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SEX EDUCATION

Why does sex hurt?

SEX should feel enjoyable, but both men and women may experience some pain between the sheets.

It’s not always something to worry about - it could be due to constipation or jumping into things too quickly.

Sex can be uncomfortable sometimes - but there are some signs it's more serious
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Sex can be uncomfortable sometimes - but there are some signs it's more seriousCredit: Getty

Dr Babak Ashrafi, of online doctors service told The Sun: “Although sex can be uncomfortable depending on what kind of sex you're engaged in, it shouldn't have to be. 

“You need to make sure you're using plenty of lubrication, and that all parties involved in sex are aware of the pain and can make changes to try to minimise the cause. 

“It could be caused by anxiety or stress during sex, so not being able to relax. 

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“Putting yourself in a relaxed state will help your pelvic muscles relax and therefore allow for easier and less painful penetration. Having trust in your sexual partner(s) will help you relax more.”

The NHS says women with IBS may be more likely to feel pain during sex, and constipation may also make it uncomfortable. 

It may also be an allergy - such as to latex in condoms - or simply a lack of sexual arousal. 

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Dr Babak said if you are satisfied that the pain isn’t due to something fixable, then you should speak to a doctor, especially if there are other symptoms.

He said: “If you're experiencing unwanted pain during sex, then this could be a sign that something isn't quite right.

“You have other causes like vaginismus (tensing of the vagina before/during penetration) and phimosis (problem pulling back your foreskin), which affect females and males respectively.”

Dr Angela Rai, gynaecology specialist and founder of said painful sex is known as dyspareunia.

And for women, there are a number of causes of deep pain in the pelvis, as opposed to just at the opening of the vagina.

“It might be worse in certain positions,” she said.

“Causes include certain medical conditions such as endometriosis, pelvic inflammatory disease, cystitis, pelvic floor dysfunction, ovarian cysts.”

Infection

An infection such as thrush, or a sexually transmitted infection (STI), such as chlamydia, gonorrhoea or genital herpes, can make sex painful.

Common signs of these infections include unusual discharge (smell, consistency, amount), itching or lump, warts or bumps around the genitals.

Given that most people with chlamydia don’t know they are carrying it, “pain during sex may also be the only sign that you have an infection,” said Dr Babak.

Women can have pain in their belly and bleeding after sex, while men may have painful and swollen testicles. 

Dr Angela said: “If there is an unusual discharge, itching or soreness you may need to be tested for infections such as thrush or other sexually transmitted infections.”

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is when an infection travels up from the vagina into the reproductive organs of a woman.

It can be treated with antibiotics in the early days, but the fallopian tubes can become scarred and narrowed, increasing the chance of infertility.

The symptoms, which are typically mild and therefore potentially missed, include pain in the pelvis or lower tummy, pain felt deep in the pelvis during sex, pain when peeing, and bleeding between periods. 

Vaginismus 

Dr Angela said: “Vaginismus is when there are involuntary spasms of the muscles of the vaginal wall and the vagina suddenly tightens up making penetration painful.”

It’s not only the penis that can cause muscles to tighten - sex toys, fingers, tampons and medical instruments used for examinations can be triggering.

Usually, a woman discovers that they have vaginismus when they first become sexually active, but they can also develop it over life.

Causes include anxiety, childbirth injuries and fear of sex, perhaps due to sexual abuse or trauma.

Endometriosis

Around 1.5 million women in the UK are living with endometriosis, a condition that, among other symptoms, causes painful sex.

Endometriosis is when cells similar to the womb lining are found elsewhere in the body. They act the same as the womb, building with blood and bleeding every month.

This is agonisingly painful for those with the condition, as the blood has nowhere to escape.

Pain can occur during or after sex, on ovulation and during periods.

A person may also suffer heavy periods, bleeding between periods, symptoms of IBS during a period, tiredness and back pain.

Menopause

One of the dozens of potential symptoms of the menopause is vaginal dryness, and this lack of lubrication can cause superficial pain [pain on entry].

Dr Angela said: “When there is a drop of oestrogen levels, it can cause dryness in the vagina and a condition called atrophic vaginitis. 

“Vaginal atrophy is thinning, drying and inflammation of the vaginal walls when your body has a lack of oestrogen.”

But you don’t need to suffer in silence.

Dr Angela said: “If you suffer with dryness or maybe near the time of the menopause you may be advised to use vaginal lubricants or hormonal treatments.”

In men…

Men can also experience pain during sex for a smaller number of reasons.

Like women, infections like thrush, and some STIs, such as herpes, can make the penis more painful or irritated, especially during sex.

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What causes itching around the penis?

Small tears in the foreskin - sometimes not noticeable to the naked eye - may cause soreness and a sharp, stinging pain, the NHS says.

And a tight foreskin can cause painful erections - making sex difficult - as well as pain when peeing, frequent UTIs and bleeding or a thick discharge.

If there is pain around the penis, testicles, anus and lower stomach and back, this could be a sign of prostatitis.

Prostatitis is inflammation of the prostate gland, which lies between the penis and bladder.

It also can cause pain during ejaculation, an inability to pee or pain when using the toilet. 

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Go to a doctor if you have any of the above symptoms because acute prostatitis can be potentially life-threatening. 

Testicle pain and swelling can be a sign of an infection, such as chlamydia.

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