Pain during sexual intercourse is a significant issue affecting many women, often leading to discomfort and distress. According to a survey conducted by YouGov, over 57 percent of women in the UK have experienced pain during sex at some point, with many unable to enjoy the experience. The phenomenon, known as dyspareunia, can manifest as a sharp sting, deep ache, or burning sensation, and may occur in various areas, including the vulva or cervix. Awareness of this issue and understanding its causes is crucial for women who experience such discomfort.
Common Causes of Painful Sex
The reasons behind painful sex can range from temporary issues to more complex medical conditions. Dr Sima Al Asad, founder of Dr Sima Aesthetics, highlights that many women suffer in silence, unaware that effective treatments are available. Common causes include infections, hormonal fluctuations, and physical changes resulting from weight loss or lifestyle factors.
Alcohol consumption, for example, can lead to discomfort during sex. Dr Al Asad notes that alcohol acts as a dehydrating agent, reducing genital blood flow and impairing lubrication, which can result in vaginal dryness. This is particularly relevant for women who consume alcohol around the time of ovulation or in the premenstrual phase, as hormonal changes can heighten sensitivity.
Infection and Medical Conditions
Sexually transmitted infections (STIs) pose another risk factor. According to NHS statistics, approximately 364,750 new STIs were diagnosed in the UK in 2024. Chlamydia, gonorrhoea, and herpes are common culprits that may cause discomfort during intercourse. Professor Vijay Nayar from Healthium Clinics advises that symptoms can include unusual discharge, itching, and visible sores. Women experiencing such symptoms should seek testing at local sexual health clinics, which offer confidential and free services.
Another overlooked cause is Pelvic Congestion Syndrome (PCS), which affects an estimated 1.5 million women in the UK. PCS results from faulty veins in the pelvis, leading to pelvic pain and other symptoms, including discomfort during sex. Sophie Strong, a lead consultant gynaecologist at the Pelvic Pain Clinic at The Whiteley Clinic, points out that PCS is frequently misdiagnosed as endometriosis. Diagnosis typically involves a transvaginal duplex ultrasound scan, and treatment may include pelvic vein embolisation to alleviate symptoms.
Rapid weight loss due to medications like Mounjaro, Ozempic, or Wegovy can also affect sexual comfort. As Dr Al Asad explains, significant fat reduction may alter the natural padding around the vulva and vagina, resulting in increased friction and dryness. While these changes are not inherently dangerous, they can influence comfort during sex.
Hormonal Influences
Hormonal fluctuations, particularly during the menstrual cycle, menopause, or changes in hormone replacement therapy (HRT), can significantly impact sexual comfort. Dr Al Asad emphasizes that low estrogen levels can lead to thinning and dryness of the vaginal tissues, making intercourse uncomfortable. Certain contraceptives that suppress ovulation may further exacerbate this issue. Treatments can include lubricants, vaginal moisturisers, or local estrogen therapy, which can provide relief.
For some women, conditions like endometriosis, fibroids, and pelvic inflammatory disease (PID) can lead to severe pain during sex. Endometriosis affects around 10 percent of women globally, causing inflammation and heightened sensitivity. Fibroids, non-cancerous growths in or around the uterus, affect two in three women at some point in their lives. If a woman experiences significant discomfort, medical evaluation through ultrasound or other diagnostic methods is essential.
Common Infections and Skin Conditions
Conditions such as thrush, bacterial vaginosis (BV), and urinary tract infections (UTIs) are also prevalent causes of pain during sex. Dr Al Asad notes that thrush, which can result from hormonal changes or antibiotic use, leads to intense itching and discomfort. BV, caused by an imbalance of vaginal bacteria, may result in a strong odour and irritation. UTIs can cause burning sensations and pressure in the bladder. Treatment for these conditions typically involves antibiotics or antifungal medications, and recurrent infections should be evaluated by a healthcare professional.
Skin conditions like eczema can also affect the vulvar area, causing pain and discomfort. Approximately one in ten adults in the UK suffers from eczema, which can lead to soreness and irritation. Treatment may include topical steroids and emollients prescribed by a doctor.
Psychological Factors
Lastly, psychological factors such as anxiety or past trauma can contribute to painful experiences during sex. Dr Al Asad explains that anxiety often leads to involuntary tightening of the pelvic floor muscles, which can hinder lubrication and make penetration painful. Communication with partners about sexual preferences and feelings is essential for improving intimacy and reducing discomfort.
For women experiencing persistent issues, seeking professional help through psychosexual therapy or trauma-informed counselling may provide significant benefits. Organisations like the College of Sexual and Relationship Therapists (COSRT) can assist in finding qualified therapists.
Understanding the multifaceted causes of painful sex is vital for women seeking relief. By identifying underlying issues and seeking appropriate medical advice, many can find effective treatments and reclaim their sexual wellbeing.
