Pain During and After Sex: Causes and Treatment

Medically reviewed by Dr Edmond Edi-Osagie, Consultant Gynaecologist  ·  Last reviewed: August 2026

If sex hurts, your body is telling you something. Pain during or after sex, known medically as dyspareunia, almost always has an identifiable physical cause: vaginal dryness, an infection, a skin condition, involuntary tightening of the vaginal muscles, or an underlying gynaecological condition such as endometriosis, fibroids or ovarian cysts. Once the cause is found, it can nearly always be treated.

Painful sex is far more common than most people realise. UK research suggests that close to one in ten sexually active women experience it, yet many put up with the discomfort for years before asking for help, often because it feels awkward to talk about. Please do not wait. Persistent pain during or after sex is not something you have to live with, and it can sometimes be the first sign of a condition that benefits from early treatment.

At Aurora Healthcare in Manchester, our consultant-led gynaecology team investigates and treats every cause of painful sex in complete confidence. This page explains the most common causes, the signs that mean it is time to see a specialist, and the treatments that can help you enjoy intimacy comfortably again.

Why does sex hurt? The most common causes

Specialists group painful sex by where the pain is felt, because the location of the pain is often the strongest clue to its cause.

Pain at the entrance of the vagina (superficial pain)

Pain felt around the opening of the vagina, usually at the start of penetration, tends to be caused by one of the following:

• Vaginal dryness. The most frequent cause of all. Hormonal changes after childbirth, while breastfeeding or around the menopause reduce natural lubrication, as can certain medications and simply not being fully aroused.
• Infections. Thrush, urinary tract infections and some sexually transmitted infections can leave the area sore, itchy or burning during and after sex.
• Skin conditions. Conditions such as eczema or lichen sclerosus can make the delicate skin of the vulva fragile and painful to touch.
• Vaginismus. An involuntary tightening of the muscles around the vagina that makes penetration painful or impossible. It often has an emotional trigger and responds very well to the right support.
• Scarring, cysts and abscesses. Scar tissue from childbirth or previous surgery, and cysts or abscesses near the vaginal opening, can all cause localised pain.

Pain felt deep inside the pelvis (deep pain)

A deeper ache, sharp pain or cramping felt inside the pelvis during sex, or lingering afterwards, points towards a different set of causes:

• Endometriosis. A condition where tissue similar to the womb lining grows elsewhere in the pelvis, causing inflammation that makes deep penetration painful. It affects around one in ten women of reproductive age.
• Adenomyosis. A related condition in which similar tissue grows within the muscular wall of the womb itself, causing deep tenderness and heavy, painful periods.
• Uterine fibroids. Non-cancerous growths in or around the womb that can cause pressure and deep discomfort during sex.
• Pelvic inflammatory disease (PID). An infection of the reproductive organs that inflames the pelvis. It needs prompt treatment to protect future fertility.
• Ovarian cysts. Fluid-filled sacs on the ovaries that can cause a sharp or one-sided pain when touched during deep penetration.
• A retroverted (tilted) womb. Some women naturally have a womb that tips backwards, which can make certain positions uncomfortable.

Why do I have pain after sex?

Pain that appears or lingers after intercourse is usually an extension of one of the causes above. Deep conditions such as endometriosis, adenomyosis and PID involve tissue that is already inflamed, so it continues to ache once intercourse has finished, sometimes for hours. Cramping after sex can also happen as the womb and pelvic floor muscles contract, and soreness at the entrance often follows friction where there was too little lubrication.

Occasional, mild discomfort that settles quickly is rarely anything to worry about. But if pain after sex is a regular pattern, or comes with bleeding or unusual discharge, it deserves proper investigation.

Pelvic pain and womb pain after sex: could it be endometriosis?

Many of the women we see describe a cramping, dragging pain low in the tummy after sex, often around the womb area. When this deep, lingering pelvic pain sits alongside painful or heavy periods, pain when opening the bowels, or difficulty conceiving, endometriosis is one of the most likely explanations. It is a condition that takes years to diagnose on average in the UK, largely because its symptoms are so often dismissed as normal.

Our team includes recognised specialists in endometriosis and pelvic pain, and painful sex is frequently the symptom that first brings the condition to light. You can read more about endometriosis diagnosis and treatment at Aurora.

Worried your symptoms could be endometriosis? Our specialist team can investigate properly and explain your options. Explore our endometriosis and pelvic pain service.

When should you see a specialist?

We would encourage you to book an appointment if any of the following sound familiar:

• Sex is painful most of the time, or the pain is getting worse
• Pain continues for hours or days after intercourse
• You notice bleeding after sex, or discharge that is unusual for you
• Your periods are also becoming heavier or more painful
• You find yourself avoiding intimacy, and it is affecting your relationship or how you feel about yourself
• Lubricants and self-help measures have not made a difference
• You are trying to conceive, since some causes of painful sex can also affect fertility

You do not need to see your GP first. You can book directly with our consultant gynaecologists, and everything you tell us stays completely confidential.

How we find the cause

Your first appointment is an unhurried, private conversation with a consultant gynaecologist. We will listen carefully to where the pain is, when it happens and how it is affecting you. Nothing happens without your consent, and every step is explained before it takes place.

Depending on your symptoms, we may recommend a gentle examination, swabs to check for infection, or a pelvic ultrasound scan to look at the womb and ovaries. Where a condition such as endometriosis is suspected, a laparoscopy, which is a short keyhole procedure, allows us to confirm the diagnosis and often treat the problem at the same time.

Treatment for painful sex

Treatment always depends on the cause, which is why an accurate diagnosis matters so much. Options we offer include:

• Vaginal lubricants and moisturisers, with guidance on which genuinely help
• Hormonal treatment where dryness is linked to breastfeeding or the menopause
• Antibiotics or antifungal treatment where an infection is found
• Psychosexual counselling for vaginismus and the emotional side of painful sex, which matters just as much as the physical side
• Advanced keyhole surgery for endometriosis, fibroids and ovarian cysts, performed by our specialist laparoscopic surgeons

Most women who seek help for painful sex see a significant improvement once the underlying cause is treated. The hardest step is usually the first conversation, and we make that as comfortable as we possibly can.

Common questions about painful sex

Talk to us in confidence

You do not have to put up with painful sex, and you do not have to explain it to anyone but us. Call us on 0161 244 8623 or get in touch and our team in Cheadle, Manchester will arrange a confidential consultation at a time that suits you.