arrow-right cart chevron-down chevron-left chevron-right chevron-up close menu minus play plus search share user email pinterest facebook instagram snapchat tumblr twitter vimeo youtube subscribe dogecoin dwolla forbrugsforeningen litecoin amazon_payments american_express bitcoin cirrus discover fancy interac jcb master paypal stripe visa diners_club dankort maestro trash

Shopping Cart

Pelvic Health

Dyspareunia: Causes, Symptoms & Treatment

Dyspareunia: Causes, Symptoms & Treatment

by Dr. Barb DePree, MD

Wondering why sex hurts all of a sudden? Medically referred to as dyspareunia, pain during sex can be embarrassing to talk about but is easily treated once the underlying cause has been identified.

Typically caused by an infection, irritation, hormonal imbalances, an underlying condition, or a psychological issue - pain during sex is a signal from your body that something needs attention. If left untreated, painful sex will affect your quality of life and could result in a more serious issue.  

What Causes Dyspareunia?

Dyspareunia can be caused by a variety of underlying issues that will vary from woman to woman and the causes can be broken down into two categories – physical and psychological. 

Physical causes of dyspareunia include: 

  • A lack of sexual arousal at any age can cause friction and pain during sex.
  • Vaginal dryness caused by less vaginal lubrication due to hormonal fluctuations during menopause or breastfeeding
  • Irritation due to allergic reactions to fragranced soaps or washing detergents – commonly known as vaginitis. 
  • Sexually transmitted infections (STIs) and vaginal infections like bacterial vaginosis, urinary tract infections (UTIs), and yeast infections are additional physical causes sex hurting all of a sudden
  • Conditions affecting the female reproductive organs such as endometriosis, fibroids,  lichen sclerosis, ovarian cysts, vaginismus, and vulvodynia are also instigators of painful sex 
  • Scar tissues after pelvic surgery and vaginal atrophy after radiation treatment also contribute to dyspareunia
  • Restriction or tender points in the pelvic floor muscles

Psychological causes of painful sex include:

  • Fear or doubt about your first sexual performance 
  • A pre-planted belief that sex is painful
  • Anxiety surrounding the first sexual encounter after a traumatic childbirth or pelvic surgery 
  • Psychological causes of painful sex can also be more deep-rooted and connected to previous sexual abuse.   

One condition that falls into both categories, is vaginismus. Primarily, it can seem as if the involuntary physical tightening of the vaginal muscles is causing pain during sex. People often report that upon penetration it feels like their partner is hitting a wall, and in turn this can feel quite painful. 

Common Symptoms of Dyspareunia

  • Discomfort/pain during penetration (including when inserting tampons or gynecological instruments)
  • Vaginal and/or pelvic pain during sex
  • A sensation that the penis is hitting a wall inside the vagina during sex
  • Burning sensation in the vagina
  • Throbbing pain that lasts hours after intercourse

How to Treat Pain During Sex

To treat pain during sex, the first step is to schedule a consultation with a doctor to clarify what is causing the discomfort. This is often the most difficult step for women to take due to the embarrassment that exists in talking about female sexual issues. 

It might help to know that you are not alone, that pain during sex happens to women all over the world aged 16-74, and that you can return to more pleasurable sex once the underlying cause of your dyspareunia is identified. To make it easier to talk about, consider meeting with a primary care doctor, gynecologist, and pelvic health physical therapist.  

Pain Due to Vaginitis

For example, pain during sex that is caused by vaginal irritation, or vaginitis, is resolved by eliminating the irritating product, which is typically fragranced hygiene products or new detergents, scented soaps, or douching products that alter the vaginal pH. 

Painful Sex Caused by Infections

Pain during sex that is accompanied by additional symptoms like a burning sensation while peeing, an unusual vaginal discharge, and itching or redness is usually due to an underlying infection. In these cases, taking the correct medication to treat the infection, along with a probiotic to rebalance the vaginal pH, will also relieve dyspareunia. 

Painful Sex Caused by Lack of Sexual Arousal

When a lack of sexual arousal or loss of libido is at the root of painful sex, using a personal lubricant during foreplay and intercourse can relieve pain and friction. Remember to use a water-based lubricant to avoid altering the vaginal pH or damaging condoms. 

Painful Sex Caused by Fear, Anxiety or Previous Sexual Abuse

If anxiety, fear, doubt, previous pain during sex, or former sexual abuse is causing you to tighten the vaginal muscles upon penetration and eventuate in painful intercourse, speaking with a counselor or therapist can be helpful to unravel emotions and move forward with the rest of your life. 

Painful Sex During Menopause 

When dyspareunia is caused by fluctuating hormones during perimenopause, menopause, or postmenopause, many women have turned to hormone replacement therapy (HRT) for help. However, with so much research now existing on how HRT increases the risk of blood clots, dementia, strokes, and uterine cancer, alternatives are necessary. 

And thankfully, confounding research has proven the efficacy of the following natural remedies to treat menopause symptoms without side effects or underlying risks. 

Do Dilators Help With Dyspareunia?

Vaginal dilators, which are designed to relax tight vaginal muscles, improve the production of natural lubrication, and re-strengthen weak pelvic floor muscles, are highly recommended medical tools for treating vaginal atrophy and pain during sex associated with menopause. The medical-grade silicone dilators from Intimate Rose are our top pick for their perfect sizing, comfortable feel inside the vagina, and the fact that they are the only FDA-approved silicone dilator on the market. 

What Are Vitex (Chasteberry) Supplements?

Used by ancient civilizations for thousands of years to treat female health conditions like PMS, fertility, and menopause, vitex agnus-castus, also known as chasteberry, is known to help the pituitary gland rebalance fluctuating hormones.

Although chasteberry does not contain any hormones, it behaves like an adaptogen to boost the production of progesterone and reduce the secretion of progestin. Chasteberry also contains phytoestrogens, which are natural elements that mimic the effects of estrogen in the body. 

By rebalancing the hormones that typically fluctuate during menopause, chasteberry is significantly effective in treating symptoms like breast tenderness, mood swings, interrupted sleep, hot flashes, and a lack of libido, which can contribute to sex hurting all of a sudden.  


When sex hurts all of a sudden it can be caused by one of several factors, including irritation from hygiene products, hormonal changes during menopause, vaginal atrophy, or lack of sexual arousal.

Although it can be awkward to talk about, the good news is that painful sex can be successfully treated once the underlying cause is determined. If you are embarrassed, speak with a female doctor about relieving dyspareunia. It could be as simple as using a personal lubricant for sex or relaxing the vaginal muscles with dilators. 


Family Doctor – Dyspareunia -

Mayo Clinic – Yeast Infection -

World Health Organisation – Sexually Transmitted Infections -

My Cleveland Clinic – Vaginitis -

WebMD – Vaginismus -

Intimate Rose – What is Dyspareunia and How Is It Treated -

Science Direct – Vaginal Dilators -

The Pelvic Hub – Dilators for Dyspareunia -

Cleveland Clinic – Chasteberry -

National Library of Medicine - Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms: A Randomized Double-Blind Study -