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Pain during sex
Category: Women's Health · All women's health symptoms
What it can feel like
Pain during sex (dyspareunia) is pain felt at entry (superficial) or deep inside during intercourse. It is common, under-reported, and almost always has an explanation once the pattern is mapped — dryness and skin conditions at the entry, pelvic conditions deep inside.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Superficial pain can be associated with vaginal dryness (breastfeeding, menopause), skin conditions of the vulva such as eczema or lichen sclerosus, thrush or other infections, and scarring after childbirth or surgery. Deep pain can be associated with pelvic infection, constipation, and ovulation timing.
Other possible causes
Deep pain can also be associated with endometriosis (classically pain with deep penetration and painful periods), adenomyosis, fibroids pressing on structures, ovarian cysts, and pelvic floor muscle spasm (vaginismus), which produces entry pain with muscle tightening.
Red flags — when to seek help promptly
- Pain during sex together with bleeding after sex, fever or discharge
- New deep pain with pelvic pain at other times or difficulty conceiving
- Entry pain with visible skin changes — white patches, splitting or shrinking of vulval skin
- Pain that begins suddenly with severe pelvic pain (possible cyst problem) — urgent
What a clinician may do
A clinician will take a careful, unhurried history — location, timing, accompanying symptoms — and examine externally and internally as you permit. Infection swabs, pelvic ultrasound and review of contraception and menopause status follow the pattern; pelvic floor physiotherapy and psychosexual support are part of the toolkit.
Related guides on MedicalVideos.com
Frequently asked questions
Is pain during sex ever 'just normal'?
No — penetration is not meant to hurt, and persistent pain always deserves a structured look. Even when examination and scans are normal, mechanisms such as pelvic floor spasm and vulval pain syndromes are real, diagnosable and treatable.
What does deep pain suggest compared with entry pain?
Location localises: entry pain points to the vulva, vagina and pelvic floor (skin, dryness, infection, spasm); deep pain points inside the pelvis — endometriosis, infection, cysts, adenomyosis. Describing which one you have is the most useful single detail you can bring.
Related symptoms — Women's Health
Browse the P section of the A–Z list or return to the Symptoms A–Z hub.