Common causes of pain during sex – and when you should see a doctor

A GP and former surgeon is urging women to seek help if experiencing pain during or after sex.

In a YouTube video, Doctor Simi Adedeji explored both the physical and mental causes of painful sex, advising it’s something you “should really” speak to a professional about.

Speaking to her more than two million subscribers, she explained that there are two types of dyspareunia – another word for pain during sex.

These can be superficial – meaning it is felt at the entrance of the vagina – and deep – meaning it can be a “throbbing” or “aching” pain higher up in the vagina.

There are various potential causes for these types of pain.

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According to Dr Adedeji, they could be due to:

  • Vaginal dryness
  • Vaginismus
  • Genital injury
  • Infection or inflammation
  • Genital warts
  • Thrush
  • Skin disorders
  • Fibroids
  • Endometriosis
  • Ovarian cyst
  • Pelvic inflammatory disease
  • Cystitis
  • Inflammatory bowel syndrome.

Vaginal dryness

This is the “most common” cause of superficial dyspareunia, she said.

Dr Adedeji explained: “If you are not aroused or you’re not excited enough before sex the vagina doesn’t have time to produce fluids and to lubricate itself and therefore sex can be painful.

It could also be dry due to changes in your hormones.

“The vagina can feel dry if there’s a reduced amount of oestrogen,” she said.

“Now this happens if you’ve just had a baby, it can happen when you’re breastfeeding, it can also happen to women in menopause.”

Certain medications such as antihistamines and birth control pills could also cause this.

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Thrush, or a yeast Infection, is another common cause of this type of pain.

She said: “Having thrush which is a yeast infection is a classic one that gives superficial dyspareunia.

“So with thrush the whole area can just feel or even look sore. So it can be swollen it could be red, the actual lining of the vagina the walls of the vagina can be really tender and trying to have sex or even trying to put a tampon in can be excruciating.”


Endometriosis can cause deep dyspareunia, making every day life difficult.

It is thought to affect around one in 10 women but is difficult to diagnose and often takes years to do so.

“Endometriosis is a condition where the lining of the womb which should be growing in the uterus starts developing in other parts of the stomach so you could have some on the bowel, you could have some on the ovaries,” Dr Adedeji.

“So sex when you have endometriosis can be painful, you can experience really severe abdominal pain.”

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Mental causes

Pain during sex isn’t always caused by a physical issue, the GP said.

It could also be a response to trauma, depression, anxiety or stress.

She said: “Dyspareunia is actually really linked to emotions so how you’re feeling affects your perception of pain and it’s no different for pain during sex.

“Women that have had like a traumatic experience of sex in the past maybe because of rape or sexual violence or sexual abuse can find sex very painful.

“The same goes for women who perhaps are having feelings of anger towards their partner or if they are feeling scared or worried about getting pregnant or worried about their body image.

“Any kind of negative emotion that is surrounding sex can heighten your perception of pain.”


The appropriate treatment if you are experiencing pain during or after sex “really depends” on the cause, the doctor said.

If it is caused by vaginal dryness, yeast infections or other infections or skin disorders, there will be creams, tablets and lubricants that could help.

Issues such as endometriosis, fibroids or cysts could require surgery.

Pain linked to trauma or mental health issues might mean the affected person needs counselling from a professional.

Whatever the cause, Dr Adedeji said speaking to your doctor is important as pain during or after sex is not something you “should put up with”.

She said: “I know that we don’t necessarily talk about it as women even to our closest friends.

“I know it can be embarrassing but it’s something that you should really speak to your doctor about.”

However, she also advised that pain during sex is not always a physical or mental problem.

“Bearing that in mind, the other thing I want to say is that pain during sex is not always due to a problem,” she added.

“I’ll give you an example – if your partner’s particularly forceful you can get a situation where the penis is touching or hitting the cervix this will be moving the uterus around and this can feel uncomfortable.

“Some women also find that they might not experience pain unless they’re in certain sexual positions. This doesn’t necessarily mean that there’s something wrong, so change your position and see if that helps with the pain.”

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