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Why Does Sex Hurt?

Mar. 7, 2012
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I recently received two similar questions about pain during sex:

  • My friend is not a virgin but is afraid to have sex because it hurts. She's been to a gyno and nothing seems to be wrong. Why does it hurt?
  • What is the best solution for painful sex?
While the gender of the person asking the second question is not clear, I'm going to answer these as if they are both about female-bodied people, since this type of concern is most often about pain during vaginal penetration.

Pain during vaginal sex can be caused by many things. Sometimes it's as simple as needing more lubricant to reduce friction or adding other types of arousing play (clitoral stimulation, oral sex, breast and nipple play, etc.) before attempting vaginal penetration. Sometimes people are worried that needing lubricant or clitoral stimulation in order to enjoy vaginal sex means there's something “wrong” with them—not true! Adding lube and thinking “outside the box” when it comes to sex is normal and can make it much more enjoyable.

Sometimes pain during vaginal penetration can be a sign of a sexually transmitted infection (STI), like chlamydia. Pain during sex is not something that you should just accept—it can be a sign of a serious issue—so I commend the friend in the first question for seeing a health care provider and not being afraid to ask questions. Hopefully, her gynecologist tested her for STIs.

Lube, clitoral stimulation and STI testing are some of the simpler solutions to pain during sex. Often, the issue is much more complex and difficult to figure out. There are a number of medical conditions—such as vulvodynia or vaginismus—that can lead to extreme pain when the vulva (external female genitals) is touched or when the vagina is penetrated. Unfortunately, these conditions are not well known even by health care providers, and sometimes people who seek medical help for painful sex are told that “it's all in your head” or that “you just need to relax.” These patronizing answers are not appropriate; your sexual well-being is important and should be taken seriously.

While there's no easy treatment for vulvodynia, vaginismus or other, similar conditions, the book When Sex Hurts: A Woman's Guide to Banishing Sexual Pain, published last year, can help you understand your pain better and make you a better advocate for yourself with your health care provider.

A few months ago, a customer at the Tool Shed told me that she ran a vulvodynia support group in the Milwaukee area and promised to come back with some fliers about the group. If this customer is reading this, please do get in touch with me and give me more information about the group—we get this question frequently at the store, and I'd love to be able to refer people to such a group! Meanwhile, for those who find it helpful to hear about others' experiences, xojane.com published a post on one person's experience with vulvodynia last week.

Want Laura to answer your questions in SEXpress? Send them to laura@shepex.com. Not all questions received will be answered in the column, and Laura cannot provide personal answers to questions that do not appear here. Questions sent to this address may be reproduced in this column, both in print and online, and may be edited for clarity and content.

Laura Anne Stuart has a master's degree in public health and has worked as a sexuality educator for more than a decade. She owns the Tool Shed, an erotic boutique on Milwaukee's East Side.


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