Painful sex (dyspareunia)

Sex is any activity that one or more people do to feel sexually excited. Sex is broader than sexual intercourse (penetrative sex). It can involve touching, kissing or even talking.

Sex should be enjoyable for everyone involved. And everyone should agree or consent to the sexual activity.

Painful sex is when you experience pain during arousal, foreplay or orgasm. You may feel pain with external stimulation or during penetration. Some people experience pain after sex has finished.

It’s important to know that painful sex doesn’t have to happen every time to be a concern. Even occasional pain during sex is considered painful sex.

If you have painful sex, you might feel:

• entry pain (with penetration)
• deep pain (with thrusting)
• burning, aching or throbbing pain.

Treatment options depend on the cause of your pain. Your doctor may recommend:

• lubricant creams and gels, vaginal moisturisers and oestrogen cream or pessaries (for vaginal dryness)
• menopausal hormone therapy (MHT) to improve general wellbeing around the time of menopause
• changing medicines or contraception – some types may impact vaginal lubrication and sex drive
• seeing a psychologist or sex therapist to help reduce your fear of pain
• relationship counselling
• seeing a qualified pelvic floor physiotherapist to help with pelvic floor muscle relaxation, trigger-point therapy, vaginal trainers
• or soft tissue and vaginal massage.

In this video, physiotherapist, Janetta Webb talks about pelvic floor physiotherapy for the management and treatment of dyspareunia.

If you want to improve your sexual experience, you can try these practical ideas:

• Tell your partner what you like or don’t like – and stop sex if you feel pain.
• Change sexual positions or techniques. If you experience pain during thrusting, sit on top of your partner so you can control the depth of penetration. You can also try different or longer foreplay to increase your arousal.
• Use lubricants to increase arousal and comfort during sex.
• Focus on yourself. Try to switch off any worries, tune in to your body and enjoy the moment.
• Be intimate in different ways. If you have a partner, try kissing, cuddling, massage, mutual masturbation and oral sex. This may enhance your sex drive.
• Try a vaginal dilator (a tube-shaped device to stretch your vagina) or a small vibrator. These may help you to relax your pelvic floor muscles.

If you are experiencing painful sex, see your doctor. They will find and treat the cause or refer you to a specialist.