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30 Jan 2017 (Last updated 22 Jan 2024)

Pain during sex: causes and tips

Sexual Health 6 min read
Expert Dr Jessherin Sidhu
Author
pain during penetrative ex, cucumber and a vaginal vibrator being held
Featured

For us to talk about pleasure as much as we do, it’s also important to acknowledge that many of us vulva owners may feel the exact opposite during sexual activity.

It is that little burning sensation, that tightness, or discomfort from penetration. Pain during sex, solo or partnered, is very common. In fact, 8 in 10 women have experienced pain during sex. Yet, it doesn’t mean we should accept painful sex as the norm. Sex isn’t supposed to hurt

We’ve worked with sexologists to get the lowdown on the causes of painful sex, to help normalise vulva owners talking about it. The more we discuss, the less we will continue to suffer or feel anxiety around the pain- and ultimately uncover advice and ways for more pleasure.

Why do we feel discomfort or pain during penetrative sex?

Heard of dyspareunia? This is the medical term for pain that occurs during or after intercourse. A lot of the time, discomfort or pain comes from one fact: the vagina or vulva is not moist enough. Lubrication is a natural phenomenon that prepares the vagina for penetration, and when this process is not working properly, the penetrative movement creates friction on the dry membrane, which will cause itchiness or pain. So, why would your body not do its job, and naturally lubricate?

According to our experts, there are two key types of causes to painful penetrative sex: physiological and psychological/environmental.

Physiological causes of vaginal dryness.

The most common physiological causes are:
  • Hormonal imbalances: the contraceptive pill, pregnancy, menopause, chemotherapy, PCOS, and other circumstances can trigger a hormonal imbalance that can lead to vaginal dryness.
  • Infections: local infections in the vagina like yeast infection can also cause vaginal dryness. Common infections like yeast infection can be very rapidly settled with medication, but it is always good to check with your doctor.

Psychological & environmental causes of vaginal dryness.

The main psychological and environmental causes that shined through our research are:
  • Stress
  • Insufficient arousal and stimulation to help the body lubricate
  • Dehydration
  • Food can also have an impact on the vaginal flora, hence on your vagina's health

The usual suspects. So, here’s the thing: lack of natural lubrication is in most cases a very normal thing, just as not being hungry when we are stressed or having dry skin when we don't hydrate enough. Relief for those of us that worry there’s something wrong. Rather, natural lubrication will fluctuate throughout our lives, impacted by daily stresses, situations, and changes – especially for those that do or have menstruated. So, cut yourself, your vagina, and your vulva some slack. Let’s downplay the ‘always wet’ conjecture!

Tips to relieve vaginal dryness.

Perhaps it goes without saying, but the way to counteract lack of lubrication is to add more lubrication! If you ever experience vaginal dryness, it means your body is just asking for a little help, and the help is here: outercourse and intimate lubricants.

Outercourse to help natural lubrication.

Outercourse is THE basis for smooth (and fun!) sex. Outercourse, which includes all sexual acts that are NOT penetrative, basically covers 90% of the options on the menu. From sexting to strip teases and clitoral masturbation. It builds up excitement and can also lead to orgasm(s). All this is a great way to trigger vaginal lubrication. So, before you even think about penetration play, prepare your body. Whether solo or partnered, keep on exploring outer pleasure spots and techniques. You are not lacking options in this field!

Note: partnered sex goes way beyond penetration and is especially important to remember if your partner has a penis. Intercourse is just one form of sex, so may it is just penetrative sex that you find painful. Worth a thought!

Intimate lubricants for extra help.

Lubricants, if chosen well, are here to support us when we need that extra glide. They are the perfect accessory for your bedside table, to be used alone or with a partner.

First of all, intimate lubes are a great way to make outercourse more fun (hint: using fingers, yours or your partner's), and will add extra smoothness if your vagina is having a lazy day. If you feel discomfort during penetration, and outercourse is not helping with lubrication and you really want to proceed; see how it feels to apply lubricant on your partner's penis/strap-on/your sex toy and re-apply any time you need.

  • If you are using a condom, make sure your lubricant is condom compatible.
  • If you’re using a silicone sex toy, make sure you use a water-based lube.

Other things & conditions that cause pain during sex.

Some of us vulva owners experience pain beyond dryness or penetration. As we always say, our overall mental and physical wellness is affected by our sexual health and vice versa. Things that may not seem directly related to pleasure (or pain), can really impact our sex lives. Similarly, certain experiences can cause trauma – and our body carries trauma in ways we often are not aware of.

Vaginismus.

A physical reaction to trauma in which the muscles of the vagina tighten up or the pelvic floor spasms, making penetration extremely hard and therefore painful. Trauma can be through past lived pain, surgical concerns during pregnancy for example, or from negative sexual experiences. A reminder that our mind and pleasure anatomy are closely connected!

Vulvodynia.

A consistent, ongoing pain in the vulva (the external part of our genitalia) that does not have an overt cause such as bruising etc. This kind of chronic pain can be experienced as burning, stinging, throbbing or soreness; it can be spontaneous, or triggered by touch. Localised vulvodynia can also be referred to as vestibulodynia – a more focused pain around the vaginal entrance but still external.

Pelvic floor health.

The pelvic floor is a group of muscles that act as a sling to support organs such as the bladder, bowel and uterus. The muscles also assist with sexual function and continence. Pregnancy can affect the pelvic floor, and in turn, a mother’s sexual pleasure. Stress on the muscles, birth trauma and hormonal changes can all lead to pain during sex.

Pain during anal sex.

Anal sex can be super pleasurable for vulva owners and penis havers alike. But, and it’s a big butt but, the anus does not naturally lubricate! No matter how much outercourse you enjoy, lubrication is simply not a function that comes with our behind... Outercourse will still have a very positive effect on an anal experience, but we HIGHLY recommend using a thick lubricant that will last for easier penetration. Anal sex is all about slooow insertion and breathing deeply – and plenty of lube!

We can experience pain in other ways too, and it’s important to talk with a professional if the pain recurs and is ruining your pleasure potential. Reading about other people’s stories with overcoming pain to gain pleasure also helps us feel less alone!

Extra resources.

Listen to our 15 minutes podcast episode 'Pain During Sex', where gynaecologist Dr Jess shares tips on how to navigate pain for a more pleasurable sex life.


Sources: Smile Makers consumer studies in France, UK, Taiwan, Belgium, Hong Kong and Australia.
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