HBO Entertainment
Sammy Nickalls
March 10, 2016 1:40 pm

Sex is supposed to feel pretty darn great, so it can be unsettling — not to mention, frustrating — when you feel pain instead of pleasure. Pretty soon, it can become hard to relax when you start to get intimate because you’re anxious about what’s to come. Why’s it hurting down there when you’re just trying to have a good time tangling up the sheets?!?

The good news is that if sex is painful, you’re not alone. According to the American Congress of Obstetricians and Gynecologists (ACOG), nearly three out of four women experience pain during sex (also called dyspareunia) at some point during their lives. There are several reasons why you could be experiencing pain during sex and while some of them may call for a consultation with a doctor, others could be easily fixable.

Here are 10 reasons sex might hurt. . . and what to do about it.

1. Jumping in too fast

As they say, you wouldn’t go down a slip-and-slide without any water. If you’re not “warmed up,” so to speak, the vagina won’t be properly lubricated, and this can lead to some seriously uncomfortable friction that feels a bit like sandpaper. . . which doesn’t exactly lead to pleasurable sex.

The solution: Luckily, the way to fix this is really, really fun: more foreplay. Make sure you’re properly warmed up to ensure the best lubrication before sex, and communicate with your partner to let them know what really turns you on (toys, perhaps?). There is no set amount of time that foreplay is supposed to last, so take as long as you and your partner need.

2. Not using lube

Sometimes, your brain can be ready to go but it’s just not translating to your situation down there. And that’s totally OK! Human bodies are all different and some days you may not get very wet no matter how aroused you feel. There are factors like medications that can affect your ability to be properly lubricated. Plus, it can take several minutes for the brain to communicate the fact that you’re turned on to the rest of your body. However, the fact remains that having sex without any slippery factor can lead to some serious pain.

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The solution: Lube! There’s a stigma associated with lube, with many women feeling like they’re supposed to get “ready to go” with no help, but it’s totally, 100% OK to use lubricant. In fact, it’ll make everything feel much better for both parties, and you don’t have to use it every time — just the days when you need an extra boost.

That said, if dryness seems to be a perpetual problem, see a doctor to find out if there are other options for you.

3. You’re not really feeling it.

Maybe you’re hooking up with someone, and you suddenly realize he or she has terrible B.O. Maybe you have gnarly period cramps. Or maybe you’re about to have sex with your long-time partner, but your libido isn’t matching up to theirs on this particular evening. Going from “yay!” to “meh” is also completely normal sometimes. However, trying to make sex happen when you’re not mentally present can lead to some pain, mainly due — once again — to a lack of lubrication.

The solution: You have two options, both of which mean being completely honest with yourself and your partner. You can either tell your partner that you just don’t feel up to it tonight, or you can let them know that you’ll need a little extra ~attention~ to get things going the right way. Either way, he or she should understand.

4. Stress

Sure, sex can be very relaxing, but you have to be relaxed to have it. That is, you have to relax your muscles down there — and when you’re feeling really stressed out after a particularly hard day at work or school or because of family, it can be difficult to do let go … which can lead to some pain during sex.

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The solution: If you’re feeling really on edge, ask your partner for a massage. Your shoulders, your neck, your lower back, your thighs … anywhere you feel tight. Massages can help you physically relax while also turning you both on. Get some body oil involved to make things extra steamy. (Just don’t use the body oil as lube—it can break the condom!) 

5. Feeling ashamed

If you feel ashamed of having sex — perhaps due to religious beliefs or body insecurities — it can be difficult to relax those pelvic muscles, which can cause that painful response. Sex, as many people say, is mostly mental.

The solution: Of course, you should never feel ashamed for your own sexuality and sex life, but many people struggle at different points in their lives. If you’re feeling complicated emotions about having sex or about your body that are preventing you from having sex, it’s best to address them before continuing further — either by working through them personally, talking to a loved one, or potentially seeing a therapist.

6. Vaginismus

It’s possible to tense your pelvic muscles when you’re stressed, but vaginismus is a step further than that. Vaginismus is a seemingly involuntary spasm of your muscles in response to penetration, much like you’d automatically blink if something touches your eye. It can lead to burning, painful sex due to tight muscles, and in severe cases, it can make penetration seemingly impossible. It’s often caused by a psychological fear of pain during sex or by past trauma, such as sexual abuse.

The solution: If you suspect you may have vaginismus, consult your OB-GYN for an official diagnosis. But don’t fear — vaginismus is highly treatable! You can work with your doctor to figure out the best treatment plan.

7. Vaginal infections

There’s literally nothing fun about having an infection down there. An infection, like a UTI or a yeast infection, can cause pain when you’re trying to get busy.

The solution: If you have an infection, it’s likely you’re experiencing other symptoms as well, such as burning, itching, a funky smell, or pain during urination — so see a doctor for a diagnosis. Many times, an infection just requires taking an antibiotic for a week or two, and then you can get back down to business as usual.

8. The cervix being touched

Everyone’s vagina is a different shape and size. For some people, certain positions and angles hurt them because their cervix was touched, and this causes pain or discomfort.

The solution: This is more likely to be the problem if the pain goes away after changing positions, so if that’s the case, work together with your partner to find positions that don’t cause you pain. Not all positions work for everyone, and that’s totally normal!

9. Endometriosis

If you feel a cramping, aching feeling deep within your pelvic area during sex, it’s possible that you’re suffering from endometriosis, a condition where the endometrium (a mucous membrane) grows outside of the uterus instead of inside. Other symptoms include very heavy periods and particularly painful cramps. Endometriosis affects one in 10 women in the U.S., according to the Endometriosis Foundation of America.

The solution: If you suspect you may have endometriosis, talk to your doctor, as it requires an official diagnosis and could vastly affect your quality of life and your fertility if untreated. Treatment often involves pain relievers and hormone therapy.

10. Vulvodynia

If the pain is located on the outside and the opening of your vagina when you have sex, it’s possible that you have vulvodynia, which makes the tissues surrounding the entrance of your vagina highly sensitive (and not in a good way). This can cause pain not only during sex, but when wearing tight pants or exercising.

The solution: See your doctor if you think you might have vulvodynia. Currently, not much is known about the condition, but treatments involve medications and physical therapy.

The most important thing to remember when sex is painful is that you’re never alone. There are a lot of reasons sex might hurt and many women know them well, so you should never feel like something is wrong with you!

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