What to do when sex hurts

Sex is all about feeling great—until it doesn’t feel great. Unfortunately, dyspareunia (pain during sex) is more common than you might think. In fact, it’s so common that 3 out of every 4 people with vaginas experience it at some point in their lives. (Although some people enjoy experiencing pain during sex, that’s not the kind of pain we’re talking about. We’re talking about the kind that’s unwanted and a total mood-killer.)

The first thing you need to know about experiencing pain during sex is that sex isn’t supposed to hurt. Secondly, you always have the right to stop if sex is making you uncomfortable in any way. You don’t have to keep going just because you started. Third, you don’t have to suffer through dyspareunia without help. There are a number of causes for discomfort during sex, ranging from minor to more serious—but there are also a variety of potential treatments.

Before you head to see your provider, you may want to try some simple things at home first. Here are two relatively easy (and fun) things you can try first to make sex less painful:

1. Spend more time on foreplay. Giving yourself the time and stimulation you need to be aroused is important for making penetrative sex pleasurable. That means you might need to spend a little more time on foreplay before attempting penetration. Be patient with your body and try not to rush it.

2. Double up on lube. Vaginal dryness during sex can be a straightforward cause of pain. In other words, lube it up! Remember to only use water-based or silicone lubes (not oil-based) when using latex condoms. The more lubricant, the better. Apply it at any moment—even in the middle of sex—to prevent and/or ease any potential soreness caused by friction. And remember, using lube doesn’t mean there’s something wrong or that you’re not into the sex you’re having. It just means your body needs a little extra moisture.

If sex still hurts after you’ve exhausted your tube of lube and tried all the foreplay you like, then it might be time to check with your medical provider for answers. Take notice of where and when your pain occurs so that you can let your provider know during your appointment. Here are three reasons sex might still be causing you pain:

1. You might have an infection. Something as simple as a yeast infection can cause vaginal dryness that makes sex painful. A sexually transmitted infection (STI) could also be the culprit for discomfort during sex. In either case, check in with your provider for testing and treatment.

2. Your pain may be caused by a gynecologic problem. Several reproductive disorders have pain during sex as a symptom, including endometriosis, vaginismus, pelvic inflammatory disease (PID), and uterine fibroids. Birth injuries can also cause pain during sex. Your health care provider may need to perform a pelvic exam or order other exams (i.e. ultrasound, MRI, or laparoscopy) to determine the exact cause of your discomfort. For some causes of dyspareunia, pelvic floor physical therapy may be a treatment option.

3. Your pain might have a psychological or emotional origin. Sometimes sex can hurt physically because we feel anxiety or stress, or because of a past sexual trauma. A psychological reason for sexual pain could require treatment, as well. If your provider is unable to diagnose a physical reason for your pain, they may refer you to a psychotherapist who specializes in sex therapy methods or in treatment for trauma.

Whether your dyspareunia is chronic or situational, mild or severe, you don’t have to let the unwanted pain ruin your sex life. In most cases, there is a treatment available that can help ease your discomfort. It’s important to remember that experiencing dyspareunia doesn’t mean your body is “broken” or that you’re just not meant to enjoy sex. It’s important not to ignore dyspareunia or soldier through painful sex because that’s “just how sex is.” And you don’t have to go through it alone.

While you’re exploring causes and treatment options, there may be other sexual activities that do feel good for you, like oral sex or masturbation. Don’t be afraid to see what feels good for you, by yourself or with a partner.