When Sex Hurts

The experience of pain during sex can be a common occurrence at different stages of life and for different reasons. Understanding where that pain comes from is an important step to overcoming it.

When sex hurts

Women can experience varying degrees of pain during penetrative or non-penetrative sex at any stage of their lives. This type of pain can be experienced by up to 3-18% of women and is often diagnosed as Genito-Pelvic Pain/Penetration Disorder (also vaginismus (involuntary spasms of the muscles), vulvodynia or dyspareunia (recurrent genital pain)).

A recent study in Britain of 6,669 sexually active women, found that 7.5% experienced painful sex 1. It is important to acknowledge that the experience of sexual pain is more common than people think.

Understanding the pain

First and foremost, if you experience any type of pelvic pain and pain during sex the first step is always to consult a medical professional to determine the underlying cause of this.

There can be many reasons for this pain to occur:

  • Physical: There can be many reasons for the experience of pain to occur including, physical illness such as endometriosis, surgery, gynaecological cancers, pelvic floor issues, post child birth, pudendal nerve issues, and the physical size of the vagina.
  • Hormonal: Changes in hormone levels such as menopause and post-menopause can impact on the elasticity of the vaginal and cause vaginal dryness.
  • Non-physical: Past or present trauma such as sexual assault and abuse, medical trauma, feeling stressed or self-conscious, anxiety.


No matter what the underlying case of this pain is, the pain is very much real.

While a diagnosis may be helpful to one person because it gives them something tangible to investigate, for others, a medical diagnosis may further medicalise the individual as being dysfunctional when experiences of pain may be a part of normal life cycles such as stress, relationship ebbs and flows, and hormone cycles. Whether or not this is the case, it is important to understand why pain may be experienced.


Ongoing Cycle of Pain

There are many different theories which attempt to explain the experience of sexual pain. This section will focus on the Fear Avoidance Model as this theory is simple yet powerful in its explanation.

This model essentially explains that pain may be experienced simply by the anticipation or fear of pain. This could be for a variety of reasons. Once pain is anticipated, the body will have an involuntary reaction of tightening pelvic floor muscles, diminished arousal and natural lubrication.

These physical reactions then lead to more pain. When this cycle occurs, avoidance of any type of situations which may lead to this pain (eg. kissing, touching or hugging) are avoided or a woman may accept this situation and continue to experience sexual pain and anxiety. This diagram outlines this response cycle.

This is just one example of how pain can impact a person.

Source material from www.vaginismus.com

What can be done?

Lots of things! It is important to remember that you are not alone. Many women will experience this type of pain throughout the course of their lives.

There are many reasons for experiencing pain so it is essential to consult a medical professional to explore any underlying explanations for the experience of pain.

Some helpful things to do to overcome pain may include:

  • Seek further information from a trusted medical professions. It is important to find someone who understands this type of experience. A professional who specialised in women's health is a good place to start.
  • Seeing a women's health physiotherapist who focuses on pelvic floor therapy.
  • Seek a counsellor who is experienced in sexual health and wellbeing.
  • Greater sex education including learning about your body and creating opportunities for pleasurable sexual experiences which don't always need to involve penetration.