Painful sex (dyspareunia): is it normal?

Published February 2026 | 5 min read
Expert contributor: Dr Vijay Ramanathan, Senior Lecturer in Sexual Health at the University of Sydney’s Westmead Clinical School
Words by Sabrina Rogers-Anderson

Experiencing painful sex is common, but you shouldn’t have to live with it. Here’s what you need to know about dyspareunia and how to treat it.

Painful sex is a common condition affecting about one in 10 women. Also known as dyspareunia, it refers to pain before, during or after sex. While men can also experience dyspareunia, it’s less widely studied and men may be less likely to report it. Some sources estimate it affects 5% of men worldwide.

Shame and stigma around sexual health issues can prevent many people from seeking help for painful sex, but leaving it unchecked can affect both physical and mental wellbeing.

“Dyspareunia is more than a sexual health problem,” says Dr Vijay Ramanathan, Senior Lecturer in Sexual Health at the University of Sydney’s Westmead Clinical School, who adds that it can impact a person’s self-confidence and “challenge their sense of self”.

What causes pain during sex in females?

Dyspareunia can be caused by physical or emotional factors – or a combination of both.

“It’s important to see the issue as a whole, because emotions are experienced in the body and whatever the body feels will be reflected in your emotions,” says Dr Ramanathan. “The biggest mistake we can make is saying it’s only psychological, because then you’ll wonder if it’s all in your head. And if we say it’s only physical, you may ignore the emotional aspects.”

Pain during sex can either be felt inside your pelvis (deep pain) or at the entrance of your vagina (superficial or entry pain). The pain may be felt as burning, aching, stabbing, tearing or itchiness. Some people may also experience abdominal pain after sex.

Dr Ramanathan says that the causes of deep pain include:

• endometriosis, when tissue similar to the lining of the uterus grows in other parts of the body
• adenomyosis, when cells that line the uterus also grow in the muscle wall of the uterus
• fibroids, which are benign tumours in the muscle wall of the uterus
• ovarian cysts, which are fluid-filled sacs on the ovaries
• ovarian torsion, when an ovary twists around the ligaments that support it
• pelvic inflammatory disease (PID), inflammation or infection of the pelvic area
• ectopic pregnancy, when a fertilised egg implants somewhere other than your uterus, often in a fallopian tube
• recent childbirth
• bladder infection
• thrush
• urinary tract infection
• sexually transmitted infections (STIs) like chlamydia or gonorrhoea
• previous surgery or radiation
• irritable bowel syndrome (IBS).

Superficial or entry pain may be caused by:

• lack of sexual arousal
• vaginal dryness, possibly due to recent childbirth, perimenopause, menopause or certain medications
• vulvodynia (pain in the vulva), chronic pain or discomfort in the vulva
• skin conditions like eczema (skin inflammation) and folliculitis (inflamed or infected hair follicles)
• vaginismus, which occurs when the muscles in the vagina tighten involuntarily
• injury or scarring in the vagina, possibly due to childbirth, surgery or an accident
• STIs
• an intact or thickened hymen
• a partner with a large penis.

“Vaginismus is a condition that mimics dyspareunia, but it's a very different set of issues,” notes Dr Ramanathan. “Pain is the starting point with dyspareunia, whereas with vaginismus the fear of pain causes involuntary muscular contractions. Despite her wish to engage in intercourse, a woman with vaginismus isn’t able to because her vaginal muscles involuntarily contract and cause her pain.

“Both the desire to have sex and the involuntary aspect of the contractions are two key aspects that are very important when diagnosing vaginismus.”

Stress, mental health conditions, relationship issues, fear of getting pregnant, past sexual abuse and gender dysphoria can all contribute to or exacerbate pain during sex and pain after sex.

How perimenopause and menopause can lead to painful sex

The drop in oestrogen levels during perimenopause and menopause can cause dyspareunia in several ways, including:

• Vaginal and vulval tissues become thinner and less elastic.
• The vagina produces less lubrication and becomes dry.
• Bladder changes can cause recurrent urinary tract infections.

These changes are known as vulvovaginal atrophy and affect more than 50% of postmenopausal women. They can lead to sensations of irritation, itching, swelling, burning or pain during or after sex.

Menopausal hormone therapy (MHT), vaginal moisturisers and lubricants can all help relieve these symptoms. To find out more about reclaiming your sex life after menopause, listen to episode 3 of our Menopause Matters podcast hosted by Alison Brahe-Daddo.

How to prevent pain during sex

Dr Ramanathan recommends talking to a GP or other health professional if you’re experiencing painful sex.

“You need to make sure your diagnosis is correct,” he says. “Self-help techniques may end up inflicting more pain, which only makes the situation worse.”

Here are a few measures Dr Ramanathan suggests you can try at home to relieve dyspareunia:

• Engage in longer foreplay to increase arousal.
• Use a vaginal moisturiser or lubricant.
• Try different sexual positions.
• Be intimate in different ways.

“Sex is not limited to intercourse,” Dr Ramanathan adds. “Having dyspareunia shouldn't sway a person from engaging in pleasurable sexual acts that don’t involve penetration.”

Getting professional support for painful sex

Talking about sexual health issues may feel embarrassing or shameful, but health professionals have heard it all before and are there to help.

“It's important to open up and not live in a state of denial or ignore it, thinking it will go away on its own,” says Dr Ramanathan.

If you don’t feel comfortable talking to your regular GP, Dr Ramanathan suggests consulting another one or seeing a gynaecologist who specialises in these issues.

“You can also talk to a nurse, pharmacist or pelvic floor physiotherapist. Most people don’t realise how well trained these health professionals are and how helpful they can be. And if you’re having trouble adjusting to a diagnosis, a psychologist can help. Treating dyspareunia needs to be a multidisciplinary approach.”

Eligible members can also access mental health programs like a free online annual HealthyMinds Check-in^{^} and claim on a range of online cognitive behavioural therapy programs (including one to help you manage chronic pain) through THIS WAY UP⁺.

It’s important to find a health professional who takes your concerns seriously. “It’s your fundamental right to have pleasurable and safe sex,” says Dr Ramanathan. “It’s your right to be looked after. So, keep advocating for yourself until you find the help you need.”

Speak to a GP

If you’re concerned about your sexual health, book a GP appointment to get support. Through our partnership with GP2U, you can access an online GP consultation* (up to 10 minutes) for a fee of $50. The consultation can be for a range of services, including getting medical certificates, referrals and prescription medications, to help you get access to care when you need it.