5 Reasons Sex Might Be Painful

Reviewed by Alice Child, Somatic Sexologist

Somatic Sexologist Alice Child talks about 5 common reasons why sex might be painful.

This guide contains general advice only. If you need more tailored support, please book in a session.

How common is painful sex?

Sex is meant to feel enjoyable, connecting, and pleasurable — not painful. But sadly, 75% of women have reported experiencing painful sex at some point in their lives.

Is painful sex normal?

No! Pain during sex is your body’s way of waving a red flag, letting you know that something isn’t quite right. Sex should never be painful.

If you’re experiencing pain during sex, it’s important to see a healthcare professional for support. The good news is that it’s often treatable and sometimes linked to an underlying health condition.

What causes painful sex?

So let’s explore five common reasons why sex might be painful:

1. Endometriosis

   Endometriosis happens when tissue similar to the lining of the uterus grows outside of the uterus. This can create inflammation or adhesions in the pelvis, causing pain during penetration.

   
   

   Many people also notice that the pain is worse at certain times in their cycle, especially around their period, when inflammation in the pelvis can increase.

   
   

   Endometriosis is also much more common than many people realise. In Australia, it’s estimated that around 1 in 7 women will have endometriosis by the time they reach their 40s.

   
   

   If sex is painful, it’s important to listen to your body and seek support from a medical professional.

2. Vaginismus

   Vaginismus is a condition where the pelvic floor muscles tighten involuntarily during penetration. These muscles contract automatically, which can make penetration painful and difficult, or sometimes impossible. It is estimated that roughly 1 in 10 women experience vaginismus.

   
   

   For some people, penetration might feel painful right at the entrance, like “hitting a wall” or their muscles are clamping shut. Because the tightening is involuntary, it’s not something a person is consciously doing or able to control in the moment.

   
   

   Vaginismus can develop for many different reasons. Sometimes it’s related to stress, anxiety, shame, fear of pain, or the body bracing in anticipation of discomfort. In some cases, there may not be a clear cause at all — it’s simply the body’s protective response.

3. Vulvodynia

   Vulvodynia is a chronic condition with ongoing pain on the external part of the genitals, called the vulva. This includes the inner and outer labia and the head of the clitoris.

   
   

   The pain can feel like burning, stinging, rawness or irritation. For some, the area may feel very sensitive to touch, which can make things like penetration, tampons, tight clothing, or even prolonged sitting uncomfortable.

   
   

   The causes of vulvodynia can vary. In some cases, it may be related to nerve sensitivity, while for others it may be linked to skin irritation, inflammation, or changes in the tissues of the vulva. Like many types of pelvic pain, the experience can look different for everyone.

4. A complicated history with sex

   Not all pain during sex has a purely physical cause. For some people, sex comes with a complicated history and isn’t always associated with pleasure or enjoyment.

   
   

   Experiences like sexual trauma, shame, seeing sex as a taboo, or other negative past experiences, can show up in the body in different ways. If your body has learned to associate sex with stress or discomfort, your nervous system may go into a protective response. When the nervous system doesn’t feel safe, the body can brace, tighten, or disconnect, which can sometimes lead to pain during sex.

5. Going too fast

   Painful sex can also happen when things are going too quickly. Desire and arousal take time to build! When you’re aroused, blood flow increases to the pelvis and genitals, making everything feel more sensitive and pleasurable. It also helps your body produce natural lubrication, which reduces friction and makes penetration more comfortable.

   
   

   Natural lubrication doesn’t always happen, even if you’re really turned on. Factors like hormones, medications and stress can affect natural wetness. That’s why lube is incredibly helpful. It not only reduces the pain that can come from friction, but it also removes the pressure for someone to feel like they need to be “wet enough.”

   
   

   Try slowing things down and taking your time, and learning external pleasure techniques- like vulva massage. Foreplay doesn’t just mean heading straight for penetration— take time to explore other erogenous zones like the neck, breasts, belly, thighs, and bum.

What to do if you experience painful sex

Pain during sex is rarely just about one thing. Rather than only looking at the physical symptoms, Somatic Sexology focuses on getting curious about both the body and the mind.

In sessions, this might include practices that build awareness of the brain–body connection, such as mindfulness, breath work to release tension, and pelvic floor exercises that focus on both strengthening and relaxing the muscles. We also explore skills like communication, helping you feel more comfortable expressing what you want, what feels good, and where your boundaries are.

Most importantly, it’s about helping people reconnect with what sex is meant to be about — pleasure and connection. This could be through exploring new kinds of foreplay, erogenous zones, or experimenting with toys that can help release tension and enhance pleasure.

Sex should never be painful, and with the right support, it can become something that is enjoyable and pleasurable!

Best,

Alice x

Alice Child - Somatic Sexologist, Sex Therapy & Sex Counsellor - helps people achieve happier and healthier sex lives through 1:1 sex coaching, couples sex counselling, hens parties, and workshops. Book a session here.