What Is Dyspareunia and What Does Painful Intercourse Actually Mean?
If sex has ever been painful for you, you are not alone. Yet for many women, trans and non-binary people, painful intercourse is something that’s endured quietly, often without language, validation or support.
Dyspareunia is the medical term used to describe pain before, during or after sexual intercourse. While the term itself can sound clinical and detached, the experience is anything but.
Painful Sex Is Not One Single Experience
Dyspareunia can look and feel different from person to person. Some experience pain right at the entrance of the vagina, often described as burning, stinging, tearing or sharp discomfort. Others feel pain deeper inside the pelvis, which may feel like aching, pressure or stabbing sensations. For some, pain lingers after sex has ended.
Pain can be consistent or unpredictable. It may happen every time, only with penetration, only in certain positions, or only during particular life stages.
All of these experiences are valid.
Dyspareunia Is a Symptom, Not a Diagnosis
One of the most important things to understand is that dyspareunia is not a single condition. It’s a description of pain. That pain always has contributing factors, even if they haven’t yet been identified.
Painful intercourse may be influenced by:
• Hormonal changes affecting tissue health and lubrication
• Pelvic floor muscle tension or dysfunction
• Inflammation or infections
• Chronic conditions such as endometriosis or vulvodynia
• Nervous system sensitisation
• Previous experiences of pain or trauma
• Emotional and relational stress
Often, it’s not just one factor, but a combination.
Why Pain Is Often Missed or Dismissed
Sexual pain is still poorly understood and under-researched, particularly when it comes to people assigned female at birth. Many clients tell me they’ve been told that pain is “normal”, that they need to relax, or that nothing appears wrong.
Pain that doesn’t show up clearly on scans or tests is often minimised. This does not mean it isn’t real. Pain is a nervous system experience, and the absence of obvious pathology does not invalidate it.
The Role of the Nervous System
Painful sex is not only about tissues and muscles. The nervous system plays a central role.
When the body anticipates pain, it becomes protective. Muscles tighten, breathing changes, and sensitivity increases. Over time, the nervous system can become sensitised, meaning it responds more strongly and quickly to stimuli that feel threatening.
This is not something you consciously choose. It’s the body doing its best to protect you.
You Are Not Broken
One of the most painful parts of dyspareunia is not the physical sensation, but the story people tell themselves about it. Many feel defective, ashamed, or disconnected from their sexuality.
Pain is not a failure of your body. It’s communication.
Understanding what dyspareunia actually means is the first step toward reclaiming trust in your body and opening the door to compassionate, effective support.