Painful sex is not something to put up with

Many women believe that pain during sex is natural and has to be tolerated. It is not. Pain is the body's way of saying something is wrong. It is not your fault, and you do not need to hide it to please a partner. If it hurts, you have every right to stop or say no.

Possible causes include:

• not enough lubrication, stress or certain medicines;
• thrush, bacterial vaginosis or sexually transmitted infections;
• irritation from soap and other products, or skin conditions;
• vaginismus, when the muscles tighten involuntarily;
• vulvodynia, lasting pain in the vulva with no clear cause;
• changes after childbirth or healing stitches.

This type of pain is sometimes linked to endometriosis, pelvic infection, ovarian cysts or fibroids. Bladder or bowel problems can play a part as well.

Fear, a difficult past experience, shame or tension in a relationship all affect how the body reacts. This does not mean the pain is imaginary. If you have been through violence, or someone is pressuring you, you do not have to endure that. Talking to a doctor or psychologist can help.

The doctor will ask where and when the pain starts, and will examine you only with your agreement. Treatment depends on the cause. It may involve treating an infection, hormonal products, pelvic floor physiotherapy or psychological support. You and your doctor can choose together what suits you.