Sex shouldn’t hurt. I’m not just talking about assault; consensual sex with a partner or masturbation should not include pain. For the purposes of this article, I won’t get into S&M, but if you are into it, great. I’m the last person to judge what you do to get off, and I am not in the business of shaming anyone’s sex life. My point is that if you experience pain during sex when you’re not looking for it, do not tolerate it, ignore it, or power through it. If you have a vagina and enjoy penetration, there are some reasons why sex may hurt.
Just to be clear, when we’re talking about penetration here, we’re including all people with vaginas. This includes transgender and nonbinary folks too. I am also including sex toys, dildos, fingers, and penises when it comes to the object that could be inserted into one’s vagina. Sex does not just happen between heterosexual cisgender men and women, so let’s open our minds while we open up this discussion about painful vaginal sex.
Unfortunately, 75% of people with vaginas experience pain during penetration at some point in their lives. Recurring pain during intercourse is called dyspareunia. When the pain is in the pelvic floor it is called vaginismus and can cause muscle spasms so strong that penetration is impossible—and should NOT be forced. Chronic pain in the vulva or vagina is called vulvodynia. Pain during sex can be both physical and psychological.
If sex is painful, the first thing to consider is this: are you ready? Penetration should not be rushed. Take your time, because a dry vagina is a sore vagina. Are you properly lubricated? If you and your vagina are aroused, it will relax, open, and become wet. External touch and oral sex can help the process. And lube. There is nothing wrong with assisting your body with a water-based lubricant to make sex more enjoyable.
But maybe wetness is not the problem. You are ready! But you experience sudden pain, bleeding, burning, and/or discharge during sex. It’s possible you have an undiagnosed STI and you need to get yourself checked.
If you are experiencing numbness during sex or pain in your anus or perineum (that space right above your anus), it could be from nerve damage. The main nerve that connects the perineum to the external genitals and anal sphincter is the pudendal nerve. It can be damaged during childbirth (episiotomy), vaginal trauma, prolonged sitting, or injuries during exercise or yoga. Damage to this nerve is often unnoticed or undiagnosed, but it has a big job: it communicates information from the vagina and clitoris to the brain and back again. You want this to work during sex.
Some people experience pain every time they have sex. Please don’t power through this. Chronic pain may be from endometriosis or cysts. Cervical sensitivity or bleeding could be a sign of an underlying issue. If you have any of these symptoms, whether they are once in a while or every time you have sex, please call your doctor or gynecologist. It’s not just your sexual health we are discussing; it is your overall health and mental well-being. Because who wants to have sex if it hurts? And if you don’t want to have sex and do it anyway, it’s going to be even more painful because a lack of desire and arousal does not allow the body to relax or do that self-lubricating process I mentioned earlier.
Sometimes the reasons for pain during or after sex aren’t physical. We store trauma in our bodies, and for those of us who have been sexually assaulted, raped, or body and sex shamed, even consensual sex can be painful. We experience memories of fear and stress. We tighten up, disconnect, and hurt. Our autonomic nervous system tells us we are in pain—that is the same system which sends signals of sexual sensations to the brain. The same system that controls pleasure also controls our fight or flight response. Talk to a therapist. Talk to your partner if you can. Fun and pleasurable sex can happen after trauma, but it will take some work and a compassionate partner. Be kind to yourself. Find someone who will be kinder.
Others experience post-sex cramping behind the pelvic bone, but the pain can travel to the back or upper thighs. Some people are sensitive to the oxytocin released during sex and can feel cramps because of that. Other reasons include what is mentioned above as well as urinary tract infection or irritable bowel syndrome. Because UTIs and IBS by themselves don’t already suck enough as it is. Sigh.
Okay, so it hurts when you have sex. What to do? Call your doctor or gynecologist. And be honest. Advocate for yourself, because not only do you not want sex to be painful, you want to enjoy it. Your doctor will have suggestions for you and can rule out possible problems by doing pelvic floor exams, ultrasounds, or other procedures. Physical therapy with a pelvic floor specialist or talk therapy could be the answer too.
If sex is your thing, get it! You deserve to have a great sex life, so try to let go of the bullshit around people thinking vaginas aren’t as worthy or capable of experiencing pleasure as penises. Vaginas are beautiful and powerful and very deserving of love. Okay, fine. I have a vagina and also love vaginas so I’m biased. But I’m also right.
You don’t owe sex to anyone. Not your partner or spouse. Ever. Period. So if you don’t enjoy it, if it’s painful or causes anxiety, don’t do it. If something doesn’t feel right, it’s probably not.
And if you are the one doing the penetrating, pay attention. Focus on your partner. Take note of your lover’s body language and check in. Are they giving you verbal reassurance that what you’re doing feels good? Is your partner tense? Are they wincing? And if you are not sure, which is kind of an excuse, folks because we are all capable of noticing when someone is uncomfortable, ask. And if your lover is showing signs of discomfort, stop. Consent is sexy. Sex should be fun and pleasurable for both people involved.