Pain during sex: Why it happens and when to take it seriously

When sex hurts, some people blame themselves: perhaps they are too tense, too inexperienced or simply ‘bad at sex.’ But pain during intercourse is a health concern, not a test of endurance. The American College of Obstetricians and Gynecologists says nearly three in four women experience pain during intercourse at some point in their lives, although for many it is temporary.

Possible explanations include inadequate lubrication, irritation, infections, pelvic-floor muscle problems, childbirth-related changes and conditions such as endometriosis. Stress and relationship difficulties can also influence arousal and pain, but physical pain should not automatically be dismissed as psychological. The location, timing and severity of symptoms matter when a clinician looks for a cause.

You can stop any activity that hurts; you never have to push through it. If pain is frequent or severe, a qualified healthcare professional can assess possible causes and discuss appropriate treatment. Asking for help is not an admission that your relationship or sexuality has failed—it is a way of taking your body’s signals seriously.

Further reading: Comfort and pleasure differ from one person to another. Our article on penis size, individual preferences and sexual pain puts that in perspective.

• Evidence: American College of Obstetricians and Gynecologists: When sex is painful.
• Related reading: Mismatched sex drives: What happens when one partner wants sex more often?; and an earlier discussion of intimacy in marriage.
• Image credit: Adrien Moreau, The Courtship, public-domain painting via Wikimedia Commons. Illustrative artwork, not a medical diagram.