Sex is something many of us expect to feel good. It can be a source of connection, pleasure and closeness, and when that changes, it can leave you feeling worried, frustrated or quietly wondering whether something is wrong with you. The answer, almost always, is that something is happening in your body that has an explanation, and often a very treatable one.
If sex has become uncomfortable, painful or simply joyless, you are far from alone. Many women go through exactly this, at different stages of life and for very different reasons. What matters is knowing that you do not have to just put up with it.
Why doesn’t sex feel good any more?
The reasons sex can stop feeling good are wide-ranging, and for many women, more than one factor is at play at the same time. Physical causes, hormonal shifts, emotional responses and relationship dynamics can all overlap, which is part of why this can feel so hard to unpick on your own.
What is worth knowing from the start is that a loss of sexual pleasure is a recognised medical concern. It isn’t a personal failing, and it’s not something you should feel embarrassed to raise with a doctor. A good gynaecologist will have heard it many times before, and will approach it with exactly the care and discretion it deserves.
The most important thing to take away? In most cases, there is a clear reason, and a path forward. Yes, you can get back to an enjoyable sex life once again!
Why sex hurts
Painful intercourse, known medically as dyspareunia, refers to pain that occurs before, during or after sex. It might feel like burning, stinging, aching, sharp discomfort or a sense of tightness, and it can be felt at the entrance to the vagina or deeper within the pelvis.
A British population study published in the journal BJOG found that around 7.5% of sexually active women in the UK, roughly one in thirteen, experience persistent painful sex. Given how rarely many women report it, the true figure is likely higher.
The location and character of the pain can tell a doctor a great deal about what is going on. That is why a proper assessment is so valuable, rather than trying to manage or dismiss the pain on your own.
Let’s look at some of the most common causes.
Vaginismus
Vaginismus is a condition where the muscles around the vagina tighten, making penetration painful or sometimes impossible. It’s not something a woman does consciously or can simply will herself out of. The tightening is a reflex response, and it can be triggered by anxiety, a previous painful experience, or even the anticipation of pain itself. Over time, this can create a cycle that becomes harder to break.
Vaginismus can develop at any point in life, including in women who have previously experienced sex without difficulty. It can follow childbirth, a difficult procedure or a stressful period, or appear with no obvious trigger at all.
The encouraging news? It responds well to treatment. Pelvic floor physiotherapy, vaginal trainers and psychosexual therapy are the most commonly used approaches, but are not always successful. At The Gynae Centre, we combine these with Botox treatment to relax the muscles around the vagina to allow penetration and to break the cycle. With over 90% of our patients making a full recovery, and the outlook for women who seek help with us is genuinely positive.
Vulvodynia
Vulvodynia is persistent pain or discomfort in the vulva for which no obvious underlying cause can be identified. The pain is real, it can be considerable, and yet many women wait a long time before receiving an accurate diagnosis, partly because the condition is still not as widely understood as it should be.
The pain tends to be described as burning, stinging, throbbing or a feeling of rawness. It may be constant or intermittent, and often gets worse during or after sex.
Sex and persistent pain of this kind can affect far more than the physical. Confidence, relationships and emotional wellbeing can all suffer, and that matters just as much as the physical symptoms.
Again, treatment is available and effective for many women. Depending on the woman, this might include topical treatments, pelvic physiotherapy, nerve block injections or cognitive behavioural therapy. Many women find the most benefit from a combination of approaches, guided by a specialist who understands the condition well.
Hormonal changes and the menopause
For women in perimenopause or beyond, declining oestrogen levels are one of the most common reasons sex becomes uncomfortable. As oestrogen falls, vaginal tissues can become thinner, drier and less elastic. Without adequate lubrication and tissue health, penetration can cause friction, irritation or even small tears, which is as uncomfortable as it sounds.
A survey of women in the UK found that a quarter of women aged between 50 and 50 experience vaginal dryness and problems during sex, with 16% experiencing pain.
Here’s where the good news comes in: it’s one of the most treatable causes of painful sex. Topical oestrogen therapy, vaginal moisturisers, lubricants and systemic HRT where appropriate can all make a real difference. Discomfort during sex is not an inevitable part of getting older, and it does not have to be accepted as such.
Infections and STIs
It’s worth mentioning infections as a cause of painful sex, because they’re frequently overlooked. Thrush, bacterial vaginosis and urinary tract infections can all cause localised soreness or inflammation that makes sex uncomfortable.
Sexually transmitted infections, including chlamydia, gonorrhoea, genital herpes and trichomonas, can also cause pain during sex, sometimes alongside other symptoms and often with very few signs at all. If there is any chance an infection could be contributing to what you are experiencing, getting tested is a simple and worthwhile step. STIs are common, they carry no moral weight, and most are straightforwardly treated.
The emotional weight of it all
Living with chronic pain and intimacy difficulties is genuinely hard. When sex consistently hurts or feels wrong, the ripple effects can be significant. Anxiety about future encounters, distance in relationships, a sense of loss around what sex used to feel like, and a quiet erosion of confidence are all experiences many women describe. None of that is trivial, and all of it is worth addressing.
Psychosexual therapy can be a valuable part of recovery for many women, not because the pain is imagined, but because pain and emotion are deeply connected, and both deserve care.
“So many of the women I see have been living with painful or uncomfortable sex for far longer than they needed to. I want women to know that there is no threshold you have to meet before asking for help. Whether you’ve been dealing with this for a few weeks or several years, you deserve a proper assessment and a clear answer. In the great majority of cases, we can find out what is going on and we can help,” explains Dr Alex Eskander, Consultant Gynaecologist, The Gynae Centre.
Getting back to enjoying sex
Whatever is behind the symptoms you’re experiencing, if sex doesn;t feel good anymore, the most important thing to hold onto is this: Things can get better. Painful intercourse isn’t a life sentence, and for most women, with the right diagnosis and treatment, a comfortable and fulfilling sex life is very much achievable.
At The Gynae Centre, our consultants offer thorough, confidential assessments for all concerns relating to sexual health and gynaecological wellbeing. If something feels wrong, or if sex has simply stopped feeling the way it should, come and talk to us. The first conversation is often the hardest, and also the most important.
Get in touch with our team to book a consultation, and let’s work together to help you start enjoying a pleasurable and fulfilling sex life once again.
