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Sex is supposed to feel good, but unfortunately, pain before, during, or after sex is not uncommon. Symptoms of dyspareunia, the medical term for painful sex, can vary depending on the person and the cause.1 Infections, injuries, allergies, and certain health conditions, can all increase the likelihood of experiencing sex-related pain.
While anyone can experience pain related to sex, it’s more common to experience vaginal pain after sex than it is penis pain. Some people may feel pain externally on the penis, vulva, or vaginal entrance. Or, pain is felt deep inside the vagina, uterus, or lower pelvis.1 It’s estimated that 3 out of 4 women will deal with painful sex at some point in life.2
Here are some potential situations that can cause pain during and after sex and what you can do about it.
Yeast and Bacterial Infections
Vaginal yeast infections and urinary tract infections (UTIs) can cause vaginal inflammation, also known as vaginitis. When the vagina is swollen, friction from sex can cause additional pain or a burning sensation.1 A yeast infection or UTI affecting the penis can also make sex painful.3
Candida yeast overgrowth from a yeast infection can cause itching, thick white discharge, and pain while peeing.4 Treating the infection through either prescription or over-the-counter antifungal medicine should relieve symptoms of painful sex if the infection was the cause.
If you have a UTI, sex can irritate the infected urinary tract tissue and cause pain and burning. Healthcare providers usually treat UTIs with antibiotics, which should get rid of any related pain. If you’re prone to UTIs, you can also take preventative measures like peeing after sex, hydrating, and avoiding baths or using scented products on your genitals.5
STIs
Sexually transmitted infections (STIs) like chlamydia and gonorrhea cause vaginal inflammation that can make penetrative sex feel painful or burn.1 They can also cause abnormal discharge or painful burning while peeing.
Genital herpes can also make sex hurt if you have an active infection.3 If you have chlamydia or gonorrhea, your healthcare provider will prescribe medication to treat the infection. There is no cure for herpes, however, medication can reduce your risk of transmission and painful outbreaks. Using a barrier method like condoms during sex can also help reduce your risk of future STIs.
Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is an infection of the upper female reproductive organs often caused by untreated gonorrhea or chlamydia.1
PID can cause:
Deep pelvic pain during penetrative sex
Scarring
Pelvic pain
Infertility6
Damage to Fallopian tubes
Fever
Systemic infection
Abscess (an infected pus-filled lump)
Bleeding during sex or between periods
Pain while peeing
Lower abdominal pain6
If you suspect you have PID, see your healthcare provider as soon as possible. PID is treated with antibiotics, but damage from the infection can be permanent.6
Vaginal Dryness
If you don’t have enough lubrication, chafing from penetrative sex can lead to vaginal soreness. You may also experience vaginal dryness if you have penetrative sex before getting aroused or if you’re dealing with hormonal changes.
If you recently had a baby or are breastfeeding, hormonal changes can decrease the amount of estrogen in your body and lead to vaginal dryness that makes sex painful.7 Childbirth-related vaginal dryness should eventually resolve on its own. However, your healthcare provider may suggest using vaginal estrogen, moisturizers, or lubricants to help with hormone-related dryness.2
Similarly, perimenopause and menopause can also lower estrogen levels and lead to vaginal dryness and inflammation.2 This vaginal dryness can also be a symptom of vaginal atrophy, which is when the vagina becomes thin, dry, and inflamed due to decreased levels of estrogen in your body.
If your dryness is related to menopause, lubricants or hormone therapy can help restore moisture.
If dryness is related to not being aroused, you can also try lubricants and more foreplay to get in the mood.
Genital Injury
Any injury to the genitals can cause painful sex. During childbirth, tearing or an episiotomy (making a cut in the space between the vagina and the anus) can cause pain during sex – especially if you are still healing.7 To help mitigate painful sex after childbirth, don’t rush into having sex until your healthcare provider tells you it’s OK.
Some research suggests using perineal massage or lidocaine gel on sensitive scar tissue may help treat lingering pain.7 Be sure to check with a healthcare provider before using any topical treatments.
Any damage to the penis head, foreskin, or shaft can also cause painful rubbing or tearing during penetrative sex. It may be a good idea to abstain from sex while any injuries heal to avoid further irritation and pain.