When Sex Hurts
I was shocked to learn that nearly 75% of women experience pain during intercourse at some time in our lives. Sexual desire and pleasure are portrayed in the media, but not pain – from consensual sex, that is. I’ve not heard much about pain from penetration. Discovering how common it is made me feel less alone to have felt discomfort or soreness in certain moments before, during, or following intercourse.
Here are some possible causes, along with how to address or alleviate, so that sex can bring PLEASURE and JOY rather than pain.
Possible Causes of Pain During Sex
Physical causes can include:
Contact dermatitis A common skin disorder that affects the vulva, which can cause itching, burning, and pain. It is a reaction to an irritating substance such as scented soap, douches, or lubricants.
Vaginitis Yeast or bacterial infections can cause inflammation of the vagina. Symptoms include discharge and itching and burning of the vagina and vulva.
Vaginismus An involuntary reflexive tightening of the muscles at the opening of your vagina.
Childbirth Women who had a surgical incision or tears in the perineum (the region between the vagina and the anus) during childbirth may have pain during sex that may last several months.
Hormonal changes Decreasing levels of the female hormone estrogen during perimenopause and menopause may cause vaginal dryness.
Other gynecological conditions Endometriosis, ovarian cysts, and pelvic inflammatory disease are all associated with pain during sex.
Pain during intercourse can also be due to issues with sexual response, such as lack of desire or lack of arousal. Common reasons that impact sexual response include:
Your state of mind Fear, guilt, shame, embarrassment or awkwardness about having sex may make it hard to relax, which then makes arousal difficult, and pain may result. Stress and fatigue can affect your desire to have sex.
Relationship issues A common relationship issue is a mismatch between partners in their level of desire for sex.
Medications Some birth control and pain medications can reduce sexual desire.
Medical and surgical conditions Diabetes, cancer, thyroid conditions, and arthritis can indirectly affect sexual response. Some women who have had surgery find that it affects their body image, which may decrease desire for sex.
Your partner If your partner has a sexual problem, it can make you anxious about sex. Erectile dysfunction drugs may cause delayed orgasms, which can lead to long, painful intercourse.
History of trauma Past events may affect how you feel about sex.
Medical Care to Address Painful Sex
Diagnosing painful sex can be challenging because it is often complicated by emotional discomfort and shame. Some women are embarrassed to tell their doctors they avoid intercourse because it hurts, and may associate painful sex with sexually transmitted infections or feelings of failure.
If you have frequent or severe pain during penetration, your doctor may be able to determine if you have a medical condition that could benefit from treatment. Keeping a journal with notes on recent sexual activity, feelings, and pain levels could help the discussion, including specific details about exactly where the pain is and when it occurs, such as before, after, or during sex.
In addition to medical treatment, your doctor may also suggest therapy – including desensitization therapy to learn vaginal relaxation techniques such as Kegel exercises, or sex therapy to learn to reestablish intimacy and improve communication with your partner.
Self-Care Measures to Relieve Painful Sex
Aside from discussing potential health conditions and treatments with your doctor or ob-gyn, here are some measures you can try to relieve pain on your own:
Use lube Water-soluble lubricants are recommended if you experience vaginal irritation or sensitivity.
Make time for sex Set aside time for when you and your partner are both rested and relaxed.
Talk to your partner Tell your partner where and when you feel pain, as well as what activities feel pleasurable.
Try non-intercourse sexual activities Focus on oral sex or mutual masturbation.
Try nonsexual but sensual activities Enjoy receiving a massage from your partner.
Take pain-relieving steps before sex Use the restroom, take a warm bath, or take over-the-counter pain relievers before intercourse.
Ice it Relieve burning after intercourse by placing a frozen gel pack wrapped in a towel to the vulva.
Sex can – but does not have to – be painful. If you are experiencing pain during sex, I hope you consider some of these steps to increase your comfort and connection – with your body, and with your partner.