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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. Dryness, infections and vaginismus can be treated or started on a plan by video; deep pain that needs an examination or a scan is assessed in person.
- How common: pain during sex affects 3 out of 4 women at some point in their lives. It is common, and it can be treated.
- Two kinds: pain at the entrance of the vagina, often from dryness, infection, vaginismus or vulvodynia, and deep pain, which can come from conditions such as endometriosis or pelvic inflammatory disease.
- Vaginismus: the vaginal muscles tighten on their own when something is inserted. It is an automatic reaction, and it can be treated.
- Emergency: call 112 for severe pain low in the tummy with a high temperature, heavy vaginal bleeding, or collapse.
Do not book a video appointment if you have severe pain low in your tummy with a high temperature, heavy vaginal bleeding, or you feel faint or collapse: call 112 or go to an emergency department. After a sexual assault, go to an emergency department or a specialist sexual assault service.
Can an online doctor help with painful sex?
Partly. Many causes of pain during sex are recognised from what you describe: where it hurts, when it started and what comes with it. A doctor can assess that by video, treat dryness and infections such as thrush, start a plan for vaginismus, and refer you for psychosexual therapy or pelvic floor physiotherapy. Deep pain that needs an examination or a scan, bleeding after sex, and pain with a fever are assessed in person, and the doctor tells you where to go.
How an online consultation helps with painful sex
- A private, unhurried conversation: Pain during sex is common, and you can describe it from home, at your own pace.
- The likely cause: Entry or deep pain, dryness, infection, vaginismus, vulvodynia or a condition that needs a scan.
- Treatment that fits: Moisturisers, lubricants, vaginal oestrogen or treatment for an infection, when they are right for you.
- The right specialist: A referral for psychosexual therapy, pelvic floor physiotherapy or gynaecology when that will help most.
What the doctor checks in an online consultation about painful sex
The doctor asks about the signs that need an examination first, then about the pain. The doctor asks about:
- Warning signs: bleeding after sex, between periods or after the menopause, pain low in the tummy with a fever, or unusual discharge.
- Where it hurts: at the entrance of the vagina, or deep inside, and whether it depends on position.
- When it happens: at first penetration, with tampons or a smear test, throughout sex, or afterwards.
- Dryness: the menopause, breastfeeding, and medicines such as hormonal contraception or antidepressants.
- Other symptoms: itching, discharge, sores, painful periods, or pain when peeing or opening your bowels.
- Your history: childbirth, surgery or cancer treatment, earlier painful experiences, and how you feel about sex now.
You decide what you share, and you can ask for a female doctor. If an examination would help, the doctor tells you why and where.
Why does sex hurt? Entry pain and deep pain
Pain during sex, called dyspareunia, is pain just before, during or after sex. It affects 3 out of 4 women at some point. Where it hurts is the first clue to the cause:
Swipe sideways to compare →
| Type of pain | Where you feel it | Common causes | Read more |
|---|---|---|---|
| Entry pain | At the opening of the vagina, at first penetration | Not enough lubrication or dryness, infections such as thrush, skin conditions, vaginismus, vulvodynia, injury | Thrush Lichen sclerosus |
| Deep pain | Deep in the vagina or pelvis, often worse in some positions | Endometriosis, pelvic inflammatory disease, fibroids, pelvic organ prolapse, scarring from surgery or cancer treatment, bowel and bladder conditions | Endometriosis Cystitis |
| Both, or changing | Anywhere | Anxiety, depression, worries about your body, fear of intimacy or relationship problems, which lower arousal | Anxiety |
Pain can feel burning, stabbing or aching. Often more than one cause plays a part: thrush or an earlier painful experience, for example, can both lead on to vaginismus.
Why does it hurt when he hits my cervix?
Deep pain with deep penetration, sometimes called collision dyspareunia, can come from conditions such as endometriosis, pelvic inflammatory disease or fibroids, and it is often worse in certain positions. If deep pain happens regularly, see a doctor: it is worth finding the cause rather than avoiding positions for good.
What is vaginismus?
Vaginismus is when the vagina suddenly tightens when you try to insert something, such as a tampon, a penis or a speculum at a smear test. It can cause a burning or stinging pain, or make penetration impossible. It is an automatic reaction that you do not control, and it does not necessarily affect arousal or enjoying other kinds of sexual contact. It is more common in women in their late teens to early 30s.
Is vaginismus psychological?
Not only. The reasons are not always clear. Anxiety or fear about sex, an earlier painful experience, a difficult examination or birth, sexual assault, or a belief that sex is shameful can all play a part, and so can physical causes such as thrush. Whatever started it, it is not your fault, and it is not something you are doing on purpose.
How is vaginismus treated, and can it be cured?
It can be treated. Treatment usually focuses on easing the feelings around penetration and getting used to it gradually, under specialist guidance at first and then with practice at home:
- Psychosexual therapy: a talking therapy about feelings towards your body and sex.
- Relaxation: mindfulness, breathing exercises and gentle touching.
- Pelvic floor exercises: squeezing and relaxing to gain control of the muscles.
- Sensate focus: exercises to help you relax during sex and increase desire.
- Vaginal trainers: smooth, tampon-shaped trainers in increasing sizes, used at your own pace.
Partners can be involved if you choose. A treatable cause, such as thrush, is treated at the same time.
What is vulvodynia?
Vulvodynia is pain in the vulva, the area around the opening of the vagina, that lasts at least 3 months without another clear cause. It can be burning, throbbing, stabbing or sore. It can start on its own, or when the vulva is touched, for example by a tampon or during sex, and it can be constant or come and go.
The exact cause is not known; nerve irritation or over-sensitivity, earlier infections, lower oestrogen and weak pelvic floor muscles may all play a part. A doctor examines the area, often touching it gently with a cotton bud to find the painful areas, and may take a swab to rule out infection. Treatments include a numbing cream, tablets for nerve pain, pelvic floor exercises and cognitive behavioural therapy (CBT); surgery is offered only occasionally.
Vaginal dryness and painful sex
Not enough lubrication is one of the most common reasons for painful sex. Lower oestrogen makes the vagina drier, so dryness is common:
- during and after the menopause
- in pregnancy and while breastfeeding
- with some medicines, including hormonal contraceptives and antidepressants
- after a hysterectomy, especially if the ovaries were removed, and after cancer treatment
- with perfumed soaps, washes or douches in or around the vagina
Dryness can also cause soreness or itching, needing to pee more often, and repeated urine infections. Vaginal moisturisers used regularly, water-based lubricants before sex, and more time for foreplay help many women. When they are not enough, the doctor may prescribe vaginal oestrogen, as a cream, gel or other form, if it suits you. The menopause page covers the wider picture.
Which painful sex treatment might the doctor recommend?
Treatment follows the cause, and often combines several steps. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Dryness, for example around the menopause or while breastfeeding | Moisturisers and lubricants, then vaginal oestrogen if needed | Yes | If bleeding or pain continues |
| Itching, soreness or discharge with painful sex | Treatment of thrush, BV or another infection | Yes | For a swab or STI tests if the cause is unclear |
| Penetration that feels impossible, or tightening when you try | A plan for vaginismus, with trainers and therapy | Yes | For specialist therapy or physiotherapy |
| Burning vulval pain for 3 months or more | Assessment for vulvodynia | Partly | For an examination and a specialist |
| Deep pain, painful periods or pain opening your bowels | Assessment for endometriosis, with a scan | Partly | For an examination and an ultrasound |
| Bleeding after sex, between periods or after the menopause | An examination | Only to assess | Promptly, in person |
| Pain low in the tummy with a fever or unusual discharge | Examination for pelvic inflammatory disease | No | Promptly; call 112 if the pain is severe |
Sex that hurts? A doctor can help you work out the cause and the next step in one consultation.
See available times →Treatment options for painful sex
What you can do yourself
- Use a water-based lubricant before sex, on the vagina, your partner’s penis or fingers, or a sex toy.
- Use a vaginal moisturiser regularly if dryness is part of the problem.
- Take time over foreplay and arousal, and stop if it hurts.
- Use unperfumed soaps and washes, and avoid douching and products not made for the vagina.
- Wear loose cotton underwear, and try relaxation such as breathing exercises, yoga or mindfulness.
- With vulval pain, pads may be more comfortable than tampons during a period, and very hot baths can make it worse.
Prescription treatment
A prescription is never issued without a consultation. Depending on the cause, the doctor may prescribe vaginal oestrogen for dryness, treatment for thrush, BV or another infection, or a numbing cream, and may refer you for psychosexual therapy, pelvic floor physiotherapy or a gynaecology assessment. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Putting up with pain, or pushing through it. Perfumed products, douching, and creams or lotions not made for the vagina. Repeated thrush treatment without checking the cause. Assuming deep pain is only about position without a check.
Special situations
The menopause
Lower oestrogen makes the vagina drier, which is a common reason for sex to hurt after the menopause. Moisturisers, lubricants and vaginal oestrogen help, and new bleeding after the menopause always needs checking.
After childbirth and while breastfeeding
Dryness is common while breastfeeding, and a difficult birth can make you anxious about penetration. A lubricant, time, and help with any tension or scarring make a difference; tell your midwife or doctor if sex still hurts.
Men
Men can feel pain on the head or shaft of the penis, in the testicles or in the pelvis during sex. Causes include a tight foreskin and infections of the genitals or urinary tract: see balanitis, tight foreskin and urethritis.
After sexual assault
Painful sex and vaginismus can follow sexual assault. Support is available, and you can go at your own pace. If an assault was recent, go to an emergency department or a specialist sexual assault service.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When painful sex is treated online, and when you need in-person care
Treated online: dryness, infections that fit online care, vaginismus plans with trainers and therapy referrals, painful sex around the menopause or after childbirth, and advice for you and your partner.
In-person care: deep pain that needs an examination or a scan, vulvodynia that needs a specialist, bleeding after sex or after the menopause, pain with a fever, physiotherapy and therapy sessions, and any emergency sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- severe pain low in the tummy with a high temperature
- heavy vaginal bleeding
- fainting or collapse
- a recent sexual assault
Get medical advice the same day for:
- pain low in the tummy with a temperature or unusual discharge
- deep pain during sex that is new and severe
Bleeding after sex, between periods or after the menopause needs a doctor to check it promptly, even if it is a small amount.
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the pain: say where it hurts and when, how long it has been happening, and mention dryness, discharge, the menopause, breastfeeding or anything else that worries you.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Painful sex can have more than one cause. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Endometriosis can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about painful sex and vaginismus
Why does sex hurt?
Pain at the entrance of the vagina often comes from dryness, an infection such as thrush, vaginismus or vulvodynia. Deep pain can come from endometriosis, pelvic inflammatory disease or fibroids. Anxiety and relationship worries can also make sex painful.
What are the symptoms of painful sex that point to the cause?
Painful sex that burns or stings at the entrance points to dryness, thrush, a skin condition such as lichen sclerosus, or vulvodynia; a wall-like tightness that stops penetration is vaginismus; deep pain in some positions points to endometriosis, pelvic inflammatory disease, fibroids or an ovarian cyst; pain with bleeding after sex needs a check for infection or cervical changes; and pain in men at the tip or under the foreskin suggests balanitis or a tight foreskin. The pattern tells the doctor where to look.
Is it normal for sex to hurt?
Painful sex is common, affecting 3 out of 4 women at some point, but it is not something you have to put up with. Pain that happens often is worth a check, because most causes can be treated.
What is vaginismus?
Vaginismus is an automatic tightening of the vaginal muscles when something is inserted, such as a tampon, a penis or a speculum. It can cause burning or stinging pain or make penetration impossible, and it can be treated.
Is vaginismus psychological?
Not only. Anxiety, fear, earlier painful experiences or assault can play a part, and so can physical causes such as thrush. The reasons are not always clear, and it is an automatic reaction, not something you do on purpose.
Can vaginismus be cured?
Vaginismus can be treated. Psychosexual therapy, relaxation, pelvic floor exercises, sensate focus and vaginal trainers, used gradually and at your own pace, help many women.
What can I do at home about painful sex?
Use a good lubricant every time, and a vaginal moisturiser two or three times a week if dryness is the issue; spend longer on arousal, choose positions that limit depth, stop when it hurts rather than pushing through, treat thrush or an infection, avoid soaps and scented products on the vulva, try pelvic floor relaxation and slow breathing, and talk to your partner so sex is not avoided altogether. Painful sex that does not improve within a few weeks needs a consultation.
Why does it hurt when he hits my cervix?
Deep pain during sex, felt with deep penetration, can come from conditions such as endometriosis, pelvic inflammatory disease or fibroids, and it is often worse in some positions. If it happens regularly, see a doctor.
Is it normal for sex to hurt if it’s been a while?
Not having enough lubrication is a common reason for painful sex. A water-based lubricant and more time for arousal help. If the pain continues, see a doctor to check for dryness, infection or vaginismus.
Can painful sex be prevented?
Often: keep the vagina lubricated with a lubricant and, after the menopause, a moisturiser or vaginal oestrogen; treat thrush, BV and skin conditions early; use condoms with new partners to avoid the infections that cause deep pain; keep the pelvic floor relaxed with breathing or physiotherapy if it tends to clench; after childbirth or surgery wait until healed and go gently; and keep talking to your partner, because fear of pain tightens the muscles and makes painful sex more likely next time.
What is vulvodynia?
Vulvodynia is pain in the vulva, a common cause of painful sex, that lasts at least 3 months without another clear cause. It can be burning, throbbing or stabbing, and it can start on its own or when the area is touched.
How long does painful sex last, and what is the outlook?
It depends on the cause: painful sex from dryness or an infection settles within days to weeks of treatment, vaginismus usually improves over 2 to 6 months of therapy and trainers, vulvodynia takes months and sometimes years of combined treatment, and deep pain from endometriosis or fibroids eases as those conditions are treated. The outlook is good: most women and men with painful sex regain comfortable sex once the cause is found, which is why it is worth raising rather than enduring.
Can the menopause make sex painful?
Yes. Lower oestrogen after the menopause makes the vagina drier, thinner and less stretchy, which often makes sex painful or causes a burning feeling afterwards. Vaginal moisturisers used regularly, lubricants during sex and vaginal oestrogen in a cream, pessary or ring help many women, and a doctor can prescribe vaginal oestrogen after a video consultation.
Can men have painful sex?
Yes. Painful sex in men can be felt on the head or shaft of the penis, in the testicles or in the pelvis. A tight foreskin and infections of the genitals or urinary tract are among the causes.
Can an online doctor help with painful sex?
Partly. A doctor can assess the likely cause by video, treat dryness and infections, start a plan for vaginismus and refer you for therapy. Deep pain, bleeding after sex and pain with a fever need in-person care.
- Vaginismus, NHS, National Health Service (UK), reviewed 13 May 2024.
- Vulvodynia, NHS, National Health Service (UK), reviewed 16 January 2024.
- Vaginal dryness, NHS, National Health Service (UK), reviewed 24 July 2025.
- Painful intercourse (dyspareunia): symptoms and causes, Mayo Clinic (US), updated 12 September 2026.
- Dyspareunia (painful intercourse), Cleveland Clinic (US), updated 25 July 2024.
- Pelvic inflammatory disease (PID), NHS, National Health Service (UK), reviewed 17 December 2025.
- Help after rape and sexual assault, NHS, National Health Service (UK), reviewed 6 November 2024.
- Tight foreskin (phimosis), NHS, National Health Service (UK), reviewed 6 March 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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Read article →Speak to a doctor about painful sex over video, usually within 15 minutes
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