Today’s society is considered to be the most progressive yet. From advances in the rights and treatment of disenfranchised groups to a greater acceptance of viewpoint diversity, the 21st century might just be the best time to be alive. At the same time, there is so much progress to be made—for instance, regarding sex and sexual health. The word sex itself is often considered a taboo, let alone sexual health. It shouldn't and doesn't have to be this way. Women and men shouldn't have to struggle in silence. According to the American Congress of Obstetricians and Gynecologists (ACOG), three in four women experience pain during sex at least once. Most pain is generally short-term, but it can often develop into a long-term problem. Here are the main reasons you experience pain during sex and what you can do about it.
1. It's your first time
Losing your virginity is a deeply personal situation. No matter your age or relationship history, many women experience pain the first time that they have sex.
Samantha Petersen, a senior at Minnesota State University, experienced a lot of pain the first time she had sex. “When my cherry was popped, it was very painful and I never wanted to do it again. I realized this was a one time thing and it gets a lot better!”
However, not every first time involves the tearing of your hymen, which can also occur due to injury or exercise. Regardless, from taking it slow to talking with your partner beforehand, there are several ways to make your first time less painful.
At the same time, sex should not be severely painful. "Sex is not supposed to hurt," says Dr. Katherine O’Connell White, MD, MPH and Assistant Professor of OB/GYN at the Boston University School of Medicine. “Sex isn’t always really painful when you start if you’re with a gentle and responding partner. If you take it slow, and especially use lubricant, it doesn't have to hurt. If sex makes you sore, it should be better within a few hours.”
The short story? Don't get stressed out by the horror stories you read online.
2. Your arousal is low
Having a low sex drive can be the result of several factors, ranging from side effects of medications to a hormone problem.
“The most common reason for pain during intercourse is the simplest one - not enough foreplay,” says Dr. White. “The average woman needs 20 to 30 minutes of foreplay before her body is ready for intercourse.” While you might not have this much time (like if your roommate’s getting back from class soon), according to Dr. White, rushing is the worst thing you can do. “If you’re not getting 20 to 30 minutes, when intercourse starts, [your] body isn’t ready.”
Speaking of not-sexy, being as dry as a desert isn’t pleasant, so using lube can help with arousal. “Everyone should use lube,” says Dr. White. “It can be pretty sexy to put it on each other. Lube has a lot of purposes, too. It can be helpful for a handjob and if you’re going to engage in anal intercourse, lube is absolutely essential for it to be safe and pleasurable.”
Using a water-soluble lubricant is recommended by the ACOG if you have experienced "vaginal irritation or sensitivity." Lube can even help with preventing tears in your vaginal tissue, decreasing your stress.
3. You’re stressed out
Whether it’s coming from your end or your partner’s end, a mismatch in sexual desire can often cause stress and pain during intercourse. Sex shouldn’t be something that you’re dreading, and if it is, we recommend talking it out with your partner. If they’re not understanding or willing to communicate, it might be time to evaluate the relationship.
“Anybody who you are considering getting naked with physically, you should feel comfortable with getting naked emotionally,” suggests Dr. White. “Honesty and being direct is the best way to go. Say, for instance, ‘I’m a little bit nervous about sex hurting and I’ve heard that if we take it slow and use lube, that things might be better for me, and I hope that’s okay with you.’”
Amanda Hoffman*, a senior at California Polytechnic State University, was super stressed after getting an intrauterine device (IUD). “I was so nervous that it would either be painful for me or that he'd be able to feel the strings,” she says. “I was in so much pain the entire time that I went to my doctor. She reassured me, telling me that my stress was causing me the pain, not the IUD. Turns out she was right. Once I was able to relax a little, it was enjoyable again.”
While pain during your sex isn’t all in your mind, according to Dr. White, “the mind is a very powerful part of sex too.”
“The more engaged and excited and aroused that you are, the less it is likely to hurt,” she suggests. So, if you’re having any negative feelings, “your body [can] become more tense and less lubricated, causing more discomfort.”
Think about why you’re uncomfortable. “Any kind of sexual play should be with a person you really want to be with,” Dr. White says. “You should be comfortable with what you’re doing. Your body is going to follow your mind, and if you are feeling really happy and secure about what you’re doing, your body will respond to that. Being sure that you’re with the person and the right place doing the things you want to be doing is the best way to reduce stress.”
Have sex when both you and your partner are a little less stressed. There’s no reason to rush.
Related: What to Do When You Like Someone But the Sex is Bad
4. You’re in the wrong position
Spicing up your sex life isn’t the only reason to try out some new positions. Don’t be hesitant to try them especially if you’re experiencing pain in the current positions that you and your partner tend to use.
“Women being on top is a good position because it lets you control how deep he goes inside you and the speed of sex,” says Dr. White. “Being able to control both of those things will help you stay comfortable at all times during intercourse.”
According to Dr. White, positions with deep penetration might be uncomfortable, like doggy style or the knees-to-ears position. In addition to being on top, she recommends spooning, since it always limits how deeply your S.O. goes.
Veronika, a student at the University of Toronto, says that when she experiences pain during intercourse, it's often because of an awkward position. “It most often happens when my partner's penis isn't angled properly and ends up hitting my cervix,” she says. “This usually happens if my partner's penis is a bit big (oops!) and regular positions like missionary or from behind start to hurt on impact. To remedy this, we usually switch to either me being on top or doing it while we're lying down on our sides.”
Stephanie Murray, a junior at Savannah College of Art Design in Georgia, also recommends trying positions different than missionary. “Missionary, no matter how much foreplay or sexual attraction with my partner, I always bleed.” She believes that ovarian cysts are to blame for her discomfort, which brings us to...
5. You have a health issue
Pain during sex can be the sign of a serious gynecological condition. They're not just ‘women’s troubles’ or something to be taken lightly. If you experience frequent or unusual pain during intercourse or feel any unusual lumps down there, reach out to your doctor. That's what they're there for, after all!
“Vaginal infections, especially yeast, can lead to pain with intercourse,” says Dr. White. “They tend to have symptoms, particularly vaginal discharge and sometimes odor."
On the other hand are sexually transmitted infections (STIs). “STIs might not have symptoms, but they are harmful. You should be screened for them regularly at least once a year, as soon as you’re engaging in vaginal or anal sexual intercourse, no matter how young you are," Dr. White says.
Like most things in life, there’s also some middle ground: trichomoniasis. “It’s often lumped with the vaginal infection, but it is an STI that often has symptoms, like an unusual odor and a lot of discharge,” says Dr. White. “If you feel any symptoms, be sure to get evaluated by a clinical professional.”
Sophia Durst* also struggled with pain during sex due to a yeast infection. “I thought yeast infections only caused itching and redness, so at first, my boyfriend and I were really worried,” she says. “However, I later found out that the burning was just another symptom of a yeast infection and that I should wait until my infection is cleared to have sex again. It's fairly common, so I don't want other girls to be unnecessarily worried!”
Dr. White confirms this. “Vaginal yeast infections are very common,” she says. “When women come into the clinic, if it’s an infection, it’s usually either bacterial vaginosis (BV) or yeast. BV is incredibly common but not a large concern in the sense that it’s not an STI, and it doesn’t have any serious health risks unless someone is pregnant.”
Dr. White often hears about endometriosis, which she finds is more common with women with very painful periods. According to the National Institute of Health, 11 percent of women have endometriosis, one of the most common and painful reproductive disorders, whether they are aware of it or not.
A retroverted uterus is found in about 47 percent of patients with endometriosis. “Having a retroverted uterus is often not talked about, however,” says Dr. White. “The uterus and cervix are like a seesaw. If the uterus tips back, the cervix tilts up. This isn’t dangerous regarding fertility, but it results in the cervix being bumped easier during intercourse, causing a deep aching or cramping feeling.”
While endometriosis is common, it’s definitely not the only health condition that has pain during sex as a side effect or even the most common.
“Besides infections, a cervical polyp can cause bleeding during sex,” says Dr. White. “This growth inside the cervix which gets irritated during sex is not common in college age women, but it is a possibility. Vulvar pain disorders, not surprisingly, can also cause pain. If you’re experiencing pain with tampons or even tight jeans or light touch in the vulva area, you might also have pain during intercourse.”
As always, before you self-diagnose, be sure to visit your doctor and discuss any issues you're having!
*Names have been changed.
