What to do about painful sex


Question: I am a woman and sex with my partner almost always hurts. What might be causing this?

— Concerned Female

Answer: I would like to start by saying that communication with your partner is always of utmost importance, so the first step in handling any intimacy issues is to talk to your partner.
Dyspareunia is a term used by doctors to describe painful sexual intercourse. This pain can be due to physical or psychological causes and usually only affects women. Much of the time, painful sex is simply a case of not having enough lubrication, which is pretty easily fixed with some water-based lube like KY-Jelly. Never use oil-based lubricants like Vaseline because these can weaken condoms.
If you’re sure that inadequate lubrication isn’t the problem, then the best advice I can give you is to see your doctor as soon as possible. Painful sexual intercourse can be caused by many different things, such as a simple yeast infection or urinary tract infection, or something more serious like chlamydia, endometriosis or ovarian cyst, just to name a few.
Sometimes painful sex is psychological. The pain may start out as physical, such as after sustaining a pelvic injury, for example. But sometimes even after the injury has healed, the woman may continue to feel pain during sex purely because she expects to. Some rape survivors experience an extreme form of dyspareunia called vaginismus in which the vagina has uncontrollable vaginal muscle spasms that can prevent a penis, finger or tampon from entering. If an object is able to penetrate in spite of the spasms, it can be extremely painful for the woman. Vaginismus doesn’t only affect rape survivors. It has also been known to affect women who have been taught that sex is dirty and immoral, and women who have a fear of pain associated with being penetrated. Vaginismus is typically treated with the help of a therapist.
Another type of pain associated with sexual intercourse is known as vulvodynia, which mainly consists of irritation, burning or stinging of the vulva and/or vaginal opening either spontaneously or when penetration or other type of touching is attempted. The cause of vulvodynia is mainly unknown, but could be due to a number of things such as environmental irritants, or an injury to the nerves surrounding the vulva. In any case, sex is supposed to feel good. If you are experiencing constant pain with sexual activity, you should seek the treatment of a gynecologist and/or therapist just to be on the safe side.

Editor’s Note: Lyndsay Mercier is a senior Psychology major. She is also the president of Vox: Voices for Planned Parenthood, a trained sexual education peer educator and a teaching apprentice for Psychology of Sex Behaviors. Lyndsay is not a medical doctor and her advice should never replace the advice of a doctor. E-mail her your sexual health related questions at: [email protected]