Painful Sex? Let’s Talk About Dyspareunia & How to Fix It
As our Vulva Doctors regularly explain to patients: “pain with sex is called dyspareunia, & this has many different causes. The pain can be felt in different sites: just at the entrance to the vagina; only with deep penetration, in certain positions; or everywhere. People use lots of different words to describe what they feel – stinging, tearing, stabbing, dryness, friction, cramping, pulling, aching, & many others. Some people have pain at the beginning of sex that gets better after they finish, but others find the pain begins after they stop” [1]
Here at the London Vulva Clinic, all our Vulva and Pain Doctors are very sensitive to women’s issues. We understand that this is a subject that has in the past, been taboo. But thanks to leading pioneers (including our Dr Christopher Jenner) who have brought this field to the forefront, mainstream media has recognised the importance of discussing it and informing sufferers that there are now a plethora of options to ameliorate dyspareunia.
Key Cause of Dyspareunia: Nerve & Muscle Issues
Muscle and nerve problems are classed as the most widespread root cause of painful sex. Moreover, this disorder can come about in healthy women of all ages. Indeed, there are numerous aspects that can trigger a muscular or nerve issue. Anything that impacts the:
- Feet
- Legs
- Coccyx
- Hips or
- Spine can generate pelvic floor muscle and nerve problems [1]
As your Vulva Specialist will tell you, injuries to these aforementioned parts of the body are commonplace. They can easily come about through:
- Falls
- Broken bones
- Motor accidents
- Repetitive strain syndrome (for example, from the workplace)
- Scoliosis (favouring the left or right side of the body over the other)
- Unequal leg length
- Uneven weight-bearing
- Activities (such as long-distance cycling or horseback riding)
- Giving birth
- Pregnancy
- Surgery to the vulva or pelvis [1]
Furthermore, other scenarios can also create issues. These comprise:
- Recurring pelvic or vaginal infection
- Vulvovaginal skin conditions (this is particularly prominent with: chronic candidiasis, psoriasis, lichen sclerosus and lichen planus). In this case, your Vulva Specialist will advise you to refrain from having sex until it is rectified. This is because it can generate skin tearing and result in muscle and nerve pain. Sweat, friction, moisture and heat can generate skin issues and flares. To that end, it is crucial to bypass sex until your Vulva Doctor has fully rectified the issue
- Urinary tract infection
- Traumatic sex
- Having overactive pain nerves
- Hormones (at the time of perimenopause and post-menopause, oestrogen levels decrease). The latter enables vagina and vulva tissue to have greater blood flow, be thicker, and have more elasticity. Each of these aspects contribute to comfortable sex. Post-menopause, women experience fragile dry skin [1]
Getting It Sorted ASAP
If you are suffering from painful sex (dyspareunia), do not hesitate to come forward and get it sorted. Here at the London Pain Clinic, our patients are able to request a female Vulva Doctor, if they feel they would be more comfortable. When you have an online or in-person consultation, you Vulva Specialist will first review you medical history and ask you any pertinent questions, They will then arrange for you to have any necessary examination, tests and scans. Then as soon as they have given you can accurate diagnosis, your Vulva Doctor will provide you with a Holistic Personalised Treatment Plan which you can get started on right away. This may be multifaceted and include conventional medication/topicals and the latest cutting-edge therapies and injectables.
Reference
[1]. ANZ Vulvovagina Society (2025). “Painful sex (Dyspareunia) Is it normal for sex to be painful?”
https://www.ascgynaecology.co.nz/site_files/38219/upload_files/Painful-sex-Dyspareunia.pdf?dl=1