Introduction

Sex is supposed to be pleasurable and intimate. But for many women, it can come with unexpected pain — a condition known as dyspareunia. Despite being common, it’s rarely talked about openly. Understanding what's happening in your body can be the first step toward healing, confidence, and restored intimacy.

What Is Dyspareunia?

Dyspareunia is the medical term for persistent or recurrent pain during or after vaginal intercourse. The pain can be:

  • Superficial: felt at the entrance of the vagina.

  • Deep: felt inside the pelvis or lower abdomen.

  • During penetration, or after intercourse.

  • Burning, aching, sharp, or throbbing in nature.

Common Causes of Dyspareunia

Painful sex can have many causes — physical, emotional, or both. Here are some common contributors:

1. Vaginal Dryness

Often linked to low oestrogen levels (e.g. menopause, breastfeeding, birth control pills), dryness can cause friction and discomfort.

2. Infections

Yeast infections, urinary tract infections (UTIs), or sexually transmitted infections (STIs) can lead to irritation and pain.

3. Vaginismus

This is an involuntary tightening of the vaginal muscles, often due to anxiety, trauma, or fear.

4. Endometriosis

A condition where uterine tissue grows outside the uterus, causing deep pelvic pain during sex.

5. Pelvic Floor Dysfunction

Tight or uncoordinated pelvic muscles can make penetration painful.

6. Recent Surgery or Childbirth

Healing from episiotomies, C-sections, or pelvic surgery can affect comfort during sex.

7. Emotional and Psychological Factors

Stress, anxiety, relationship issues, or a history of sexual trauma can play a major role.

Diagnosis: How Is It Identified?

If you're experiencing painful sex, don’t suffer in silence. A visit to your gynaecologist may include:

  • Medical history review

  • Pelvic examination

  • Testing for infections

  • Imaging (ultrasound or MRI in some cases)

Your honesty during consultation helps tailor the right treatment plan.

Treatment and Management

Thankfully, dyspareunia is treatable — and solutions vary depending on the cause:

1. Lubrication

Use a water-based lubricant to ease friction, especially if dryness is the issue.

2. Topical or Systemic Oestrogen

For menopausal women, vaginal oestrogen creams or rings may help restore moisture and elasticity.

3. Pelvic Floor Therapy

Working with a physiotherapist can help with muscle relaxation and coordination.

4. Treating Underlying Infections or Conditions

Appropriate medications or surgeries may be needed for infections or endometriosis.

5. Counselling or Sex Therapy

Talking to a therapist, especially if trauma or anxiety is involved, can be transformative.

Products That Can Help

  • Water-based lubricants: e.g. Yes, K-Y Jelly

  • Vaginal moisturisers: e.g. Replens

  • Oestrogen creams or vaginal rings

  • Pelvic floor trainers (only after professional guidance)

Avoid douching, scented soaps, or harsh chemicals near your vagina, as these can worsen irritation.

When to See a Doctor

Seek medical advice if:

  • Pain persists or worsens

  • You notice unusual discharge, bleeding, or odour

  • There’s a history of trauma and sex becomes distressing

  • You’re avoiding intimacy due to pain

You deserve a sex life that feels safe and enjoyable — not one filled with discomfort and fear.

Final Thoughts

Pain during sex is not something you should “learn to live with.” Whether it’s physical or emotional, the first step is to talk about it — with your partner, your doctor, or a therapist. Healing is possible, and you’re not alone.