References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Pain during sex — known medically as dyspareunia — is common and usually treatable. It affects women more often than men but can happen to anyone. Causes range from simple things like lack of lubrication to infections, skin conditions and structural issues. Most are fixable once the underlying cause is identified.
Here’s an honest look at the common causes and what you can do about them.
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Common Causes in Women
Vaginal dryness and low oestrogen
Hormonal changes around menopause, breastfeeding, some contraceptives and certain medicines can reduce vaginal lubrication. Sex without enough moisture can be painful. Water-based or silicone-based lube, or vaginal moisturisers, often help. For menopausal dryness, topical oestrogen is very effective.
Infections
Thrush, bacterial vaginosis, chlamydia, gonorrhoea, trichomoniasis and herpes can all cause soreness during sex. Testing and treating the underlying infection usually resolves the pain.
Skin conditions
Lichen sclerosus, eczema, psoriasis and contact dermatitis can affect the vulva and make sex uncomfortable. A GP or gynaecologist can diagnose and prescribe appropriate treatment.
Vaginismus
Involuntary tightening of the pelvic floor muscles can make penetration painful or impossible. It’s often linked to anxiety, past trauma or fear of pain. Pelvic floor physiotherapy and, if needed, counselling can help.
Endometriosis and fibroids
Deep pelvic pain during sex, especially with certain positions, can signal endometriosis or fibroids. Both are treatable but need a proper diagnosis.
Common Causes in Men
Infections
Thrush, bacterial infections of the urethra or prostate, and STIs like chlamydia or gonorrhoea can all cause pain during or after sex.
Tight foreskin (phimosis)
A foreskin that won’t retract or is too tight can make sex painful. Treatments range from steroid creams to, rarely, circumcision.
Peyronie’s disease
Scar tissue in the penis causes curvature and pain during erection. It’s treatable — ask your GP about referral.
Prostatitis
Inflammation of the prostate can cause pain during or after ejaculation. Treatment depends on the cause.
When to See a Doctor
| Symptom | Action |
|---|---|
| Persistent pain during sex | GP or sexual health clinic |
| Burning, unusual discharge, itching | STI test |
| Bleeding during or after sex | GP — usually needs examination |
| Deep pelvic pain | GP — may need gynaecology referral |
| Pain with a new partner only | Think about lubrication, pace, comfort |
Things That Often Help
- More foreplay and slower build-up
- Water or silicone-based lubricant
- Changing position to reduce deep pressure
- Pelvic floor exercises
- Talking openly with your partner
- Seeing a specialist if pain persists
Painful sex is common and should never be dismissed as something to live with. Help is available, and most causes are treatable.
Read more: What is chlamydia? | What is gonorrhoea? | What is herpes?
Frequently Asked Questions
Is painful sex always a medical problem?
Not always. Sometimes it’s linked to lack of lubrication, tiredness, anxiety or a new partner. But persistent pain during sex should be investigated — there’s almost always something that can help.
Can STIs cause painful sex?
Yes. Chlamydia, gonorrhoea, herpes, trichomoniasis and others can all cause pain or discomfort during sex. Testing is quick and treatment is usually straightforward.
Should I just use more lube?
Lube often helps, especially for pain caused by dryness or friction. But if pain persists despite lube, or if you have other symptoms, it’s worth seeing a clinician to find the cause.
Related reading
- Abnormal Genital Discharge and Chlamydia
- Asymptomatic STIs: Silent Infections Explained
- Cold Sores vs Syphilis Sores: How to Tell the Difference
- Common STI Symptoms in Women
- Do STIs Always Have Symptoms?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
