8 Painful Sex Solutions: How to Relieve Pain During Sex

For many women, sex is a source of connection, intimacy, and joy. But for others, it can also be accompanied by pain. If this resonates with you, know that you are not alone—and most importantly, you don’t have to live with it. Painful sex, or dyspareunia, is more common than you might think, but it is never normal. 

Everyone deserves a pain-free and pleasurable sex life. So, below, we’ll explore the causes of painful sex, solutions, and when to seek professional help.

How common is pain during sex?

Up to three in four women will experience dyspareunia at some point in their lives, according to the American College of Obstetricians and Gynecologists. For some, it’s an occasional occurrence, but for others, it’s chronic and impacts their quality of life and relationships. Dyspareunia can be categorized as:

• Superficial: which involves pain in the vulva and vaginal opening.

• Deep: where discomfort occurs during deeper penetration. Sometimes, you might even feel pain in your lower back or stomach.

• Primary: when the pain has been there since your first sexual experience.

• Secondary: when the pain shows up after you've had a period of pain-free sex.

How the pain manifests can also vary significantly. It might feel like burning, chafing, throbbing, or even tearing. No matter how mild or severe the pain may be, it’s important to take it seriously and seek help if needed. 

Painful sex isn’t something you should just put up with, and yet, many women suffer in silence due to shame, stigma, or the misconception that pain is just “part of the package.” Let’s be clear: it’s not. Whether the pain is mild or severe, there are solutions.

Causes of painful sex

Understanding the cause of pain is the first step toward relief.

Vaginal dryness

One of the most common — but luckily, easily treatable — reasons why women experience pain during sex is a lack of natural lubrication. This could be due to:

• Hormonal changes, such as those during menopause, postpartum, or while breastfeeding.

• Medications, like antihistamines, antidepressants, or birth control pills.

• Foreplay, or lack thereof. Your body might simply need more time to become aroused.

It’s also worth pointing out that while getting “wet” is often a normal part of your body’s sexual arousal response, it doesn’t happen every time. Sometimes, your vagina just doesn’t get the memo. This is known as arousal non-concordance, a completely normal phenomenon where your mind and body are out of sync. If this happens to you occasionally, don’t worry, you’re normal!

Infections

Conditions like yeast infections or bacterial vaginosis (BV) can make the vaginal tissue irritated, leading to pain during penetration. Equally, many sexually transmitted infections (STIs), like chlamydia, trichomoniasis, and gonorrhea, can cause pain and discomfort during penetrative sex. 

Vaginismus

Vaginismus is a condition where the muscles of the pelvic floor involuntarily tighten or spasm during penetration, making sex, tampon insertion, or even pelvic exams uncomfortable or painful. This response is usually out of the person’s control and can range from mild discomfort to complete inability to allow penetration. 

This tightening can create a sensation of burning, stinging, or even sharp pain during attempts at penetration. Over time, the anticipation of pain may lead to increased anxiety, which exacerbates the muscle tension in a self-perpetuating cycle.

Doctors aren’t sure of the exact cause of vaginismus, but it may be due to past trauma (both physical or psychological), or without any identifiable reasons.

Endometriosis

Endometriosis is a chronic condition where endometrium (the internal lining of the uterus)  grows outside of it. This can happen on organs like the ovaries and fallopian tubes in the pelvic area. This tissue sheds blood similar to the internal uterine lining into the abdominal cavity and can lead to inflammation and scarring, both of which can cause discomfort or pain during sex. About two-thirds of women with endometriosis have some sexual dysfunction, including pain during sex, according to a study published in the journal Reproductive Sciences.

Vulvodynia

Vulvodynia is a chronic pain condition affecting the vulva. It can be localized (affecting specific areas such as the vaginal opening) or generalized (affecting the entire vulva). The pain may be constant, intermittent, or triggered by activities like sexual penetration, tampon use, sitting for long periods, or wearing tight clothing.

Other medical conditions

Conditions like interstitial cystitis, fibroids, or ovarian cysts, and bowel disorders  may also contribute to painful intercourse.

Solutions for painful sex

The good news is that painful sex is often treatable. Here’s a list of solutions ranging from simple over-the-counter options to professional interventions:

Lubricants and moisturizers

One of the simplest and most effective ways to address pain caused by dryness is to use lubricants. Water-based lubricants like Vella’s Pleasure Serum and Intimate Elixir are non-irritating and compatible with condoms. This makes them ideal for women experiencing occasional or mild dryness during the intercourse..

Silicone-based lubricants, like Vella’s Super Slip & Slide, last much longer and don’t evaporate as quickly as water-based options. They’re particularly helpful for women experiencing more severe dryness or friction-related discomfort. Silicone lubricants are also waterproof, making them a good choice for intimacy in water (for the shower sex fans out there).

For ongoing dryness, vaginal moisturizers can be used several times a week. These products work by replenishing and retaining moisture in the vaginal tissues, making them a great option for women dealing with chronic dryness from menopause, breastfeeding, or certain medications.

Pelvic floor therapy

If your pain stems from tight pelvic floor muscles, pelvic floor therapy can be life-changing. A certified pelvic floor physical therapist can assess the state of your muscles and use a combination of manual therapy, stretches, and exercises to help release tension. Biofeedback may also be used to help you learn how to relax these muscles. Additional treatment modalities include muscle relaxants and Botox.

This type of therapy is particularly effective for women with vaginismus or pelvic floor dysfunction and can also aid those recovering from childbirth or surgery. Regular sessions combined with at-home exercises can significantly reduce pain and improve sexual function.

Hormonal treatments

Hormonal changes during menopause can lead to thinning and dryness in the vaginal walls, which can be uncomfortable for many women. One great option to consider is vaginal estrogen therapy. It offers a gentle solution by delivering low-dose estrogen right where it’s needed, helping to improve elasticity, lubrication, and overall comfort during intimacy. In addition it helps to prevent bladder infection and maintain vaginal health. You can choose from various forms, like creams, tablets, capsules, or rings, based on what feels best for you.

Prescription medications

Certain medical conditions require targeted medications to alleviate pain. For example, women with vulvodynia might benefit from topical anesthetics like lidocaine, which numb the painful area during sex. 

In cases where nerve pain is involved, drugs like gabapentin or amitriptyline can help calm overactive nerve signals. For women with endometriosis or chronic pelvic pain, anti-inflammatory medications or hormonal therapies like progestins can reduce inflammation and pain. 

Where an infection is responsible for painful sex, your doctor can prescribe an antifungal or antibiotic treatment. 

Vaginal dilators

If you’re finding penetration to be a bit challenging or uncomfortable, vaginal dilators can be a great way to help your body adjust gradually and comfortably. These tools are designed to gently stretch and relax the vaginal muscles, making things easier over time. They’re especially helpful for folks dealing with conditions like vaginismus or pelvic floor dysfunction.

Vaginal dilators come in different sizes, so you can start with a smaller one and work your way up as you feel more comfortable. They can also help desensitize the vaginal area and teach the muscles to relax during penetration. To get the most out of using them, it’s a good idea to talk with a healthcare provider or a pelvic floor therapist. They can offer you useful guidance to ensure you're using them effectively.

Therapy or counselling

If emotional or psychological factors are contributing to painful sex, therapy can be an invaluable resource. Sex therapy, with a trained counselor or therapist, provides a safe space to explore past traumas, relationship issues, or anxieties around intimacy.  This can help women reconnect with their bodies and their partners. Sex therapy can also equip partners with communication skills to better understand and express themselves. Additionally, mindfulness practices like meditation can reduce tension, improve body awareness, and promote relaxation, which is key to enjoying sex.

More foreplay

Making small changes in your approach to intimacy can also have a big impact. For example, spending more time on foreplay allows your body to fully arouse, increasing natural lubrication and reducing discomfort. Experimenting with positions can also help; some positions may minimize pressure on sensitive areas or provide greater control over depth and angle. 

Medical procedures

For women with severe conditions like endometriosis, fibroids, or extensive scarring, medical procedures may be necessary. Surgeries like laparoscopic removal of endometriosis or fibroids can significantly reduce pain. Injections, such as nerve blocks, may be an option for women with chronic pelvic pain that doesn’t respond to other treatments. Always discuss these options thoroughly with your medical provider to ensure they’re right for you.

When to seek help

While occasional discomfort might not be cause for alarm, persistent or severe pain should never be ignored. It’s time to see a healthcare provider if:

• Pain occurs every time you have sex

• Over-the-counter solutions don’t help

• You notice other symptoms like unusual discharge, bleeding, or pelvic pain

• The pain impacts your emotional well-being or relationships.

Make an appointment with a sexual health professional who can help determine the root cause and create a personalized treatment plan.

Pain during sex is common, but that doesn’t mean you should put up with it. There are many solutions available, and with the right support, you can regain control of your sexual health and rediscover pleasure. Don’t hesitate to reach out for help — because a pain-free, fulfilling sex life is your right, not a luxury.