Why sex might hurt (and what you can do about it)

Let’s say it louder for the people in the back: painful sex is more common than you think. If sex has become painful, know that you’re not broken, weird, or alone—millions of women (or people with vulvas) experience discomfort during sex, and for a wide variety of reasons. That being said, just because it's common doesn't make it okay or "normal." 

The good news? There are solutions, and understanding what’s going on is the first glorious step toward feeling better in your body—and in bed.

Here we offer you 10 common causes of painful sex, and suggestions for troubleshooting each case. 

1. Vulvodynia

Vulvodynia is a chronic pain condition that affects the vulva and can feel like burning, stinging, or rawness—sometimes when merely touched. The exact cause is still a bit of a medical mystery (no thanks to gendered biases in medical research), but it may be linked to nerve inflammation, hormonal shifts, or even genetics. Sex can feel like rubbing sandpaper on a sunburn—not at all cute. A pelvic floor specialist can help, and treatments range from topical creams to nerve blocks to physical therapy. Main takeaway: no matter what the doctor says, you're not imagining it, and it’s not "just in your head."

2. Vaginismus

Vaginismus is a condition that causes the vaginal muscles to involuntarily tighten up—like a drawbridge clamping shut whenever penetration is attempted. It’s often tied to fear, anxiety, or past trauma, but it can also have no clear cause. Spoiler alert: willpower won’t fix it. What can help? Pelvic floor therapy, dilator training, and gentle, affirming sex ed that reminds you your body is not the enemy.

3. Vaginal infections

Yeast infections, bacterial vaginosis, UTIs, or even STIs like chlamydia can make sex feel like sliding into a cactus. These infections cause inflammation, dryness, and general unhappiness. Pay attention to symptoms like unusual discharge, itchiness, or odor. A quick visit to your healthcare provider (and some meds) can typically clear things up. Hot tip: for extra support and prevention against infection, take a daily probiotic supplement.

4. Lack of foreplay

Let’s get real: jumping straight into penetration with zero warm-up is like trying to bake a cake in a cold oven. Your body needs time and arousal to get juicy, relaxed, and ready to party. If foreplay is skipped or rushed, the vagina can stay dry and tight, leading to friction and...hello... pain. So, talk to your partner about slowing it down. Your pleasure deserves the spotlight, not just a cameo.

5. Sexual trauma / PTSD

Past trauma can show up in the body long after the mind says it's “fine.” If you’ve experienced sexual violence or any kind of boundary violation, sex can trigger fear, dissociation, or pain. This is a valid and well-honed trauma response—not a failure. Working with a trauma-informed therapist or sex therapist can be life-changing—reclaiming your sensuality can happen on your terms.

6. Endometriosis

Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus—often on the ovaries, fallopian tubes, or other pelvic organs—and it can make sex seriously painful. The pain is usually deep, especially during penetration, and can linger long after the fact. Other signs include intense periods, chronic pelvic pain, and fatigue. Diagnosis can be tricky and may require a specialist (often a gynecologist with experience in endo). Treatment options include hormonal therapy, pain management, and in some cases, surgery. Don’t be afraid to advocate hard for your body.

7. Lack of lube

One word: lubrication. Not enough of it turns your pleasure session into a friction-based horror show. Hormones, medications (like antidepressants or birth control), stress, and even hydration levels can affect natural lubrication. The fix? Use a good quality water-based lube—generously and without apology. You’re not less sexy because you use lube—you’re a fucking genius.

8. Awkward or incompatible positions

Sometimes it’s not your body at all—it’s the position. Certain positions can cause the penis or toy to bump the cervix or angle uncomfortably. Pain here might feel sharp, deep, or crampy. Experimenting with angles, pillows, and good old-fashioned communication can make all the difference in the world. If a position hurts? You don’t have to “grin and bear it.” You’re allowed to say "nope," and on to the next one.

9. Bad communication (and the sex to match)

If your partner doesn’t listen, doesn’t ask, and doesn’t care about your comfort, that’s not just bad sex—it’s a recipe for pain. Being tense, bored, or emotionally disconnected can make your body tighten up or shut down. Open communication, consent, and mutual enthusiasm are musts. Don’t settle for partners who treat your body like a destination they can rush through without appreciating the journey.

Bottom line: if sex hurts, that’s your body waving a red flag—not a sign to ignore. You deserve pleasure, ease, and partners who help you get there. Your comfort and pleasure are worth advocating for—always

For more support, check out Pelvic Global (a global directory dedicated to helping you find pelvic health professionals), OMGYES (for science-based pleasure education), and RAINN.org (America’s largest support organization for survivors of sexual violence).