What Causes Pain During Sex In Females? 

For many women, pain during intercourse isn’t just uncomfortable—it’s confusing and deeply discouraging. You may find yourself asking, “Why does it hurt during sex?” or “What can cause pain during sex even when I’m aroused?” The truth is, there are many reasons—some physical, some hormonal, others emotional—that can cause pain during intimacy.

Table of Contents

What Causes Pain During Sex in Females: Key Reasons
Physical Factors
Psychological Factors
What Can Cause Pain During Sex Beyond Hormones?
Physical Health Conditions
Lifestyle and Medications
Does Sex Hurt? When Pain Signals a Deeper Problem
How to Stop Pain During Sex
Does Painful Sex During Menopause Go Away?
Is It Normal For Sex To Hurt After Not Doing It For A While?
Frequently Asked Questions (FAQs)
Taking Back Control of Your Intimacy — Next Steps with BioRestore

What Causes Pain During Sex in Females: Key Reasons

Pain during sex in females—known medically as dyspareunia—can stem from a variety of overlapping physical, hormonal, and psychological causes. For many women, identifying what causes pain during sex in females is the key to finding relief and restoring confidence in intimacy. 

Physical Factors  

Physical issues are among the most direct answers to “what can cause pain during sex?” These can range from temporary irritation to chronic medical conditions.

Vaginismus

When vaginal muscles tighten involuntarily during penetration, it can make intercourse painful or impossible. Often linked to anxiety, trauma, or fear, this condition causes burning or pressure sensations that make many women wonder, “why does it hurt to have sex?”

Endometriosis

A condition where uterine tissue grows outside the uterus, leading to inflammation, cramping, and deep pelvic pain—especially during intercourse. This is one of the most complex physical explanations for why it hurts during sex and often requires a medical diagnosis.

Pelvic Inflammatory Disease (PID)

A chronic infection caused by untreated sexually transmitted infections (STIs). It leads to pelvic tenderness, swelling, and pain with deep penetration—an often-overlooked reason behind what causes pain during sex in females.

Uterine Fibroids

Noncancerous growths on the uterus that create pressure or pain during or after intercourse, affecting about 50%–70% of women by menopause. Their size and placement often determine the level of discomfort. 

Ovarian Cysts

When cysts swell or rupture, they can cause sharp or stabbing sensations during sex. If sex hurts frequently or unpredictably, cysts may be the cause.

Vaginal Dryness

Among the most common culprits of what causes pain during sex in females, dryness results from decreased estrogen—often due to menopause, childbirth, or stress. It causes friction, irritation, and soreness that make intimacy uncomfortable.

Infections

Yeast infections, bacterial vaginosis, and urinary tract infections (UTIs) all irritate delicate vaginal tissue. These issues make sex feel sore or burning—and often persist until treated.

Psychological Factors

Emotional and mental well-being play a huge role in sexual comfort. Even if there’s no physical cause, stress and anxiety can make many women ask, “Why does it hurt during sex when nothing seems wrong?”

Trauma

Past sexual or emotional trauma can lead to involuntary tension, where the body physically reacts to protect itself. This connection between the mind and body is one of the subtler but significant answers to what can cause pain during sex.

Relationship Issues

A lack of emotional intimacy, trust, or communication can make arousal difficult. Without full relaxation and mental comfort, the body struggles to respond naturally—resulting in discomfort.

Body Image Concerns

When self-consciousness or low confidence enters the bedroom, muscles tense up and natural lubrication decreases. This can make sex hurt even when no physical condition is present.

What Can Cause Pain During Sex Beyond Hormones?

Hormones play a key role in sexual comfort, but they’re not the only factor. Many women experience pain from physical health conditions, lifestyle habits, or medications. Understanding what causes pain during sex in females often means looking beyond hormone levels to see the bigger picture.

Physical Health Conditions

Sometimes the body itself contributes to discomfort. These issues can make intimacy painful even when hormones are balanced.

Pelvic Floor Dysfunction
Tight or weak pelvic muscles can create sharp or burning pain during penetration. It’s a common but often missed cause of why it hurts during sex.

Scarring from Surgery or Childbirth
Scar tissue from C-sections, hysterectomies, or episiotomies can limit flexibility and cause tension or pulling sensations during intercourse.

Chronic Infections
Recurring yeast or urinary tract infections inflame vaginal tissue, leading to irritation and soreness that can make sex hurt.

Nerve or Circulation Issues
Conditions like diabetes can affect nerve sensitivity and blood flow, reducing arousal and making intimacy uncomfortable.

Lifestyle and Medications

Habits and medications also influence what can cause pain during sex by affecting moisture, arousal, and overall sexual response.

Dehydration & Nutrition
Low hydration or nutrient deficiencies can dry and weaken vaginal tissue, increasing friction and pain.

Smoking & Alcohol
Both restrict blood flow, lowering sensitivity and lubrication, impairing the normal sex response. Over time, they can make sex hurt or feel less pleasurable.

Medication Side Effects 
Antidepressants, birth control, and allergy meds can reduce natural lubrication or libido. If why does it hurt during sex is a frequent question, medication may be part of the answer.

Stress & Fatigue 
High stress and poor sleep raise cortisol and lower sex hormones, leading to dryness and reduced desire.

Does Sex Hurt? When Pain Signals a Deeper Problem

It’s not uncommon for women to wonder, “Does sex hurt for everyone, or is it just me?” The truth is, pain during sex in females can be normal in isolated moments—but when it happens often, it may point to something deeper. Recognizing what causes pain during sex in females helps determine whether it’s a short-term issue or a sign of an underlying condition.

Temporary Pain
Usually short-lived and caused by minor, reversible factors such as:

• Lack of arousal or foreplay: Without enough stimulation, natural lubrication decreases, causing friction and mild irritation.
• Improper positioning or dryness: Certain positions or low moisture can cause brief discomfort that improves with adjustments or lubricants.
• Recent abstinence: After time away from intimacy, tissues can feel slightly tight, making initial experiences less comfortable.

Temporary pain is normal on occasion and often resolves with small changes or the use of lubricants.

Persistent Pain
If sex hurts frequently, feels deep or burning, or lasts long after intimacy, it may signal a deeper issue. Signs of persistent pain during sex include:

• Recurrent soreness or pelvic pressure after every encounter.
• Pain that worsens over time instead of improving.
• Discomfort that lingers for hours or days following intercourse.
• Avoidance of intimacy due to ongoing fear or anxiety about pain.

Consistent discomfort is your body’s way of saying something needs attention. If you notice these patterns, it’s time to consult a healthcare provider to explore what causes pain during sex in females and find lasting relief

How to Stop Pain During Sex 

If sex hurts, it’s your body’s way of signaling that something’s off. Instead of ignoring it or relying on quick fixes, it’s important to understand what causes pain during sex in females—because lasting relief starts with addressing the root cause.

Identify and Address the Source of Discomfort

Every woman’s experience with intimacy is unique, and so is the source of pain. The first step to relief is recognizing that ongoing discomfort isn’t normal—and understanding what causes pain during sex in females can guide the right plan for healing.

Instead of treating only the symptoms, it’s important to look at the bigger picture: how your body, hormones, and emotional well-being work together. A personalized approach helps determine whether the issue stems from hormonal imbalance, muscle tension, or tissue sensitivity, ensuring that care targets the true cause rather than just temporary relief.

How Does Lubricant Help with Painful Sex?

Lubricants are often the first step to ease discomfort from dryness. They can:

• Reduce friction and irritation during intercourse.
• Provide immediate comfort when moisture is low.
• Support sensitive skin when using water- or silicone-based formulas.

However, lubricants only treat the surface issue—they don’t fix the underlying hormonal imbalance.

Does Painful Sex During Menopause Go Away? 

Menopause is one of the most common times women experience pain during intimacy. As estrogen declines, vaginal tissue becomes thinner, drier, and more sensitive—a condition called genitourinary syndrome of menopause (GSM).

This leads to:

• Friction and irritation from reduced elasticity.
• Lower arousal and sensitivity due to decreased blood flow.
• Discomfort or burning during or after intercourse.

Hormone Replacement Therapy (HRT) can help. By restoring estrogen levels, HRT rehydrates and strengthens vaginal tissue, improving lubrication and sensation.

Is It Normal For Sex To Hurt After Not Doing It For A While? 

If sex hurts after a long period of abstinence, you’re not alone. After breaks, vaginal tissue can lose some elasticity and blood flow, leading to temporary tightness or soreness.

To ease back into intimacy:

• Take it slow with gentle foreplay and open communication.
• Use lubricants to minimize friction.
• Support hormonal balance—regular activity and hormone therapy from trusted providers like BioRestore help maintain moisture and flexibility.

Frequently Asked Questions (FAQs)

Can stress or anxiety really make sex hurt?

Yes. Emotional stress can tighten pelvic muscles and reduce natural lubrication, making intimacy uncomfortable. Even when no physical condition exists, mental tension can be a key part of what causes pain during sex in females.

How do hormones for women affect sexual comfort?

Healthy hormone levels—especially estrogen and testosterone—keep vaginal tissues elastic, lubricated, and sensitive. When these hormones for women decline, dryness and discomfort can make sex hurt or feel less enjoyable.

Does painful sex mean something is wrong with my relationship?

Not necessarily. While emotional connection matters, physical and hormonal changes are often the main reasons why it hurts during sex. A medical evaluation helps rule out underlying causes.

Can certain lifestyle habits make sex more painful?

Yes. Smoking, dehydration, poor diet, or lack of sleep can affect blood flow and tissue health—factors that contribute to what can cause pain during sex. Small lifestyle changes can often improve comfort and arousal.

When should I see a doctor about painful sex?

If sex hurts frequently, feels deep or burning, or lingers after intimacy, don’t ignore it. Persistent discomfort can signal hormonal imbalance or pelvic issues that require treatment—something the experts at BioRestore in Connecticut can help identify and treat.

Taking Back Control of Your Intimacy — Next Steps with BioRestore

You don’t have to accept pain as part of your sex life. Whether it’s hormonal imbalance, dryness, or underlying medical conditions, there are effective solutions available.

At BioRestore, we specialize in helping women across Connecticut understand what causes pain during sex in females and develop customized hormone therapy plans that address the root cause—not just the symptoms.

Schedule your consultation in Connecticut today!