Ouch! Top reasons sex might be painful

We often hear about people having fun between the sheets – but for some, sex can actually cause discomfort and pain. This is why.

The way we talk about sex in popular culture, it can seem like everyone is having a great time doing it.

However, Australian research shows intercourse is actually painful for about 20 per cent of women and two per cent of men.

Known as dyspareunia, painful sex not only affects enjoyment, but it also weighs heavily on people’s mental health, according to Dr Anita Elias, head of The Sexual Medicine and Therapy Clinic at Monash Health.

“The impact is huge,” Dr Elias says. “It can affect their self-esteem and lead to depression and anxiety.

“Yet, unfortunately, we don’t talk about sexual problems, and so for those people, sexual difficulties can be very isolating.”

What causes pain during sex?

There are a number of reasons people might find sex painful.

We’ve listed the most common issues that pop up, and if any of these sound familiar, our experts recommend seeking help from your local doctor.


For some women, the muscles around the vagina may tighten involuntarily.

“It’s caused by a tightness in the pelvic floor muscles surrounding the vagina,” Dr Elias says.

“This makes it very difficult for a woman to have something in her vagina – a penis, a finger or even a tampon.”

Fortunately, Pelvic Pain Foundation of Australia chair associate professor Susan Evans says often there is an underlying cause that can be treated.

“It’s about working out what the muscles are reacting to and treating that, so if, for example, those painful pelvic muscles are reacting to painful periods, if you treat that, then the muscles may improve,” the gynaecologist says.

The condition may also be psychological and can affect men, too, she adds.

Unfortunately, we don’t talk about sexual problems, and so for those people, sexual difficulties can be very isolating.

Vaginal dryness

A common problem reported by many is the feeling of burning, itching, and pain inside the vagina during sex, which is often caused by vaginal dryness.

This is something that can occur at any age, however, it’s especially common during menopause and while women are breastfeeding due to hormonal changes, Dr Elias says.

It also be exacerbated by stress, contraception, the use of harsh soaps, and some medications.

Focusing on foreplay and using a lubricant during sex will likely help alleviate symptoms.


Pain during sex is sometimes a symptom of endometriosis, which is when the uterus lining grows elsewhere in the body, like in the vaginal tract.

A penis rubbing on endometrial growths can pull, stretch and irritate the lesions, especially deep inside the vagina, Assoc Prof Evans explains.

The pain during penetration may range from slight to severe, but sometimes, the fix can be as simple as changing your sexual position.

However, in complex cases surgical removal of the growths may be required.

Lack of arousal

This may seem like a no brainer, but many people are coerced into sex with their partner, may not be turned on enough, or have not had enough foreplay to warm up, which can make sex uncomfortable.

“If you’re not turned on, then you won’t have natural lubrication, and that can lead to pain, ” Dr Elias explains.

But it’s not just about lubrication – when we are turned on “the vagina becomes stretchy and more spacious”, Dr Elias adds.

Vulvodynia (or vestibulodynia)

“This is when the opening of the vagina is painful, associated with increased nerve endings in the tissues,” Assoc Prof Evans explains.

“It’s something that you can’t see. The skin looks completely normal, but as soon as you touch it, it’s very painful.”

Evans recommends seeking help from a doctor, however, unfortunately there is much more to learn about this condition, and some practitioners may struggle to recognise the symptoms.

Other suggestions that may help include ditching the soap, using QV cream, and not waxing hair on the labia.

Find out more about painful sex and other topical health and wellness issues on The House of Wellness TV. Tune in on Channel 7, Fridays at 2pm and Sundays at 12 noon.