Why Does Intimacy Hurt? A Plain Guide for Women (and What to Ask Your Doctor)
Plenty of women have been told, in one way or another, to "just relax." So they grit their teeth, say nothing, and slowly start avoiding intimacy altogether.
Pain during sex is common. Studies suggest around three in four women have it at some point. Common doesn't mean normal, though, and it nearly always has a cause you can do something about.
Where does it hurt?
Doctors often split pain into two kinds, because the causes differ:
- At the entrance: often linked to dryness, not enough arousal time, skin conditions, thrush, or muscles tightening on their own (sometimes called vaginismus).
- Deeper inside: more likely linked to endometriosis, fibroids, pelvic infections, ovarian cysts or certain positions.
Noticing which one it is gives your doctor a big head start.
Common causes worth checking
- Hormone changes: after childbirth, while breastfeeding, around menopause, or on some birth control
- Not enough time to warm up: the body needs longer than many people think
- Infections: thrush, bacterial vaginosis or STIs
- Pelvic floor tension: muscles that stay tight after pain, stress or a bad experience
- Medical conditions: endometriosis, lichen sclerosus and others
- Stress or relationship strain: the mind and body are not separate here
Small changes that help
- Use a good water-based or silicone lubricant. It's not a sign anything is wrong.
- Slow down. More time on touch and closeness before anything else.
- Try positions where you control depth and pace.
- Stop when it hurts. Pushing through teaches the body to brace for pain next time.
How to bring it up with your doctor
Doctors hear this every day. Try: "Sex has been painful for about six months. It hurts at the entrance and burns afterwards." Mention when it started, where it hurts and anything that makes it better or worse. A gynaecologist or pelvic floor physiotherapist can help a lot.
How to tell your partner
"I want to be close to you, and I've been avoiding it because it hurts. I'm getting it checked. Can we find other ways to be close for now?"
A caring partner will want to know. Hiding it usually leads to more distance, not less.
General information only, not medical advice. See a doctor for ongoing pain.