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Permanent link for Pain During Sex?  on February 22, 2021

Part of our Sex Ed Series

Dyspareunia: Painful Intercourse
Have you ever experienced pain while having sex? Experiencing cramping or pain during arousal, sex or orgasm is not uncommon, especially for folks with vulvas. About 75% of women have painful intercourse at some point in their lives, according to the American College of Obstetricians and Gynecologists. The vulva and vagina are part of the binary female, or XX-chromosome anatomy. The penis is part of the binary male, or XY-chromosome anatomy. It is important to keep in mind that people can identify differently than their physical genitalia and a person’s body may not necessarily match their gender identity. 

Having painful intercourse is called dyspareunia, and it is much more common than you might think. Although the amount of research on the topic might lead one to believe otherwise, experiencing discomfort or pain can be quite common during sexual activities and is often very easily identified and resolved.

Pain for vulva owners
For vulva owners pain with sex can be experienced in the pelvic floor, which is the group of muscles surrounding and cupping the bladder, uterus, bowels, and rectum. These muscles are located in the pelvis and run from the tailbone to the pubic bone, as well as stretching from side to side of the hips. They play a large role in sexual function and sensation, as one of the main jobs of these muscles is to control abdominal pressure when the vagina and pelvis are straining downwards, a common occurrence during sex and masturbation. During orgasm or heightened arousal, the pelvic floor muscles contract. Pain or cramping can be caused due to these muscles cramping, similar to their reaction during the menstrual cycle. Tense muscles can lead to pain regardless of the size or location of those muscles. If you tighten or strain a group of muscles for an extended period of time, there is always a chance for those muscles to react (Pelvic Pain).

Other causes of dyspareunia include vaginal dryness, a yeast infection or UTI (urinary tract infection), STIs, and IBS (irritable bowel syndrome). Vaginal dryness can stem from stress, fear, or a naturally lower level of produced vagainal fluids. To combat this, remember to use plenty of lubricant and communicate with yourself and your partner(s) before engaging in sex. Yeast infections and UTIs can be common in vulva owners as they result from hormonal imbalances, lack of sleep, stress, and buildup of bacteria. These can be quickly taken care of with antibiotics or over-the-counter medicine. IBS or irritable bowel syndrome is a digestive/intestinal condition whose cause is unknown and whose treatments range from diets to home remedies to various medications. However in relation to pain with sexual activities, the act of penetrative sex can jostle the intestines within the pelvis and cause irritation or discomfort. 

STIs can also be the source of pain or irritation during sex as they can cause lower abdominal pain, burning sensations, pain or bleeding during penetration, itching, and genital sores or warts. However the most common symptom of an STI is no symptom, which is why regular testing is important. To protect yourself and your partner(s) from STIs, use barrier methods like external or internal condoms, or dental dams.

Pain for penis owners
There are many different reasons why someone with a penis may experience pain or discomfort during sexual activities (Penis Pain?). The most common reasons include excessive friction, prostatitis, an STI, or a UTI (urinary tract infection). Excessive friction is usually caused by particularly rough sex and/or sex without enough lubrication, as this can cause chafing. This usually makes the penis feel sore afterwards, and can also cause discoloration. Prostatitis is the inflammation of the prostate, which can cause pain in the penis particularly after ejaculation. This can be caused by bacterial infection, pelvic nerve damage, or a previous UTI and is usually checked by a prostate exam. An uncomfortable or painful sexual experience could also indicate a possible STI, so it is always best to get yourself regularly checked for STIs if you are sexually active. Finally, UTIs could also be the the cause for pain during sex. UTIs occur when bacteria from the digestive system infects the urinary tract, which in penis owners is the same tract that semen flows through during ejaculation. UTIs can also cause irritation or inflammation of the penis, so pain during sexual activities can also be an indicator of a separate urinary problem. 

It should be noted that causes of pain for penis owners tend to be less chronic than causes of pain for vulva owners. However this doesn’t mean that penis owners should worry, or care, less about their bodies, or that if they experience pain during sex they should assume it’s less of a problem and it it will go away on its own. Pain is the body’s way of telling you that something is wrong, and it is your responsibility to listen to your body’s signals and take care of it. 

Diagnosis and Treatment
If the pain you experience is ongoing and a frequent occurrence during sex or masturbation, most healthcare professionals recommend making an appointment with a doctor or gynecologist (for vulva owners). Otherwise, a one-time event of pain or discomfort is said to not be indicative of any larger problem and is most likely related more to circumstantial factors. If you do make an appointment with your doctor and they recommend treatment, treatments often include: pelvic floor therapy, kegels exercises, and medication for vulva owners, and antibiotics, topical medication, or temporary abstinence for penis owners. Working with a sex therapist is sometimes utilized for people whose pain is thought to be psychosomatic. Internalized shame can often lead to people experiencing dyspareunia due to being raised in a sex-negative household or societal pressures and stigma around masturbation, premarital sex, or sexual orientation (Recovering From Sexual Shame). 

Don’t Be Afraid
This is not to say that you should be afraid of engaging in sex or masturbation if you want to do so. Every person’s body is different and some people may never experience pain or discomfort with sex or arousal. However, for those that do, there are lots of ways to lessen and overcome that pain. For those with vulvas, the pelvic floor muscles can be strengthened through exercises known as kegels, where one learns how to locate and then relax specific muscles in their pelvis. For people with penises, ensure that generous lubrication is being used and the penis is not being thrusted or bent at uncomfortable angles or speeds. Alternatively, an STI test and gynecological or prostate exam may be conducted to rule out any diseases, bacteria or infection. 

While experiencing pain during sex can cause a person to become nervous and fearful of sex and masturbation, know that it is nothing to be embarrassed or ashamed about and that for most people it is not a lifelong concern or barrier (Demystifying Painful Intercourse). However, we still need to be mindful of others’ mental health and understand how deeply an inability to be intimate with yourself or others can relate to a person’s sense of self. It can lead a person to believe that they are not normal, possibly causing sadness, grief, distress, and shame. Be mindful of those around you and remember that everybody has different boundaries, abilities, and struggles.

By: Beck Lukins, WIT Peer Educator

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Page last modified February 22, 2021