Vaginal Dryness and Pain During Sex: What to Know

Pain may occur at the vaginal opening, deeper in the pelvis, or in both areas. Dryness can cause burning, stinging, friction, or small areas of irritation. You do not need to tolerate pain or continue sexual activity when it hurts.

Vaginal dryness can happen when oestrogen levels change, including around menopause, after childbirth, or during breastfeeding. Some medicines, hormonal contraception, stress, and products such as perfumed washes may also contribute. Reduced arousal can limit natural lubrication, but pain can then create muscle tightening and make the next attempt more uncomfortable.

Pain during sex is also a presentation of conditions such as genitourinary syndrome of menopause, vulvodynia, endometriosis, ovarian endometrioma, pelvic inflammatory disease, or lichen sclerosus. These conditions have different patterns and treatments; pain alone cannot identify which one is present. Bleeding, unusual discharge, itching, skin changes, urinary symptoms, or pelvic pain can help a clinician narrow the cause.

Pause penetration if it causes pain and talk with your partner about other forms of intimacy. A water-based or silicone-based lubricant can reduce friction during sex; a vaginal moisturiser may help ongoing dryness when used as directed. Avoid putting soap, douches, scented products, or household oils inside the vagina, because they can irritate tissue or damage some condoms.

Use gentle, unscented cleansing on the outside only and choose breathable underwear. Arrange an appointment with a gynaecologist or primary-care clinician if symptoms continue, return, or interfere with sex. They may ask where the pain is, review medicines and hormonal changes, examine the skin and vagina, and test for infection when indicated. Treatment depends on the finding and may include targeted local or hormonal care, pelvic-floor therapy, or treatment for an underlying condition.

Seek urgent medical help for severe or rapidly worsening pelvic pain, fainting, heavy bleeding, fever with pelvic pain, or feeling acutely unwell. Prompt assessment is also appropriate for pain with a new sexual partner, foul-smelling discharge, sores or blisters, or bleeding after sex that keeps happening.

Book a routine appointment for ongoing dryness, repeated painful sex, vaginal itching, skin whitening or cracking, pain with urination, or symptoms that began after a medicine or procedure. Keep a brief record of timing, pain location, bleeding, discharge, menstrual or menopause changes, and products used; this can make the consultation more focused.

You could ask: Could a medicine, hormonal change, infection, skin condition, or pelvic condition explain my symptoms? Where do you think the pain is coming from? Should I have an examination or tests? Which lubricant or moisturiser is suitable for me? What symptoms should make me seek urgent help?