Dyspareunia is genital pain during or after sexual intercourse. You may feel pain externally on your vulva or internally in your vagina, uterus or pelvis. Factors like underlying medical conditions or infections can cause painful sex. Treatment involves identifying the underlying cause of the pain.
Pain during sex, or dyspareunia, is persistent or recurring pain just before, during or after sex. Dyspareunia is more common in people assigned female at birth (AFAB), but anyone can experience painful sex.
People AFAB can have pain externally in the vulva — to the labia (lips of the vagina) or at the opening of the vagina. Some feel the pain internally in places like the:
People assigned male at birth (AMAB) can feel pain on the head of the penis, on the shaft, in the testicles or in the pelvis.
It’s a common condition that can have negative emotional and psychological effects. In addition to the physical pain, couples may experience loss of intimacy or strain in their relationships.
Your healthcare provider may refer you to a gynecologist who specializes in sexual health. They can determine appropriate treatment based on your symptoms and the underlying condition causing you pain.
The location of the pain can help determine what type of dyspareunia you’re experiencing:
Pain during intercourse can also be described as primary, secondary, complete or situational:
Pain during sex is more common in people AFAB, affecting 3 in 4 people with a vagina at some point in their lives.
Up to about 28% of all people in the United States will experience painful sex at least once. This number may be a low estimate as many people don’t seek help for painful sex because it’s a sensitive topic.
Anyone of any age can experience painful sex. But it’s more likely to affect people AFAB who are past menopause (the average age of menopause is 51). This is mainly due to a decrease in estrogen, a hormone that helps with lubrication and other aspects of your vaginal health.
Don’t assume painful sex is just part of getting older, though, because that’s not always the case.
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If you have pain during sex, you may feel:
The most common symptom is pain with intercourse that occurs at your vaginal opening or deep in your pelvis. It can be a distinct pain in one area, or it may affect your entire genital region. There can be feelings of discomfort, burning or piercing pain.
Dyspareunia doesn’t necessarily cause bleeding. Any bleeding that occurs during sexual intercourse is likely due to an underlying medical issue that isn’t always related to the pain. Seek an appointment with a provider if you’re having bleeding with sex. It could be normal, or it could be sign of an infection or underlying condition. Rarely, bleeding after sex is related to cancer.
In many cases, you can experience pain during sex if there isn’t sufficient vaginal lubrication. But you can have painful intercourse because of infection, trauma or injury, or because of a medical condition.
Pain during sex is more common in people AFAB, especially people who have reached menopause. But it can affect people AMAB, too. It also happens to people of all ages and backgrounds. The pain is often due to physical factors or medical conditions, but it can also be psychological or due to a mental health condition.
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The possible complications of painful sex are:
Your healthcare provider can diagnose the underlying cause of pain during sex with a thorough health history and physical examination. The physical exam could include checking your pelvis, abdomen, vagina and uterus.
To locate the source of the pain and diagnose any medical conditions, healthcare providers may perform the following:
Talk openly with your healthcare provider about any pain during sexual intercourse. It’s normal to feel slightly embarrassed about discussing a sensitive topic like sex. But know that your provider has heard it before and is there to help you.
Some questions your healthcare provider may ask you are:
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There are many approaches your healthcare provider can use to treat your symptoms, but it depends on the cause. For example, if pelvic floor dysfunction is causing the pain, physical therapy may be the first treatment your provider suggests.
Some treatments for sexual pain require prescription medication. If vaginal dryness is due to menopause, ask your healthcare provider about estrogen creams, tablets, rings or other medications.
Yes, medication can help with dyspareunia depending on the cause. If vaginal dryness due to low estrogen is the cause of your painful sex, topical estrogens can be applied to your vagina. The U.S. Food and Drug Administration (FDA) approved a drug called ospemifene for dyspareunia due to menopause. Your provider can also prescribe medication to treat pain due to infection or underlying medical conditions.
Applying a water- or silicone-based lubricant to your vagina, vulva and labia is helpful when dryness is the main cause. Those who have pain during sex should stop using vaginal perfumes, bubble baths or scented sanitary pads and fragranced toilet paper or wipes.
There are some things you can do on your own to manage the pain you feel during or after sex:
There’s usually not much you can do to reduce your risk of dyspareunia. It’s often something you have no control over. Some of the factors within your control are having safe and protected sex and maintaining good hygiene.
How long dyspareunia lasts varies depending on the underlying cause of the pain and the treatment. The treatment may work well right away, or it may be trial and error until you find the right treatment. All of this can affect how long you live with painful sex.
The good news is that you can often find relief and recover. Whether it’s medication, pelvic floor therapy, surgery or using lubrication — your healthcare provider can find a treatment that can improve or eliminate dyspareunia.
Contact your healthcare provider if you have symptoms like:
Painful sexual intercourse can be physically and emotionally difficult. Some questions you may ask your healthcare provider are:
A note from Cleveland Clinic
Pain during sex can lead to physical discomfort, emotional distress and loss of intimacy. You don’t have to live with the pain. The pain isn’t just part of life or a part of getting older. If having sex hurts you, contact your healthcare provider. It might be an uncomfortable topic, but knowing the underlying cause of your pain is important. Your provider can recommend treatment so you can enjoy a fulfilling sex life again.
Last reviewed on 07/25/2024.
Learn more about the Health Library and our editorial process.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy