Painful sex falls in to 2 categories: deep pain and superficial pain.

Deep pain

Deep pain is when you feel pain deep inside you, such as when your partner thrusts, or when the penis or sex aid or toy is fully inside you.

Common causes of deep pain include:

• endometriosis — a condition where cells that line the uterus (womb) grow in other parts of the body
• pelvic inflammatory disease (PID) — a condition where the uterus, fallopian tubes, and ovaries may become inflamed
• fibroids — growths in the womb
• ectopic pregnancy — where the foetus grows outside of the womb
• recent childbirth
• sexually transmitted infections (STIs) such as chlamydia or gonorrhoea
• constipation or irritable bowel syndrome
• having a partner with a large penis
• having a dry vagina

Superficial pain

Superficial pain is when you feel pain before the penis or sex toy has fully entered in to your vagina. For example, at the entrance of your vagina rather than deep inside.

Common causes of superficial pain include:

• skin irritation or a condition like eczema
• thrush
• a condition called vaginismus, which causes the muscles to spasm
• injury to part of your vagina
• a foreign body being inside the vagina
• having a dry vagina often during menopause or after childbirth
• STI’s such as genital herpes

Vaginismus

Vaginismus is a condition that causes the muscles around the vagina to tighten by themselves. It usually occurs when the genital area is touched. This can be before or during sexual intercourse, when attempting to insert a tampon, or during a gynaecological examination, for example.

You do not have to have sex if it is painful. Go to see a doctor you can talk to openly. Often it can take a while for the problems that cause painful sex to go away. Still having sex while it’s painful may delay your recovery.

Treatment

If you have painful sex, see your doctor to check there are no underlying conditions. Simple treatment may involve advice on using a lubricant, longer foreplay or changing sexual technique. For some women, seeing a physiotherapist who specializes in pelvic floor physiotherapy helps. For others, a psychologist can talk to you about psychological problems or relationship issues.