Demystifying Painful Sex: Dyspareunia - Causes, Symptoms, & Solutions

Written by: Dr. Joshua Gonzalez

Passionate. Prurient. Euphoric. Painful? One of these things is not like the other. But perhaps by NYT Connections standards, these four words could all be used to describe someone’s sexual experience.

Let us be the first to say, sex should never feel painful. Unless you’re into that sort of thing. Here at Popstar, we never kink shame. However, if whips and chains do not excite you and intercourse is painful, it should be cause for concern. Today, Popstar has the tips (and so much more than just the tip) on what could possibly be causing you pain in lieu of pleasure.

What is Dyspareunia?

Dyspareunia. While it may sound like some obscure fever you would read about in a Louisa May Alcott novel, dyspareunia is, in fact, the scientific term for painful sex. Dyspareunia is categorized as recurring or persistent pain during intercourse that is present for three months or longer. It can be related to numerous factors, both physical and psychological alike. Though it may not be the way it was intended, painful sex (dyspareunia) is also not uncommon. In fact, studies show that 1 in 5 men and even 3 in 4 women experience pain during intercourse at some point in their lives.

Symptoms and Signs of Dyspareunia

Pain : This may seem a bit redundant, but the first sign of dyspareunia is pain during or after intercourse. It can range from mild discomfort all the way to severe pain.

Burning Sensation : Not the type of burning we want in the boudoir. We want burning love a la Elvis, not a burning sensation like chlamydia. Another sign of dyspareunia is experiencing a burning sensation during intercourse or even burning with urination after sex is over.

Tenderness : Those dealing with dyspareunia may feel tender during, after, or even before intercourse.

Difficulty achieving and maintaining an erection : Having a hard time staying hard? This may be a sign of dyspareunia. Some people may find it difficult to keep the wind in their sales due to the pain involved with intercourse.

Causes of Dyspareunia

As aforementioned, the causes of dyspareunia can be both physical and psychological ranging from STIs to everyday stress. Let’s explore.

Physical Factors

Infection and Inflammation : Infections can cause pain during intercourse. UTIs and STIs alike can make sex less than enjoyable and sometimes painful. Other conditions such as prostatitis (inflammation or infection of the prostate) can cause discomfort or pain during intercourse.

Injury : Perhaps you’re dealing with a Grey’s Anatomy McSteamy penile fracture. Pause for wincing. Trauma to the genitals as a result of accident or surgery can also make intercourse painful.

Peyronie’s Disease : Peyronie’s disease is a condition where scar tissue builds in the penis, causing your carrot to curve. Peyronie’s disease may also make erections painful, therefore making intercourse difficult.

Phimosis : No, it is not the antithesis of osmosis. Phimosis is the condition where the foreskin is too tight. Like your shaft’s sweater is one size too small. While “tight” usually has a positive connotation in the bedroom, overly tight foreskin can lead to pain during penetration.

Psychological Factors

Anxiety and stress : While psychological factors such as anxiety, depression aren’t directly the cause of dyspareunia, they can contribute to or exacerbate the issue. Performance anxiety coupled with the fear of painful intercourse can keep you in your head, potentially leading to further sexual dysfunction.

Trauma : If you are a survivor of a negative sexual experience, trauma can lead to pain during intercourse.

Medical Conditions

Neurological disorders : Conditions that affect the nervous system, such as multiple sclerosis or neuropathy, can cause pain during intercourse.

Hormones levels : There he is again, our temperamental, testy, yet necessary best friend, testosterone. Hormone imbalances such as low testosterone can lead to a laundry list of problems including sexual function, potentially leading to painful intercourse.

Medication : Side effects of certain medications can manifest as sexual dysfunction and genital pain, making sex all the more difficult.

If you are experiencing pain suring sex, fret not. There are ways around it. Of course, your treatment may vary depending on your specific needs.

Treatment of Dyspareunia

If you are experiencing pain during sex (dyspareunia), fret not. There are ways around it. Of course, your treatment may vary depending on your specific needs.

Medical Intervention

Antibiotics : If your pain is due to an infection, antibiotics can be prescribed to clear it up and you will be back to knocking boots in no time (or however long the prescribed dosage lasts).

Surgery : If your pain is caused by Peyronie’s disease or phimosis, surgical intervention is possible. Don't let curvature or foreskin issues curb your fornication!

Physical therapy : Working with a physical therapist to rehabilitate your pelvic floor can help relieve pain and improve muscle function.

Pain relievers : If you are looking for short-term, immediate relief, over-the-counter or prescription pain relievers can alleviate discomfort. Again, this is a short-term fix, much like putting duct tape on a leaky pipe. Eventually you are going to want to speak with a healthcare provider to find a more permanent solution.

Hormone Therapy : If a hormone imbalance is the cause of your discomfort, hormone replacement therapy could be the cure. A routine blood test can be used to measure hormone levels and see where you may need a little boost!

Psychological Intervention

Therapy and counseling : Addressing underlying psychological issues such as anxiety, depression, or relationship problems can help improve sexual function and reduce pain.

Lifestyle Changes

Meditation, breathing techniques, and mindfulness can all help reduce anxiety and stress surrounding sex. To learn more about mindfulness and sex, click here.


When it comes to sex, communication is always key. Keeping communication open and honest with your partner can ensure that you are comfortable, feel safe, getting your needs met, and enjoying the experience. If you are experiencing dyspareunia, speak to a medical professional to see what is contributing to your pain and what course of action is best for you. Remember, knocking boots shouldn’t knock you on your behind. The sooner we address dyspareunia and find the underlying cause, the sooner you and your partner(s) can get back to using positive descriptive words regarding your sex life!

Dr. Joshua Gonzalez

Dr. Joshua Gonzalez

Dr. Joshua Gonzalez is a board-certified urologist who is fellowship-trained in Sexual Medicine and specializes in the management of male and female sexual dysfunctions. He completed his medical education at Columbia University and his urological residency at the Mount Sinai Medical Center. Throughout his career, Dr. Gonzalez has focused on advocating for sexual health and providing improved healthcare to the LGBTQ+ community.