When sex hurts—even just a little

Somehow we all come to understand—even before we try it—that sex feels good. Pleasure may not have been part of high school sex ed or “the talk” with your parents, but most of us see it as an important part of sex. Unfortunately, for some people, this is not always (or ever) the case. Up to three out of four women have experienced pain during consensual intercourse.

A quick caveat: sexual assault raises very different physical and psychological issues, and there are special resources for those instances.

Hopefully, people who experience pain while getting it on will wonder why and seek out relief. I worry that some may shrug it off as something that just happens—which is not true in most cases. If sex hurts, there’s likely a reason why, and there are multiple things that you and your partner can try to dial down the pain and dial up the pleasure. Here are 6 of them.

1. Get checked out

There are some medical issues that can cause sex to hurt, so the first step is to get checked out by a health care provider. Here are some of the common culprits:

• Sexually transmitted infections (STIs) like chlamydia and gonorrhea can cause irritation and pain during penetration. If these STIs go untreated, they can cause pelvic inflammatory disease (PID), which is an infection of the uterus and fallopian tubes. One of the most common symptoms of PID is pain in the lower abdomen, including during sex.

• Endometriosis is another condition that can cause pain during sex.

• Even a simple old yeast infection or urinary tract infection can make sex hurt.

All of these can be treated or cured to reduce pain during sex. But what if you have a clean bill of health and sex is still feeling decidedly less than good?

2. Check your gut

Yes, sex is a physical activity, but the mental component can be just as important. Maybe you’re not sure this is the right person to get naked with, or maybe the situation feels weird because there are friends right outside the door who may be able to hear your enthusiasm. Doubts, fear, or embarrassment can dial down your body’s sexual response. If you’re tense or nervous, it can be hard to get turned on. And if you’re not turned on, sex might not feel great. Things outside of the bedroom—like how you’re getting along with your partner—can impact how your body responds to sex, as well.

If your gut is saying, not this person, not here, or not now, you can take a break, offer a rain-check, or just plain stop. For ongoing relationship issues, consider talking to a therapist who understands sexuality.

3. Get wet—really wet

Sebastian was right—everything is better down where it’s wetter. If you want to put a penis, a finger, or a sex toy into a vagina easily and comfortably, the vagina has to be lubricated. Our bodies take care of some of this by sending blood to the genitals when we get turned on. This causes the walls of the vagina and the head of the penis to get wet, but most people can benefit from a little extra lubrication.

This is an easy fix—drug stores have plenty of different lubricants. Pick a bottle, any bottle: the one that calls itself extra silky, the one that works in the shower, or the one with the prettiest label. Try a few until you have a favorite (or two). Just make sure if you’re using condoms that your lube is condom friendly. A few more tips:

• If you’re using a diaphragm or a sex toy (more on that in a minute), water-based lube may be best. Silicone-based lubes can be bad for silicone-based products.

• Oil-based lubes are the enemy of latex condoms. Luckily, if oil-based lubes are your preference, you can get condoms made out of plenty of materials besides latex.

• If you’re experiencing discomfort during sex, you might want to skip lubricants that advertise tingling or warming. There can be a fine line between pleasurable warmth and the feeling of burning.

4. Change it up

Another solution to ouchy sex is to stop doing what hurts. If sex hurt when you were on the bottom and your partner was on top, try it with you on top. That way, you can control the speed and depth of penetration. If the motion of a partner’s tongue was more irritating than intriguing, ask for something new. Try to make the tone light and gentle, and express encouragement (with sounds or words) when your partner gets it right.

Ask if you can experiment together to find out what feels best, and show your own willingness to change by asking what you can do better. If this conversation feels awkward, remind your partner that it’s all in the spirit of great sex. Also, try experimenting when you’re alone. (Yes, I mean masturbating.) The more you know about how you like to be touched, the better advice you can give a partner.

5. Don’t forget about the clitoris

In my humble opinion, the clitoris doesn’t get the respect or attention it deserves. It’s the only human body part that has no other function than pleasure. That’s it. That’s all it does. Makes us feel good. And, most women can’t orgasm without some clitoral stimulation. So don’t forget about your clitoris and don’t let your partner forget either. Choose activities in which it can get some love, either indirectly from your bodies rubbing each other or directly from somebody’s fingers or tongue.

6. Try adding some buzz

For many of us, the best clitoral stimulation comes in the form of vibration. Luckily, vibration comes in many flavors: intense “back massagers” like the Hitachi Magic Wand, small bullet vibes that can be held gently on the clit, battery-powered dildos, and vibrating rings that slip right onto the penis. The best option for you depends on what sensations you prefer. If you have mild discomfort with penetration, vibrators can also provide a nice distraction for your mind and vulva. The sensation of the vibrations and the clitoral stimulation can create a net positive of pleasure.

If all else fails

If these suggestions don’t help, there may be something else going on. Up to 8% of U.S. women have ongoing pain or discomfort of the vulva or vagina that may occur only during sex or may be ever-present in their day-to-day lives. This is sometimes diagnosed as vulvodynia—a catch-all term that describes the condition (painful vulva). There are health care providers who specialize in helping people with this condition, and there are treatments that range from medication to physical therapy. Researchers are still working on understanding the causes of vulvodynia, so there may be more successful treatments on the horizon.