Pain during sex is common, but that doesn’t mean it is *normal.* According to Healthline, estimates of how many women have experienced pain during sex ranges anywhere from 10 to 28 percent. (This language—and these studies—could be more inclusive of different gender identities, but the numbers are still staggering!) If you’re experiencing intercourse pain (dyspareunia) often, you should consult your doctor to make sure it’s not a sign of something more serious. This blog should help you guide your conversation with your gyno.

Lots of things can cause pain during sex. First, ask yourself “what, when, and where?” What kind of pain is it? (Burning, poking, scratching?) When do you experience the pain? (Is it the entire time you’re being penetrated or tied to specific sex positions?) Where is the pain coming from? (Maybe you feel it deep inside or closer to your vulva.) These simple questions can help you be more specific in your search for answers. Here are some possible causes of pain during sex.

vaginal dryness

Sex always feels better when you’re wet! Up to 78% of people with vaginal dryness report pain during sex. There are tons of factors that can interfere with wetness: not being in the ~mood~, psychosomatic symptoms, menopause, not enough foreplay, not enough lubricant, taking antibiotics, or, as this writer discovered the hard way, getting on antidepressants. And that’s just to name a few. If you suspect the vaginal dryness is the culprit of your pain, we suggest switching up your sexual routine. 

In postmenopausal folks, vaginal dryness can be caused by the body’s natural drop in estrogen. Some suggest taking Replens or consider taking estrogen as a topical cream, injectable tablet, ring, or more. There are also non-estrogen based options available to combat dryness after menopause! Get the deets from your doc. 

pain specifically within the vagina

While arousal and wetness is absolutely a factor in having feel-good sex, it’s by no means the only thing responsible for causing discomfort! If the pain is inside the vagina (not the deeper pelvic region), it could be due to an STD or STI. Common causes include yeast infections, gonorrhea, and chlamydia. Perhaps your ~V~ is irritated or inflamed due to shower products such as vaginal douches, fragranced soaps, or shampoo. 

For more severe pain, you could possibly have vaginismus, a condition where the muscles in/around your vagina tighten whenever confronted with the possibility of penetration. It’s a fear-based response that’s out of your control. The resulting pain tends to make intercourse (or tampon insertion!) very difficult, if not impossible. Treatment for vaginismus includes seeing a sex therapist, pelvic floor physical floor therapist, or practicing safe penetration with other objects to adjust to the sensation. For a diagnosis and treatment plan, talk to your doctor. 

If you’ve had a baby, you could be experiencing pain due to changes in your post-baby bod (from hormone imbalances to potential nerve damage). If this is you, contact your doctor to find out what—if anything—has changed due to childbirth.

pain on the vulva

You can also experience pain during sex on your external organs (like the clitoris or labia!). This could be vulvodynia, a chronic pain condition that impacts the entire vulva and occurs, on average, around age 30 to anywhere between 3% to 14% percent of women. (Yet another moment to demand more inclusive studies!) 

The most common form for premenopausal bodies is burning near the opening to the vagina known as provoked vestibulodynia. The irritation can ebb and flow, or move around to different areas of the vulva, and still be considered vulvodynia. While there is no cure for vulvodynia, there are many options to help ease the pain such as self-care practices. Your doctor can help you develop a plan that works for you.  

pain felt within the entire pelvis

This type of pain is often caused by conditions affecting internal organs like endometriosis, irritable bowel syndrome, constipation, or pelvic inflammatory disease. While these conditions cause pain during sex, they are typically coupled with other symptoms affecting your life. Take note of anything else your body is experiencing that seems abnormal. Maybe it’ll help guide your doctor towards a diagnosis! You may want to ask your doc about pelvic floor physical therapy, which could help you learn to relax your pelvic muscles.

what to do next

1. Track your period.See if there’s any correlation between where you are in your cycle and when you experience pain. As we all remember from high school science, correlation is *not* causation (and mitochondria are the powerhouse of the cell!), but this info can be super helpful to share with your doc and provide some insight on what’s going on down there! 

2. Switch up your sex life.It’s time to explore new things, and hopefully, you’ll find a better—and wetter—position. New positions! New lubes! New toys! New anything! Communicate with your partner about your pain and see what you both are comfortable exploring. (About ⅓ of partners are unaware of their partners’ pain.) Pay attention to what, if anything, changes!

3. Rule out any underlying medical conditions.This is the part where we tell you, yet again, to talk to your doctor! Make sure you’re tested for STDs, STIs, and examined for any other possible causes like fibroids. Discuss if any prescriptions could help you!

4. Consult a sex therapist.I’ve experienced pain during sex more than once… and as a result, I became very nervous about having sex. Suddenly, it became a self-fulfilling prophecy! Wetness was unattainable. I was so afraid it would hurt, I shut down. To get back in the groove, talking to a professional can really make a difference. They can provide resources, tips, tricks, and even new recommendations for toys and positions to help you relax.

5. Don’t judge yourself.Remember: Sex is supposed to fun. You can’t shame yourself into a good time. For folks who experience pain during sex, there can be a lot of pressure to pretend you’re okay. Don’t! Be honest about what’s going on. Find both a doctor and a partner that take both you and your pain seriously. Judgment won’t fix anything. 

Have you ever experienced painful sex? What helped you enjoy yourself again? Let us know in the comments.

Amanda Melhuish was formerly a Brand Copywriter at Thinx. She’s also a comedy writer whose work has been published on Reductress, Women in Comedy Daily, and Weekly Humorist. She writes and performs sketch comedy regularly at The Magnet Theater. Check out her work (and upcoming shows) on her website. You can also follow her on Instagram.

by Amanda Melhuish