10 Causes of Pain After Sex — And What to do About It

Sex is supposed to feel good, but unfortunately, pain before, during, or after sex is not uncommon. Symptoms of dyspareunia, the medical term for painful sex, can vary depending on the person and the cause. Infections, injuries, allergies, and certain health conditions, can all increase the likelihood of experiencing sex-related pain. 

While anyone can experience pain related to sex, it’s more common to experience vaginal pain after sex than it is penis pain. Some people may feel pain externally on the penis, vulva, or vaginal entrance. Or, pain is felt deep inside the vagina, uterus, or lower pelvis. It’s estimated that 3 out of 4 women will deal with painful sex at some point in life.

Here are some potential situations that can cause pain during and after sex and what you can do about it.

Yeast and Bacterial Infections

Vaginal yeast infections and urinary tract infections (UTIs) can cause vaginal inflammation, also known as vaginitis. When the vagina is swollen, friction from sex can cause additional pain or a burning sensation. A yeast infection or UTI affecting the penis can also make sex painful.

Candida yeast overgrowth from a yeast infection can cause itching, thick white discharge, and pain while peeing. Treating the infection through either prescription or over-the-counter antifungal medicine should relieve symptoms of painful sex if the infection was the cause. 

If you have a UTI, sex can irritate the infected urinary tract tissue and cause pain and burning. Healthcare providers usually treat  UTIs with antibiotics, which should get rid of any related pain. If you're prone to UTIs, you can also take preventative measures like peeing after sex, hydrating, and avoiding baths or using scented products on your genitals.

STIs

Sexually transmitted infections (STIs) like chlamydia and gonorrhea cause vaginal inflammation that can make penetrative sex feel painful or burn. They can also cause abnormal discharge or painful burning while peeing. 

Genital herpes can also make sex hurt if you have an active infection. If you have chlamydia or gonorrhea, your healthcare provider will prescribe medication to treat the infection. There is no cure for herpes, however, medication can reduce your risk of transmission and painful outbreaks. Using a barrier method like condoms during sex can also help reduce your risk of future STIs.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an infection of the upper female reproductive organs often caused by untreated gonorrhea or chlamydia.

PID can cause:

• Deep pelvic pain during penetrative sex 
• Scarring
• Pelvic pain
• Infertility
• Damage to Fallopian tubes
• Fever
• Systemic infection
• Abscess (an infected pus-filled lump)
• Bleeding during sex or between periods
• Pain while peeing
• Lower abdominal pain

If you suspect you have PID, see your healthcare provider as soon as possible. PID is treated with antibiotics, but damage from the infection can be permanent.

Vaginal Dryness

If you don't have enough lubrication, chafing from penetrative sex can lead to vaginal soreness. You may also experience vaginal dryness if you have penetrative sex before getting aroused or if you're dealing with hormonal changes. 

If you recently had a baby or are breastfeeding, hormonal changes can decrease the amount of estrogen in your body and lead to vaginal dryness that makes sex painful. Childbirth-related vaginal dryness should eventually resolve on its own. However, your healthcare provider may suggest using vaginal estrogen, moisturizers, or lubricants to help with hormone-related dryness.

Similarly, perimenopause and menopause can also lower estrogen levels and lead to vaginal dryness and inflammation. This vaginal dryness can also be a symptom of vaginal atrophy, which is when the vagina becomes thin, dry, and inflamed due to decreased levels of estrogen in your body. 

If your dryness is related to menopause, lubricants or hormone therapy can help restore moisture. 

If dryness is related to not being aroused, you can also try lubricants and more foreplay to get in the mood.

Genital Injury

Any injury to the genitals can cause painful sex. During childbirth, tearing or an episiotomy (making a cut in the space between the vagina and the anus) can cause pain during sex – especially if you are still healing. To help mitigate painful sex after childbirth, don't rush into having sex until your healthcare provider tells you it’s OK. 

Some research suggests using perineal massage or lidocaine gel on sensitive scar tissue may help treat lingering pain. Be sure to check with a healthcare provider before using any topical treatments.

Any damage to the penis head, foreskin, or shaft can also cause painful rubbing or tearing during penetrative sex. It may be a good idea to abstain from sex while any injuries heal to avoid further irritation and pain.

Skin Irritants

Scented vaginal products, spermicides, and latex condoms can all cause skin irritation that can make sex painful, especially if you're allergic to them. Healthcare professionals don’t recommend using scented cleansers or douches to clean the inside of the vagina. Your vagina cleans itself, and these products can irritate sensitive vaginal skin and increase your risk of infection.

Some products like Nonoxynol-9, an ingredient in spermicide, can irritate both the vagina and penis.

Allergic Reactions

An allergy to latex condoms can cause itching, burning, and pain that feels worse during sex. To avoid pain from a latex allergy, you can use polyurethane condoms or natural condoms made from the intestinal membranes of lambs. However, lambskin condoms do not protect against  STIs.

Some people are also allergic to semen, though this is rare. Human seminal plasma (HSP) hypersensitivity is essentially a semen allergy that can cause vaginal inflammation and pain in response to proteins found in sperm. To avoid an allergic reaction, you’ll need to use condoms or another barrier method to avoid coming into contact with sperm.

Endometriosis

Endometriosis can cause deep, sharp pain inside the vagina or pelvis during or after penetrative sex. Endometriosis is a condition where tissue similar to the lining of the uterus grows outside of the uterus, which can cause inflammation on or around the ovaries, cervix, fallopian tubes, and bladder. 

Other symptoms of endometriosis include:

• Pelvic floor dysfunction
• Painful menstrual cramps
• Irregular bleeding 
• Infertility
• Digestive issues

Endometriosis does not have a cure, but treatment can help manage symptoms. Laparoscopic surgery can remove endometriosis lesions and reduce pain. Hormonal birth control pills and intrauterine devices (IUD) can prevent lesions from growing, which may reduce pain. For milder pain during sex, your doctor may also recommend taking over-the-counter pain medications like naproxen (Aleve) or ibuprofen (Advil and Motrin).

Penis Shape and Size

If you have a vagina and your partner has a very thick penis, this may cause pain and soreness during and after sex. A thick penis can cause small tears on your vaginal tissue from friction.

If your partner has a longer penis, it can hit your cervix, which can become uncomfortable during sex. 

To prevent pain from a long penis hitting the cervix, try to avoid positions that involve deep penetration. If penis thickness is a problem, try incorporating lube into your romps and take things slow. Communicating with your partner about what does and doesn't feel good can also help you figure out how to avoid painful sex.

Having an extremely curved penis can also make penetrative sex painful. A curved penis is most often due to Peyronie's disease, a condition where scar tissue causes the penis to bend. Treatment can vary depending on the severity. Early treatments typically include injections to help break down scar tissue and reduce curving. Other cases may require surgery to remove the scar tissue.

Tilted Uterus

Having a retroverted uterus, a uterus tilting backward instead of forward, can also cause pain during penetrative sex. When the uterus tilts backward, the cervix is angled closer to the vaginal canal, making it easier for the cervix to be poked during sex. 

Having a tilted uterus doesn't mean sex has to be painful. Communicating with your partner can help you figure out what feels good. For example, focusing on positions that allow for shallow penetration, and avoiding deep penetration, can help you avoid pain.

A Quick Review

Sex shouldn't be painful, and you should never have to endure painful sex. If sex always hurts or you begin avoiding sex altogether to prevent pain, reach out to a healthcare provider for help. A healthcare provider can help you figure out what's causing you pain, and find the right treatment.

Over time, recurring painful sex can affect your mental health and relationships. If this is the case for you, a sex therapist can help you and your partner work through any challenges  getting in the way of intimacy.