Pain during sex (Dyspareunia): more common than you think

Pain during sex isn't just in your head, and you don't have to live with it. From hormonal changes to infections to pelvic floor tension, we'll find the cause and help sex feel comfortable again.

Online and in-person appointments available in Los Angeles, San Francisco, New York and Scottsdale

Common Symptoms We Treat:

  • Pain with any vaginal penetration, including tampon use
  • Deep pain during intercourse, especially with deeper penetration
  • Burning, stinging, or aching during sex
  • Cramping during sex, including around your period
  • Bleeding, discomfort, or pain after sex
  • Urinary urgency or burning with urination after sex
  • Pain that's getting worse over time

Potential causes of pain during sex:

  • Vaginal dryness, including from perimenopause, menopause, breastfeeding, or medications
  • Vaginal infections, such as yeast infections, bacterial vaginosis (BV), and UTIs
  • Sexually transmitted infections (also known as STDs)
  • Endometriosis
  • Vulvodynia or vaginismus
  • Pelvic floor dysfunction

Dyspareunia, the medical term for pain during intercourse, usually has an identifiable cause, and it's usually treatable. Whether it's burning, sharp pain, deep aching, or cramping, we'll listen without judgment, find what's behind it, and create a Care Plan that helps sex feel comfortable again.

How the Sexual Wellness Appointment Can Help

  • A Conversation without Judgement: Your Tia provider will review your symptoms, medical and sexual history, and medications to identify possible causes or triggers. This part of the visit can happen virtually or in clinic.
  • A Gentle, Guided Exam: If needed, your provider may recommend a physical exam, including a pelvic exam, to pinpoint where the pain is and look for clues. You set the pace, and you can pause at any time.
  • Testing When Needed: Vaginal cultures, STI testing, blood work, or an ultrasound may be recommended to confirm a diagnosis.
  • Personalized Dyspareunia Treatment: Depending on the cause, your Care Plan may include treatment for infections, lubricant guidance, prescription vaginal estrogen or topical creams, pelvic floor physical therapy, or a referral for counseling or sex therapy.

The Tia difference

1. We take pain during sex seriously

Painful sex is often dismissed or brushed off. We validate your experience and give you an honest space to talk about it, even if it's been overlooked elsewhere.

2. We treat the body and mind together

We recognize how pain during intercourse can affect your confidence, mood, and relationships, and your Care Plan addresses the physical and emotional sides of it.

3. We offer real options, not just "try lube"

From prescriptions and vaginal estrogen to pelvic floor therapy referrals and mental health support, we build a plan that fits your body and your life stage.

Insurance and Pricing

Is this covered by insurance?

Yes! Tia will bill your insurance for your visit. Just like at any doctor’s office, you may be responsible for a co-pay or coinsurance, depending on your health plan.

If not, what is out of pocket cost? We are clear and transparent about pricing. Out-of-pocket costs are detailed here. Tia also offers Predictable Payments so cost is not a barrier to your health.

More accessible care with capped, predictable payments

We cap our monthly billing until your balance is paid off to help make women's healthcare more accessible, affordable, and fear-free.

  • Bills over $250 are capped at $250 per month
  • Receive one simple, clear invoice each month
  • Spread payments to keep costs manageable
  • Focus more on your health, less on your payment plan

Our experts in Sexual Wellness

Where to get an appointment

FAQs

Is pain during sex normal?

Sex should not be painful and pain can impact your ability to experience pleasure and intimacy. We believe you deserve a vibrant sex life, and we'll get to the root of your pain—from hormonal changes to muscle tension—so you can get back to feeling great.

Does sex hurt after menopause, and what can I do about it?

Painful sex during and after menopause — dyspareunia — affects 12–45% of women and is largely caused by vaginal atrophy and dryness due to declining estrogen. It's common, but it's also treatable. Options include vaginal estrogen therapy, over-the-counter lubricants and vaginal moisturizers, pelvic floor physical therapy, and systemic HRT. A 2025 study also found that regular sexual activity is associated with a lower prevalence of vulvar pain and dryness.

Why do I get cramping or pain during sex around my period?

Hormonal shifts and a more sensitive cervix and uterus can make sex uncomfortable right before or during your period. But if you regularly have cramping or deep pain during intercourse, it may be a sign of an underlying condition like endometriosis, fibroids, or ovarian cysts, and it's worth getting checked.

Additional resources

When "Ouch!" Replaces "Ooh!" - Understanding Pain During Sex and What to Do About it
Tia Tackles

When "Ouch!" Replaces "Ooh!" - Understanding Pain During Sex and What to Do About it

Understanding Sexual Dysfunction in Women
Tia Tackles

Understanding Sexual Dysfunction in Women

Book an appointment

Pain during sex can affect your confidence, your relationships, and how you feel in your own body, and it's often hard to bring up. A visit helps uncover what's really going on, whether it's hormonal changes, an infection, pelvic floor tension, endometriosis, or something else. We'll listen without judgment, find the root cause, and create a personalized plan to help sex feel comfortable and enjoyable again.