NOTE: This is primarily for vulva and vagina owners! Other kinds of pain won’t be addressed here.
Sex shouldn’t be painful. Discomfort at the start of things is one thing, as you settle in and your arousal increases that should disappear. But pain? That’s not right. Let’s look at some common causes of pain during sex and how to remedy them.
Dryness
Your vaginal “wetness” shouldn’t be the only indicator of your arousal. Sometimes I can be very aroused, but not wet at all. Emily Nagoski describes it as arousal non-concordance in her book Come As You Are, which I cannot recommend highly enough. Grab some Sliquid or your favorite brand and lube up.
This is one I struggled with for a long time. Years! It’s an involuntary muscle spasm in the pelvic floor that causes your vaginal walls to slam shut making penetration extremely painful, if not impossible. Mine was based in my anxiety. After traumatic experiences, it can be really easy to let fear take over and worry that all experiences will be painful, so you tense up, which makes it painful, which makes you tense up more… you get the picture.
Infection
Typically, vagina owners will notice something is off before pain during sex occurs. Whether it’s a change in vaginal discharge or a fishy smell emanating from your underwear, deviations from your norm can mean there’s a chance of infection. Trichomoniasis can cause pain on insertion, such as a pelvic exam. (The doctors who tested me will tell you this. Sorry for your eardrums, doc.) It’s super common, and a lot of penis-wielders don’t have symptoms, but lucky vagina owners can be met with a yucky smelling vag and pain or itching. It feels a little like a yeast infection. You’ll need an antibiotic, but it usually resolves itself within days once you’ve taken your medicine. Yeast infections, chlamydia, gonorrhea, even things like strong perfumes in soaps that cause irritation can make for painful penetration and intercourse.
So… Now What?
Once you’ve determined the cause of your pain during intercourse, you can do a few things:
- Take a break: If it’s a one-time thing, maybe you just need to focus on other things besides penetration. Some days are just better than others, and that’s okay!
- Use more lube: There seems to be some sort of stigma with lube… that if you need it, you’re not into sex or your partner isn’t doing a good job or the stars haven’t aligned or whatever. None of that is true, and lube can make sex a much more enjoyable (not to mention safer) experience.
- Masturbate more and work up to penetration: If you’re just starting out with penetration, masturbating alone can be helpful. You can start with smaller insertables, experiment with movement, and learn to relax your pelvic muscles while there’s something inside you.
- Relaxation exercises with or without dilators: When I dealt with vaginismus, my doctor recommended a set of graduated dilators. There were five in the set, ranging in size from about a pinky finger to a larger than average penis. They weren’t realistic at all, just smooth, white plastic with a handle, and I would insert one with lube and relax for 15 minutes per day. Eventually, I learned how to relax my muscles effectively enough that intercourse is rarely painful or difficult anymore. It’s also helped with my pelvic exams! Wiggling my toes and focusing on my breathing makes getting my regular pap smears much less painful.
- See your doctor: Especially if you think you might have an infection of some sort, give your doctor a ring. Sometimes there are bigger underlying causes that need treatment, sometimes there are topical creams or prescriptions that may help. If you’re nearing or in the throes of menopause, prescriptions can help. If you’re dealing with pain that doesn’t fit the above causes, it could be something like endometriosis, or a low cervix, and your doctor will need to be the one to evaluate you and plan your next steps.