Sex. Sometimes it’s earth-shattering, other times it’s uninspiring. But one thing sex shouldn’t be is consistently painful. We’ve all had those awkward moments, wondering if the discomfort we feel is simply a lack of—ahem—readiness or an actual symptom of something more serious. Here are some common and not-so common reasons sex can hurt and cures.
“At some point in her life, almost every woman will have pain during sex,” says Hilda Hutcherson, MD, assistant professor of clinical obstetrics and gynecology at Columbia University Medical Center and author of Pleasure: A Woman’s Guide to Getting the Sex You Want, Need and Deserve. But that doesn’t mean you have to suffer through it. Pain is an indication that something’s wrong… and most of those somethings are easily treatable.
Vaginal pain is discomfort during insertion and along the vaginal walls.
If you’re taking a medication like birth control or an antihistamine, vaginal dryness can be a side effect. But don’t immediately assume that you should change your medication. “It’s hard enough to find a birth control pill that really agrees with you,” says Dr. Hutcherson. “So if dryness is your only problem, use a water-based lubricant. Incorporate it as part of foreplay: Rub it onto him, then have him rub it onto you.” But if sex remains uncomfortable or you find that the dryness is just one of several side effects you’re experiencing, talk to your doctor to see if she can prescribe another pill.
Lack of arousal.
“For a young woman,” says Dr. Hutcherson, “the number one cause of pain during sex is lack of arousal, most often because she’s not getting enough foreplay from her partner.” When you haven’t had enough time to become fully aroused before intercourse, the vagina isn’t lubricated, causing uncomfortable heat and friction as it is penetrated. Treatment is easy and fun: Just tell your partner you need more time and attention lavished on you to get completely in the mood.
You could have a yeast or urinary tract infection, both easy to treat and not dangerous if taken care of right away. “A month ago, sex started to be really uncomfortable for me,” says Lesley, 24. “I assumed that the guy I had just started seeing was awful in bed. Luckily, before dumping him for lack of chemistry, I visited my doctor and found out that I had a severe yeast infection with none of the usual [white, clumpy] discharge signs.” A doctor will prescribe an over-the-counter or prescription treatment and, if you’re anything like Lesley, the sex after the infection clears should be back to “amazing.”
Pelvic pain during sex is not as common as vaginal pain, but is typically more severe and occurs with deep penetration, not insertion. If you’re experiencing pelvic pain, you should make an appointment with your doctor.
While pain during and after sex is a common sign of endometriosis—a disease in which the uterine lining that sheds during menstruation is trapped outside your uterus, causing pain and sometimes infertility—the most obvious sign is killer cramps. Which is why even though millions of women in the world have endometriosis, many aren’t diagnosed with the disease for years. There’s a “toughen up” mentality that some doctors have about pain,” says Mary Lou Ballweg, president of the Endometriosis Association. To better explain to your doctor how much pain you’re in, Ballweg recommends downloading a diagnostic kit from the Association’s website and tracking your symptoms. “Just don’t,” stresses Ballweg, “stay with a doctor who tells you the pain you’re feeling is ‘normal.’” Treatment for endometriosis typically starts with birth control pills and pain killers, but might also include surgery to remove the tissue.
Cristina, 27, felt sharp, stabbing pain on her right side every time she and her fiancé had sex. “I chalked it up to the stress of planning my wedding,” says Cristina. But the culprit was an ovarian cyst: a painful, fluid-filled growth on one of the ovaries which usually goes away on its own and most commonly occurs in women ages 20 to 35. (Smokers beware: You’re twice as likely to develop an ovarian cyst.) Cristina’s doctor checked the cyst with an ultrasound, recommended she take Ibuprofen an hour or so before sex and then rechecked her a couple months later to make sure the cyst was gone. If a cyst doesn’t go away on its own, it may need to be surgically removed before it bursts or “pops”—which can lead to infection and infertility. And if you suffer from frequent cysts, your doctor may put you on the pill or change your birth control to better regulate your hormones and keep you cyst-free.
If you have pelvic pain during sex, don’t think the worst. “It is very unusual for a young woman to have a malignant tumor,” stresses Dr. Hutcherson. But although the likelihood of having ovarian, uterine or cervical cancer is slim, it’s something to ask your doctor about if you’re experiencing pain and irregular bleeding. More likely, the pain is resulting from a more common cause like one of the ones listed above.
Whatever the cause of your pain during or after sex, be smart with your body. “Your sex life is an important aspect of your health and who you are, so it’s something you need to feel comfortable about talking over with your partner AND your doctor,” says Dr. Hutcherson. “You deserve to have a great sex life.”