Pain during sex and dyspareunia: what causes it, and how can you rediscover pleasure?

Understanding the causes of pain during sex (dyspareunia)

The medical term for pain during or after sex is dyspareunia. 

It can affect anyone, regardless of gender or sexual orientation. To understand it better, we generally distinguish between physical causes (superficial or deep) and psychological factors, which often play a decisive role. 

Superficial pain: when the vagina sounds the alarm 🔔

These usually occur during penetration or when there’s friction at the vaginal opening:

• Vaginal dryness: This is the number one cause of that pulling sensation. According to France’s national health insurance service, hormonal changes (the pill, pregnancy, menopause) or stress can reduce natural lubrication and cause painful friction. 

• Vaginismus: This is an involuntary, reflex contraction of the pelvic floor muscles that makes penetration difficult or even impossible.

• Infections or irritation: Thrush, cystitis, vestibulodynia or even an allergy to a harsh soap can inflame the delicate tissues.

Deep pain: when the lower abdomen reacts 🌊

Sometimes everything feels wonderful at first... but as penetration goes deeper, a sharp twinge or dull cramp spoils the moment 

• Endometriosis: According to the EndoFrance association, deep dyspareunia affects more than 70% of people with endometriosis. This gynaecological condition causes inflammation in the pelvic area, which can be particularly painful with deep movements or certain angles of penetration. 

• The position of the uterus: A retroverted uterus may be more sensitive to certain angles of penetration.

• Pelvic muscle tension: Just as you can get knots in your back, tension can build up in the pelvic floor and make it hard to relax.

The psychological cycle: when your mind gets involved 🧠 

We often forget it, but the brain is our most important sexual organ! Emotions play a key role in how we experience pain:

• Anticipation and fear of pain: Experiencing pain once can trigger a defensive reflex. Your mind expects it, your body unconsciously tenses up, and the pain returns... It’s a vicious circle of fear.

• Everyday stress and anxiety: When your mind is preoccupied, it’s harder to relax, which can hold back arousal and natural lubrication.

• Performance pressure or emotional blocks: Fear of disappointing your partner or unspoken relationship issues can create tension in the lower abdomen.

• Past trauma: A negative past experience can leave emotional traces that the body expresses as pain.

How to have sex without pain: our gentle plan of action

Rest assured, there are ways to ease discomfort and bring tenderness back under the covers.

1. Smooth moves: the power of lube

The essential way to reduce friction is to use a lube of good quality. Choose a neutral, intimate pH-friendly formula made with water or medical-grade silicone. Apply it generously to your delicate tissues, penis, fingers or favourite toys, and feel the difference straight away! ✨ 

2. Take your time: long live slow sex!

The body needs time for desire to build and the pelvic tissues to relax. Spend longer on caresses and massages, and explore pleasure in all its forms without focusing solely on penetration. And because stress is the ultimate mood-killer, dim the lights and put on some soothing music: a relaxed body is the key to pain-free sex! 

3. The art of gently changing positions

Some positions create an uncomfortable angle or involve penetration that’s too deep for your delicate tissues. The solution? Take control! Choose positions where the receiving partner can control the depth and pace. By adjusting the rhythm to what feels good, you can give pleasure the green light again, without any nasty surprises. 

4. Find the right allies: accessories for "comfort"

Sex toys don’t just turn up the heat: they can be wonderful companions for your wellbeing too! 

To limit penetration that feels too deep, adjustable depth-limiting rings can reduce the depth while allowing smooth movement. If you have vaginismus, vaginal dilators can be excellent allies in helping you get used to the sensations gradually and redefine your comfort zone step by step, at your own pace. 

How can you ease pain after sex?

If the pain persists after caressing, it’s time to give your body some gentle, tailored care: 

• Try different temperatures: A cold pack wrapped in a clean cloth and placed on the vulva can soothe feelings of inflammation in no time. If the pain is more in your lower abdomen, a warm hot-water bottle or a lovely warm bath can help tense pelvic muscles relax.

• Moisturise the area: Apply a soothing balm or a restorative intimate-care product to nourish irritated tissues and help them heal faster.

• Wear loose clothing: Give the area room to breathe! Skip the tight jeans and synthetic underwear. Opt for cotton knickers or, better still, very loose pyjamas (with nothing underneath!). 

When should you see a healthcare professional? 🩺

It’s important not to panic, but also to listen to the signals your body sends you. Seeking medical advice is the first step towards taking care of yourself.

Warning signs that mean you should seek medical advice:

• Pain that lasts for several hours or days after sex.

• Abnormal bleeding or unusual discharge during or after sex.

• A fever, chills or intense burning when you urinate.

• Pain that gets worse over time or spreads across the lower abdomen.

• Being unable to attempt penetration without feeling severe pain.

Who can you turn to?

Don’t hesitate to speak to a gynaecologist, midwife or GP you trust. For more targeted support, a physiotherapist specialising in pelvic floor rehabilitation or a sex therapist can help you work through physical and emotional tension with care and understanding.