Quick: describe what sex feels like in one word. Hopefully, you chose something along the lines of “fantastic” or “orgasmic.” But for some, words like “uncomfortable” or “intolerable” would be far more accurate.
If your sexual encounters are met with irritating or even excruciating pain, there’s a wide range of reasons this could be happening — from a lack of lubrication to a rare disorder, or even a partially intact hymen. But, most importantly, there are ways to fight back and reclaim an amazing, pain-free sex life.
Read on to find out what could be causing your pain, plus expert tips on how you can get it taken care of, so you can get back to gettin' busy.
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The first step is to figure out what’s wrong. More often than not, especially if you’ve never experienced painful sex before, your symptoms are caused by an infection. “Vaginal or pelvic inflammation from a yeast infection, bacterial vaginosis, or chlamydia can cause significant pain,” says Dr. Leah Millheiser, assistant clinical professor at Stanford University Medical Center and director of the Female Sexual Medicine Program. If you have an infection, you’ll most likely feel a burning sensation, along with itching and a funny discharge. Thankfully, these are easily treatable once diagnosed, usually by an antibiotic prescribed by your doctor or even an over-the-counter medication.
Another common cause of discomfort is vaginal dryness. When this is the case, the walls of your vagina will feel like sandpaper every time you attempt penetration. If you’re not properly lubricated, there’s no way a penis — or anything else — is getting in there. Most women experience some form of dryness from time to time, and that’s perfectly normal. If your mind is wandering or you’re not getting along with your partner, it may be harder to get as slippery as you’d like. But dry sex can cause tears in the vaginal walls, causing even more stinging and irritation, so avoid this outcome by grabbing a bottle of lube as soon as sex starts feeling uncomfortable. Choose one that’s silicone-based—not water-based—for extra moisture.
If dryness isn’t just an occasional happening, and you’re having sandpaper sex even when you’re incredibly turned on, there may be a deeper cause. “Recent studies show that in about 3% of young women, birth control pills can cause dryness,” says Dr. Lauren Streicher, assistant clinical professor of Obstetrics and Gynecology at Northwestern University's medical school, The Feinberg School of Medicine. If your pain began after starting the pill, a good fix may be switching to a new form of contraception, such as an IUD. The pill isn’t the only culprit, so check the side effects of any other meds you’re taking, and you may find the source of your problem.
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On the other hand, if the pain you’re feeling is deep inside you and goes away when you switch positions, your partner may have just hit your ovary or uterus. This isn’t a problem as long as it doesn’t happen all the time. “There’s a big difference between something that happens once and goes away, and a pain that lingers,” says Streicher. “If a deep pain persists even after thrusting stops, it’s time to see a doctor.” You may have an ovarian cyst or even endometriosis.
Now for the more serious stuff. There are some diagnoses that are both physical and mental. For example, if your vagina reacts to sexual contact the way a mousetrap reacts to a mouse, you may have vaginismus, a condition characterized by involuntary spasms of the pelvic floor muscles. “Vaginismus could be an anxiety response caused by a fear of pain or intimacy,” says Millheiser. “It can happen after sexual trauma, or in women who’ve grown up with a background that frowns upon premarital sex.” While vaginismus may be a primarily psychological issue, your vagina is probably acting like a Venus fly trap in order to protect itself from something that’s been painful in the past. It will probably take retraining of the vaginal muscles with a physical therapist — teaching them how to relax — before you’re able to have sex again.
Vulvodynia, another rare and debilitating condition, affects the tissues surrounding the entrance to your vagina, making them excruciatingly sensitive to touch. “Vulvodynia causes the outside and opening of the vagina to be horribly painful,” says Streicher. “Women with really bad cases can’t even put a tampon in or wear tight jeans without being uncomfortable.” While some women have always suffered from this condition, others develop it over time. You’ll need to see a doctor for treatment, which may involve medication and pelvic physical therapy.
Finally, if you’ve never been able to be penetrated because of the pain, you may have a hymen that’s partially intact. This means there’s a physical barrier preventing you from having intercourse. If you have this condition, you may have no problem with a tampon or a finger, but anything bigger is a different story. “Some women will have what’s called a septated hymen, where there’s tissue from their hymen that goes right down the middle from the top to the bottom,” says Millheiser. “When they try to have intercourse, it’s extremely painful because that little sliver is being pushed.” If your doctor determines that your hymen is the cause of your pain, you may have to have surgery to remove the remainder.
No woman should let pain come between her and a fantastic sex life. So if you feel like something’s wrong, get it checked out. “The best thing you can do is to be your own advocate and ask your physician about your sexual health concerns,” says Millheiser. “If your gynecologist doesn’t answer or blows it off, get a referral to someone who’s an expert in sexual dysfunction.” Don’t shy away from asking for help. Your toes should be curling in pleasure, not pain, and wanting that is nothing to be embarrassed about.