--- title: "Pain during sex" description: "Possible causes of painful sex, what a check involves, and how treatment, including pelvic physiotherapy, may help. Includes when to get help." url: "https://myruva.co/learn/pain-during-sex" language: "en-GB" topic: "Sexual health" published: "2026-10-18" updated: "2026-10-19" author: "Ruva team" reading_minutes: 4 --- # Pain during sex Possible causes of painful sex, what a check involves, and how treatment, including pelvic physiotherapy, may help. Includes when to get help. *Written and reviewed by the Ruva team · Updated 2026-10-19 · Sexual health* ## Key points - Pain during sex that is frequent or severe deserves a medical check. - In vaginismus, the muscles of the vagina tighten on their own. Treatment is available. - Treatment depends on the cause and may include pelvic floor physiotherapy. Pain during sex can be felt around the opening of the vagina, inside the vagina or deeper in the pelvis. If the pain is frequent or severe, get it checked. You don’t have to push through pain to finish penetration. Dyspareunia is the medical term for pain during vaginal sex. It names the pain but doesn’t explain the cause. A clinician looks at your symptoms and history, sometimes with an examination or tests, before suggesting treatment. ## Different causes need different help Vaginal dryness can make sex sore. It can happen during menopause, pregnancy or breastfeeding, and with some medicines. Irritation from products, infections, skin conditions and conditions such as endometriosis can also cause pain. Several things may need checking. Where it hurts is only part of the picture. Pain can also follow tears or an episiotomy (a cut) during birth. ACOG lists physical therapy among possible treatments. Tell the clinician if the pain started after giving birth. You can ask for help with it. ## When muscles tighten automatically In vaginismus, the muscles of the vagina tighten on their own when something comes near or goes into the vagina. It can make penetration painful or hard, including with a tampon, finger, sex toy or penis. Cervical screening may also be hard. You can’t control this reaction. It can start even if penetrative sex didn’t hurt before. It doesn’t always stop you getting aroused or enjoying other sexual contact. Treatment may combine psychosexual therapy (talking therapy about sex), relaxation and carefully guided exercises. Vaginal trainers are one option, with a specialist therapist guiding you at first. ## Finding what feels comfortable If you want sexual contact at all, choose things that don’t hurt. Tell a partner where and when it hurts and what feels comfortable. ACOG suggests alternatives to painful sex, and touch that isn’t sexual, such as massage. Sexual contact doesn’t have to include penetration. For dryness, a water-based lubricant before sex, or a vaginal moisturiser, may help. Avoid perfumed washes and douching (washing inside the vagina). Use products made for the vagina rather than ordinary body creams inside it. Ask a pharmacist or doctor if you’re not sure which product suits you. ## Talking through an assessment You may be asked about medicines, health conditions and past experiences that affect how you feel about sex. Depending on what’s found, a clinician may bring in a pelvic physiotherapist or a skin specialist. Pelvic floor physical therapy is an option for some kinds of pelvic pain. Ask what the treatment aims to help with. Before an examination, talk about how to make it more comfortable. If vaginismus is suspected, the NHS says you can bring someone you trust and ask for a female doctor. You could start with: “Penetration hurts, and I want to talk about the examination before we start.” If dryness is linked to hormone changes, a doctor may talk about oestrogen treatment. This doesn’t suit everyone, so ask about the benefits and whether it suits you. Book a GP appointment for dryness that won’t go away, unusual discharge or bleeding after sex, even if you’ve been trying lubricant. Get help today from an urgent GP service or NHS 111 (UK), or your doctor or urgent care service (US or elsewhere), if bleeding comes with pain in your pelvis. For heavy bleeding, or other emergency symptoms with pelvic pain, follow the emergency advice below. At the appointment, describe what happens in your own words: where it hurts, what was going on and what you want help with. It’s fine to say you’re not sure. You could start with: “It hurts at the entrance, and I’ve started avoiding being close because I’m worried about pain.” ## When pain needs faster care Go to A&E in the UK, an emergency department in the US, or your local emergency service now if pain in your pelvis is severe or getting worse, or comes with feeling faint, pain at the tip of your shoulder, difficulty breathing, heavy vaginal bleeding or sudden confusion. Contact an urgent GP service or NHS 111 today in the UK, or your doctor or urgent care service in the US or elsewhere, for pain in your pelvis with fever, unusual discharge or bleeding, or if you could be pregnant. If pain during sex keeps happening, book a GP or sexual health appointment in the UK, or see your doctor elsewhere. ## When to get help - **Emergency:** Go to A&E (UK), an emergency department (US), or your local emergency service now if pain in your pelvis is severe or getting worse, or comes with feeling faint, pain at the tip of your shoulder, difficulty breathing, heavy vaginal bleeding or sudden confusion. - **Same day:** Contact an urgent GP service or NHS 111 today (UK), or your doctor or urgent care service (US or elsewhere), for pain in your pelvis with fever, unusual discharge or bleeding, or if you could be pregnant. - **Book an appointment:** Book a GP or sexual health clinic appointment (UK), or see your doctor (US or elsewhere), if pain during sex keeps happening or penetration is painful or hard. ## Where you live Services and advice differ between countries. - **UK:** A GP or sexual health clinic can check for vaginismus and may refer you to a specialist therapist. - **US:** ACOG advises seeing an ob-gyn or another healthcare professional for pain during sex that is frequent or severe. You may be offered pelvic floor physical therapy. - **Elsewhere:** Elsewhere, ask your local doctor or sexual health service about getting checked and seeing a pelvic physiotherapist or psychosexual therapist. ## Sources 1. [When Sex Is Painful](https://www.acog.org/womens-health/faqs/when-sex-is-painful), ACOG 2. [Vaginismus](https://www.nhs.uk/conditions/vaginismus/), NHS 3. [Vaginal dryness](https://www.nhs.uk/symptoms/vaginal-dryness/), NHS 4. [Pelvic pain](https://www.nhs.uk/symptoms/pelvic-pain/), NHS 5. [Your Sexual Health](https://www.acog.org/womens-health/faqs/your-sexual-health), ACOG --- This guide is general information to help you keep and use your own records. It isn’t medical advice. If you’re worried about a symptom, or something changes suddenly, talk to a doctor, nurse or pharmacist.