat vaginal canal and the other person has a very big and or long penis, this can cause pain for the person with the vagina. This problem can also be experienced when having anal sex or when using a sex toy that is too big to fit into a vagina or anus. Trying different positions, using lube, and giving the receiving partner more control over the penetration can help. Again, it is important to remember that if you or someone you are having sex with experiences pain during vaginal sex, there are plenty of other types of sex you can have instead. No one should feel under pressure to fit something inside them if it is not comfortable. 

Sexual trauma 

If you visit a GP and they cannot seem to find any physical reason for you experiencing pain during sex, it could be that the pain you are experiencing is psychological. If you have experienced sexual assault, you may experience pain during sex due to trauma. People experience trauma for many different reasons. Experiences that cause a person to fear for their life or safety such as being attacked, sexually abused/assaulted, witnessing/experiencing violence, and witnessing or experiencing sexual content against their will are all examples of situations that may cause someone trauma. There are many different signs and symptoms of trauma, one of which can be experiencing physical pain.

​​Processing traumatic experiences can be challenging and painful, but there are professionals who can help you to safely work through traumatic experiences and give you guidance towards healing strategies and treatment options right for you. Speaking to your GP can be a great place to start when seeking to access professional mental health support. Your GP will be able to assess you, give you more information about your treatment options and refer you to a specialist if needed.

How to stop pain during sex

Sex should be enjoyable for everyone involved and you should never feel under pressure to keep having sex if it is hurting. If you are experiencing pain during sex, stop and let your partner(s) know how you are feeling. There may be something you can do in the moment to make having sex no longer hurt. You may need to try a few different things before you find a solution that makes sex enjoyable. 

Speak to a doctor

You may find the idea of speaking to your GP about sex difficult, but that is what your doctor is there for. They deal with all sorts of issues every day, and it will not be the first time they’ve heard about this problem. You may be referred to a gynaecologist, a doctor who specialises in reproductive health or to a sexual health clinic. Your doctor may also suggest you speak to a therapist if they believe the reasons you may be experiencing pain during sex are psychological. If you have experienced sexual assault there are also many supports available from organisations around Irlenad. 

Try different types of sex

The type of sex you want to have is up to you and it does not have to centre around penetration. If you are experiencing pain from penetrative sex, having oral sex instead of or beforehand can be a great way of increasing pleasure and enjoyment. Oral sex can allow you to become aroused, decrease dryness and relax. It can be enjoyed on its own or in partnership with other types of sex such as using sex toys, rubbing, touching and penetration. It is important when having oral sex that you always use protection such as a condom or dental dam to protect you and those you have sex with from STIs and HIV.

Not everyone will want to have oral sex and there is nothing wrong with that. If you think it isn’t for you what is important is that you and your partners feel comfortable and enthusiastic about the type of sex you choose and that you find a type that does not cause you pain. Trying out different things can help you to understand what feels good to your body. Remember, you get to choose the type of sex you want to have and it does not have to conform to previous ideas you may have had of what sex should look like. Take your time and communicate with your partner until you find something that works for you both. 

Use lube

Using lube every time you have sex can help to decrease friction and increase pleasure. Lube can be used for sex by yourself and without other people. You can buy lube online and in shops and pharmacies. If you are using condoms, make sure to use a water-based lubricant.

Do what you enjoy

If you are finding sex painful there are other ways to connect with someone other than having sex. Massage, kissing and bathing can all be ways to be physically close with someone and to enjoy sensual experiences together. Mutual masturbation can also be a way to share a sexual experience with someone while decreasing the risk of any pain or discomfort. What is important is that whatever you and your partners are doing together you both enjoy and that you do not experience pain as part of it.