6 Things To Know About Pain During Sex

by JR Thorpe
Curly and black-haired lady's face surrounded by many different condom packages

I've listened to a lot of women, both straight and queer, talk about sex through the years, and there are, in my experience, two normal reactions to experiencing pain during sex. One is to ignore it and hope for the best for fear of "rocking the boat" or discovering something awkward, and the other is to be convinced that you're dying and your vagina is going to fall off/uterus is exploding/cervix is a secret vampire. (Note: I can pretty much guarantee that your cervix is not a secret vampire.) Both of these are driven by one thing: misinformation. You're probably not going to die, but you still should get it checked out. The cure for pain during intercourse may be simpler than you think.

There are two key things that you should know about pain during sex. One, you're not alone, not even vaguely. And two, it's very important not to ignore it. If you're shy talking to your GP about this, see if you can find a gynecologist or visit a medical clinic specializing in sexual health. Even if it just turns out to be bruising because you and your partner went a little too hard too fast, you still need to get it checked out. As you'll discover, the range of possible causes of sexual pain is diverse, and some of them can be pretty serious. Plus, you deserve to enjoy your sexy-times as much as the next person, without constantly worrying about the looming threat of pain.

Oh, and if your partner gets sulky because you're in pain and can't do the things they want: dump them. Seriously. Ain't nobody got time for that.

1. It's More Common Than You Think

According to the American Council Of Obstetricians And Gynaecologists, nearly 75 percent of all women will experience pain in intercourse — by which they mean vaginal penetration, whether by fingers, toys, or other peoples' genitals, plus foreplay, touching, and post-coital resting — at certain points in their life. This massive number reflects the sheer amount of things that could be responsible for it. So you aren't alone by any stretch of the imagination.

It's even got its own specific medical term: dyspareunia, which covers every kind of pain about intercourse, including before and after. That's one of the things to keep in mind about vaginal pain during sex: it still counts if it's just in the general time frame of arousal, not just at the time of insertion.

2. Lack Of Foreplay May Be The Cause

One of the most common causes of vaginal pain, even if you believe mentally that you're raring to go and absolutely ready on every level, is insufficient lubrication of the vagina — which often means, yes, that you likely haven't had enough foreplay. A mismatch between your body and mind's levels of arousal, or perhaps just your own enthusiasm or will to please, may mean that you get busy before you're entirely ready.

It's a matter of time management: mental arousal occurs before actual blood flow to the genitals and production of natural lube. And by before, it takes an average of five to seven minutes for the body to get into the game. Lack of lubrication means that foreign objects find their way more difficult, and that the internal tissues of the vagina are more likely to be bruised or damaged. Ouch.

3. Vaginal Dryness In General Is A Common Culprit

Dryness, as we've covered, does not lead to a happy sexual time, but it may not be the fault of insufficient foreplay and arousal. Getting yourself properly lubed up may be trickier if you're doing certain things that dry out the vagina. Too many hot baths and showers, allergy medications, antidepressants, douches or powders aimed at making the vagina "smell" nicer (those are not good for you ) can all contribute to an interference in the vagina's lubrication levels, and the result is a desert.

Hormonal fluctuation can also be a cause here. It's most often associated with the menopause, but women on certain types of low-dosage estrogen birth control may also find that their hormonal balance throws off their "flow," as it were. Hormones keep the genital mucus membranes, or vaginal epithelium, producing moisture, and an adjustment of those levels can create dryness and pain. Charmingly, the technical term for this is "vaginal atrophy". Be still my beating heart.

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4. A Condition Called Vaginismus Might Also Be To Blame

It's not all about dryness. There's one little-known condition that often causes serious pain during sex, and it's not herpes or endometriosis or anything else to do with infections and bacteria: it's called vaginismus, and it causes serious contractions in the muscles of the vagina.

We're not sure what causes vaginismus (it's common, for instance, in survivors of rape and assault), but the condition means that the vagina essentially panics when anything tries to enter it, whether it's a tampon or something sexy, and has a spasm. It's completely involuntary and may be associated with fear or anxiety, painful experiences in sex before, negative beliefs about sex, or other psychological factors. Treating it will involve therapy as well as muscle treatment.

5. Locating The Pain Will Help "Finger" The Problem

Sorry for the pun, but it does seem as if tracking the precise locations and times of pain during or around intercourse can help to figure out what might be wrong. You have to be Vagina Sherlock. There are lots of places where pain can occur, from the vulva itself to the vagina, uterus, cervix, even your perineum, or bladder.

Vulva pain, for instance, might be caused by vulvodynia, a skin condition that makes the vulval skin feel burning or raw, or by a skin infection. If you feel pain deep within your pelvis, the cause may be fibroids on the uterus, or pelvic inflammatory disease. If you get the pain only when it collides with your cervix during seriously deep penetration, it's likely cervical problems causing something called "collision dyspareunia". Keep note of where and when it hurts, the occasions and situations, and take all the evidence to the doctor: it'll help immeasurably when it comes to narrowing down the cause.

6. There Are Some Unexpected Culprits

Some conditions are pretty easily linked to pain around sex. STDs, bacterial infections of the genitals, endometriosis (in which the womb lining grows over other organs too), ovarian cysts: they're pretty cut-and-dry. But a few conditions rear their head to be part of the picture too, and they may take you by surprise.

Irritable Bowel Syndrome (IBS), for instance, is often a cause of sexual pain in sufferers. IBS tends to cause havoc in the menstrual cycles and general pelvic discomfort of female sufferers, and sex can also mean that something collides with the intestine, causing immediate pain. Perineum tears can also be a cause of (obvious) ouchies, and if you have an undiscovered ectopic pregnancy, where a fetus has developed in a fallopian tube instead of the uterus, sex is going to be hell. Finally, some women have a condition where their hymen still causes blockages in the vagina after they officially lost their virginity.

The Bottom Line

If the cause isn't immediately obvious, you may be surprised what you and your doctor find. If you've got pain during sex and aren't sure why, go to the clinic prepared for internal investigations, potentially painful skin-scrapings, and some very clear questions about what you get up to in the bedroom. Take along a friend if necessary. And don't worry, they aren't going to judge you; they just want to track down the culprit and help you lead a pain-free life, because you deserve it.

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