How Much Pain During Sex Is Normal? 4 Reasons Intercourse May Be Hurting

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Certified sex educator and writer Emma McGowan reveals why sex may be painful in this week's Sex IDK column.

Q: What kinds of pain and discomfort are normal when having sex and which kinds should I be worried about?

A: One of the most common questions I get at Sex IDK is some variation of, “How do you know when pain during intercourse is normal, and when it is a sign of something else?” Because that question almost always comes from women and other people with vaginas, I'm going to be talking specifically about pain during penetrative sex for those humans.

First things first: Pain during intercourse is never “normal.” If you’re healthy, you shouldn’t be experiencing pain during sex ever — unless it’s the consensual, on-purpose kind of pain. But many women and other people with vaginas do experience pain during penis-in-vagina intercourse. And we’re often told — by health professionals, by our partners, by society at large — that some degree of pain during sex is to be expected.

That harmful belief comes from old — I’m talking Victorian era old — ideas about women and sex. Back in the Victorian era, there was the concept of the “angel of the house,” which was a wife who didn’t actually enjoy sex, but instead submitted to it for the sake of her husband and family. And while we’ve shed the corsets and bustles of the Victorian age, the idea that a “good” woman struggles with sex to some degree still persists.

In addition to the fact that expecting pain during sex is holding onto some seriously messed up, old beliefs, pain during sex can lead to major problems, like couples fighting or one member withdrawing completely.

“If you’re having pain during sex, it’s unlikely you’re ever going to want that sex,” Pam Costa, sex coach and founder of Down To There, tells Bustle. “A lot of the times when I’m doing assessments and it comes out that there’s pain, a lot of clients won’t say that up front, because they think it’s normal. It’s actually not normal.”

So: Pain during sex? That’s a sign that something isn’t going right. But don’t jump immediately to the scary potential medical problems that Google brings back for you. (I'll get there.) First, let's look at what’s actually happening in the bedroom.

1Not Enough Warming Up

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We usually call everything that comes before penetration “foreplay,” but I don’t like that term because it trivializes so many of the awesome, necessary parts of sex. And for many women, that “warming up” period is essential if they’re not going to experience pain during penetration.

Here are some things that happen as you get more aroused. Your vagina and vulva produce more lubricant. Your vagina lengthens and becomes softer. Blood rushes to your genitals, making them more sensitive to touch. All of those are essential for ensuring you don’t feel pain during sex.

So the very first thing you need to ask yourself is whether or not you’re properly aroused before intercourse. And if the answer is “no” — and be honest, because you know the truth — then it’s probably time to make some changes in your sex life.

2The Wrong Position

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Are you experiencing pain in a specific sex position? This is a “Doctor, it hurts when I do this!” problem — if it hurts, don’t do it. If it always hurts when you do it doggy style, for example, either stop doing it doggy style or figure out ways to modify the position so that it doesn’t hurt.

Sometimes the reason it hurts in one position, but not others, is because the penis or toy is penetrating too hard or too far into your body and bumping up against your cervix. If that’s the case, it can help to try positions where you’re in charge of penetration. For example, many people with vaginas find that being on top allows them to be in control of the depth of penetration. You can move up and down as far as you or you can rock back and forth, eliminating the slamming motion that can sometimes come with penetrative sex. (Added bonus for rocking: The head of your clit gets more stimulation!)

There’s also a new wearable called Ohnut that helps couples control penetration. It’s not out to market yet, but you can learn more and sign up for updates in the meantime.

3Not Enough Lubrication

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Another common cause of pain during sex is you’re just not lubed up enough. But no need to stress about it! This is a super solvable problem.

Some people’s bodies produce a lot of natural lubricant — and some don’t. Additionally, certain medications — including hormonal birth control and antidepressants — can reduce the amount of lubrication your body naturally produces. So if you’re not producing enough lubrication on your own, reach for one of the many excellent lubes that are on the market today.

But, quick reminder: Don’t ever use an oil-based lube with condoms, because it can lead to breakage. Stick with water or silicone based lubes instead. Similarly, don’t use silicone-based lube with silicone toys, because it can lead to the toys degrading.

4Possible Medical Issues

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Finally, there are possible medical issues that can make sex painful. I know from experience! I personally found out that I had an ovarian cyst when I started feeling pain during orgasm. Because I’m familiar with my body, I knew that wasn’t a normal feeling for me. I also knew it wasn’t one of the issues listed above, so I went to the doctor. That pain was a warning sign that I was dealing with a bigger medical issue — namely, a cyst the size of an orange — than I’d realized.

Ovarian cysts are just one medical condition that can cause pain during penetrative sex. Pelvic health specialist Rachel Gelman tells Bustle that other common ones are endometriosis, polycystic ovary syndrome (PCOS), fibroids, painful bladder syndrome, and interstitial cystisis, to name just a few. Vulvodynia and vaginismus are two other conditions that can also make sex really painful.

Only you can know if the pain you’re experiencing is due to one of the more common possible reasons listed above, or if it could be a medical issue. And if you’re thinking “Something’s really not right here…” it’s a good idea to make an appointment to see your doctor. They’ll be able to help you figure out what’s going on and, hopefully, find a solution.

If you’re hesitant about going to the doctor, I get it. Many women know from experience that it can be extremely frustrating to try to solve a problem related to our vaginas and vulvas. But Gelman says: Don’t give up.

“If you feel like your provider isn’t being helpful, get a new provider,” Gelman says. “Your treatment plan may not be the same as someone else, and many people need more than one provider on their team. Patients may need to work with a physician, pelvic floor PT, psychologist/sex therapist, acupuncturist, and many others, but the bottom line is that there are a lot of interventions that can help resolve their symptoms.”

While experiencing pain during sex isn't normal, it also may be something you can prevent or treat. Make sure you address the pain — you deserve to enjoy sex.

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