Why Does Sex Hurt Sometimes?
When I first had sex, I assumed it would be like it is in the movies where women always hang from the chandeliers, blissfully orgasmic and filled with pleasure. Certainly, sex can be just like that. But often itís not. Not only do some women have trouble achieving orgasm, especially from intercourse alone, but many also experience searing pain.
My first sexual encounter hurt like the dickens and didnít let up for a decade. Sex hurt so much that every time my husbandís penis came close, my body clammed up, as if to say, ďNo way in hell is that thing coming anywhere near me.Ē Fortunately, things got better and Iím now enjoying a rocking sex life with my honey, but I know Iím not alone in having suffered from painful sex.
As both an OB/GYN and survivor of†vulvar vestibulitis (inflammation of the glands that line the entrance to the vagina), I thought Iíd put together a few FAQís to help you out, in case you or anyone you know suffers from painful sex.
FAQ’s About Painful Sex
What are some less serious, common causes of vaginal pain during intercourse?
If youíre trying to have intercourse when youíre not aroused, lack of lubrication can cause friction and lead to pain. Even if you are aroused, decreased lubrication caused by hormonal deficiencies (such as†atrophic vaginitis, which can occur when estrogen levels are low after menopause or while breastfeeding) can lead to pain.
Other common causes of pain during intercourse include gynecologic conditions such asvulvar vestibulitis (inflammation of the vestibular glands at the vaginal opening),vaginismus (involuntary contractions of the vaginal muscles that may make intercourse painful — or even impossible), and†vulvodynia (non-specific vulvar pain, which is often experienced as an intense burning feeling).
How do you know if pain during sex signals something seriously wrong?
If youíve never had pain before, and all of a sudden sex hurts, itís a good idea to get checked out by a doctor. New onset of pain can signal a sexually transmitted disease (like gonorrhea or chlamydia), endometriosis, an ovarian cyst, a bladder condition like interstitial cystitis, scar tissue, or in very rare cases — a cancer.
Other medical conditions that can cause pain include vaginal dryness resulting from menopause or breastfeeding (atrophic vaginitis) or vulvar pain disorders such as vulvar vestibulitis, vulvodynia, and vaginismus. While these are not health-threatening, I speak from personal experience when I say that theyíre definitely happiness-threatening and should be investigated.
What can women do to prevent/lessen the pain if sex hurts?
Inadequate lubrication can be remedied with sexual lubricants, such as Astroglide or KY Jelly. (My personal fave is the all-natural option — coconut oil. But donít blame me if youíre jonesing for a post-coital macaroon! Keep in mind that coconut oil can break down condoms so only use it if youíre in a committed monogamous relationship.)
If you lack lubrication because of hormonal reasons, when used properly, vaginal estrogen is life-saving and safe — but youíll need a prescription, so talk to your gynecologist. My personal fave is the bioidentical vaginal estrogen called†estriol which is very safe and preferentially improves vaginal health without some of the downsides of the more commonestradiol.
If you suspect that you might be suffering from other conditions, such as vulvar vestibulitis, vaginismus, or vulvodynia, see your doctor. These conditions can be treated with things like Xylocaine jelly, antihistamines, vaginal dilators, pelvic physical therapy, and other options. Just remember, nobody should have to suffer during sex. Itís supposed to be fun!
What can their significant others do to lessen the pain?
Make sure sheís adequately aroused before intercourse is attempted. Go down on her first! Then let the woman be in charge of penetration. Go slow. Let her try being on top so she can control the pace and depth of thrusting.
What are some non-medical steps that can be taken to prevent/soothe the pain?
What level of pain should prompt a visit to the gynecologist?
In my opinion, any recurring pain during sex should be investigated by a gynecologist. That doesnít necessarily mean anything is wrong, but itís clearly not as right as it should be. Sex is not supposed to hurt, and thereís almost always a way to improve things. So donít be afraid to ask for help!
Have you ever had pain with intercourse? Do you have pain now? What helps you?
Rooting for happy, healthy, pain-free sex,
Lissa Rankin, MD: Founder of†OwningPink.com,†Pink Medicine Woman coach, motivational speaker, and author of†Whatís Up Down There? Questions Youíd Only Ask Your Gynecologist If She Was Your Best Friend and Encaustic Art: The Complete Guide To Creating Fine Art With Wax.
Learn more about†Lissa Rankin here.