Sex Hurts and It Shouldn't: Pain, Vaginismus and Who Can Help

If sex hurts, there's nothing wrong with you for wanting it to stop, and you shouldn't have to push through it. Plenty of people have been told it's normal, that they just need to relax, or that it'll get better with time. Many have kept quiet for years. Painful sex is common, and it's usually something that can be treated. You deserve to have it taken seriously.

This guide explains some common causes and who can help. It can't diagnose you, but it may help you work out what to ask. If you have a penis and sex is painful, a lot of this still applies, and your GP or a sexual health clinic is the place to start.

First, stop doing what hurts

You don't have to keep having penetrative sex while you work this out. Pushing through pain can teach your body to expect it, and that tends to make things worse. A partner who cares will understand. There are plenty of other ways to be close and to enjoy yourselves, and our guide to non-penetrative sex has plenty of ideas, if and when you feel like it. You're allowed to say no at any time, for any reason.

Where does it hurt, and when?

These details can help your doctor. It's a good idea to write them down before your appointment.

• Is it at the entrance, or deep inside?
• Is it burning, stinging, sharp or aching?
• Does it happen every time, or only sometimes? Is it with one partner, or with tampons or toys too?
• Has it always been like this, or is it new?
• Does it change with your cycle? Do you have painful periods, or bladder or bowel symptoms?

Some common causes

Not enough lubrication. This can come from not being aroused enough, hormones, breastfeeding, menopause or medication. Lube can make a big difference, and it's often the easiest thing to try. Our guide to vaginal dryness has more.

Vaginismus. This is when the muscles around the vagina tighten involuntarily when something's about to go in, making penetration painful or impossible. It's a body response, not a choice, and it isn't all in your head. It can happen from your first time, or after years of comfortable sex. Treatment usually includes pelvic floor physiotherapy, and sometimes counselling and the gradual use of dilators, with a professional's guidance. Many people do very well with treatment.

Vulvodynia and vestibulodynia. This means ongoing pain or burning in the vulva, often without any visible cause. It can be sharp when you're touched. It's real, and specialists can help.

Endometriosis and adenomyosis. These can cause deep pain during sex, as well as painful periods. Our guide to endometriosis and sex covers this in more detail.

Infections and skin conditions. Thrush, BV, STIs and conditions like lichen sclerosus can all cause pain. See our guide to thrush, BV and UTIs, and get tested.

Hormonal changes. After menopause or childbirth, or while breastfeeding, or from some contraceptives and treatments, vaginal tissue can become thinner and drier. Our menopause guide and sex after birth guide go into this.

Scar tissue and surgery. Births, tears and operations can all leave you sore.

Past trauma and anxiety. Your body remembers. Stress, fear of pain and a history of sexual assault can all affect how your body responds. If that's your experience, there's no shame in that, and support's available. Our guide to sex after trauma may help, and so can 1800RESPECT on 1800 737 732.

Who can help in Australia

• Your GP is a good place to start, and they can refer you. If you feel you've been dismissed, you're allowed to see another one. Look for one with an interest in women's or sexual health.
• A gynaecologist, for conditions such as endometriosis.
• A pelvic health physiotherapist can assess and treat the muscles involved. Our pelvic floor physio guide explains what happens at an appointment. You don't always need a referral.
• A sexual health physician or clinic, or a family planning service in your state.
• A sex therapist or psychologist, who can help with fear, anxiety and how it's affecting you and your relationship. Here's what sex therapy looks like.

Jean Hailes for Women's Health and Pelvic Pain Foundation of Australia both have reliable free information online.

What might help while you wait

• Use a gentle lube. Wicked Simply Natural is fragrance free and made for sensitive skin. Avoid warming, tingling or flavoured products, which can sting.
• Take your time. Arousal really matters, and you're allowed to take as long as you need.
• Stay in control. If you do try penetration, being on top or on your side lets you decide how far things go. Our depth guide has some ideas.
• Stop if it hurts. Every time.

Talking to a partner

It's OK to say, "This hurts, and I'm getting help. Until then, this is off the table, and here's what I'd like instead." Your partner's job is to believe you. If someone pressures you to keep having sex that hurts, that's not OK, and you can get support from 1800RESPECT.

This is general information, not medical advice. Please see a health professional about any ongoing pain. It's worth pushing for answers. You shouldn't have to live with this.