For most people, enjoyable sex is sex without pain. But even small discomforts can make sex less pleasurable. While sexual pain can have many causes, the clue to resolving it can start with our mindset.
What causes sexual pain?
Sometimes, sexual pain is situational. You might have a new partner and need time to adjust to each other’s bodies. Or you might be trying a new sexual position or having sex in a place you’re not used to. Any of these scenarios are possible, and they’re usually easy to fix.
However, sexual pain can be caused by medical conditions, too. It might be temporary, but it could be chronic. And it might be difficult to solve at first.
Here are some common and not-so-common causes:
For men:
- Phimosis (occurs when the foreskin of the penis cannot be pulled back)
- Peyronie’s disease (formation of plaques that cause the penis to bend)
- Chronic prostatitis/chronic pelvic pain syndrome (inflammation that affects the prostate gland)
For women:
- Endometriosis (growth of endometrial tissue outside the uterus)
- Ovarian cysts
- Pelvic inflammatory disease (an infection often caused by untreated STDs)
- Recent childbirth
- Vestibulodynia (pain at the entrance of the vagina)
- Vulvodynia (chronic pain in the vulva – the clitoris, labia, and opening of the urethra)
- Vaginismus (involuntary contraction of vaginal muscles)
- Gynecologic cancer
- Menopause
- Vulvar and vaginal atrophy
For both men and women:
- Arthritis
- Allergies (e.g., to personal care products, latex condoms, or sperm)
- Psoriasis
- Genital or pelvic injury
- Surgery
- Sexually-transmitted infections
- Lichen sclerosis (a genital skin condition)
For more details on these causes, please see the helpful list of resources at the end of this article.
Keeping sex pleasurable
So, what can couples do to stay intimate without pain? Here are some ideas:
- Rethink your definition of sex. Many couples believe that sex equals penetration and that other activities don’t “count.” Focus instead on what counts for you and your partner. Is it pleasure? Excitement? Connection and bonding? Think of ways you can achieve these goals without pain. It might mean trying new sexual positions, engaging in oral sex, or doing mutual masturbation. It could be kissing, fondling, or massage. Whatever it is, you and your partner can decide what will make an intimate experience satisfying.
- Talk to your partner. Lots of couples are anxious about discussing sex together. But it’s important to do so, especially if one of you is feeling pain. Be direct about telling your partner about what is painful and what it enjoyable. Be open about the ways that your sexual challenges are affecting your relationship. If you have trouble with these discussions, seeing a counselor or sex therapist can help.
- See your doctor. Many sources of sexual pain can be treated with medication, lubricants, physical therapy, counseling, sex therapy, or surgery. Talk to your gynecologist, urologist, or primary care physician about what’s happening.It may take some time to pinpoint the cause, but it’s a path worth exploring.
- Be willing to make adjustments and compromises. As noted above, some couples need to try new things in the bedroom. Take your time discovering what these things are. For example, a woman who finds vaginal intercourse painful might try a warm bath or a romantic slow dance with her partner, if those activities will help her relax. She and her partner could also decide to take intercourse out of their sexual routine while she seeks treatment.
If you are having sexual pain, you don’t have to grin and bear it. Chances are, your partner will want to do what it takes to make the experience satisfying for both of you. Work together to reach your sexual goals.
Resources
Centers for Disease Control and Prevention
“Pelvic Inflammatory Disease (PID) - CDC Fact Sheet”
(Page last updated: July 10, 2017)
https://www.cdc.gov/std/pid/stdfact-pid.htm
Health.com
“9 Problems That Can Make Sex Painful for Men”
(February 29, 2016)
http://www.health.com/health/condition-article/0,,20190111,00.html
International Society for Sexual Medicine
“Antidepressants and Vulvodynia”
http://www.issm.info/news/sex-health-headlines/antidepressants-and-vulvodynia
“What is a sperm allergy?”
http://www.issm.info/sexual-health-qa/what-is-a-sperm-allergy/
“What is chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)?”
http://www.issm.info/sexual-health-qa/what-is-chronic-prostatitis-chronic-pelvic-pain-syndrome-cp-cpps
“What is clitorodynia (clitoral pain)?”
http://www.issm.info/sexual-health-qa/what-is-clitorodynia-clitoral-pain
“What is dyspareunia?”
http://www.issm.info/sexual-health-qa/what-is-dyspareunia/
“What is lichen sclerosus and whom does it affect?”
http://www.issm.info/sexual-health-qa/what-is-lichen-sclerosus-and-whom-does-it-affect
“What is phimosis?”
http://www.issm.info/sexual-health-qa/what-is-phimosis/
“What is provoked vestibulodynia (PVD)?”
http://www.issm.info/sexual-health-qa/what-is-provoked-vestibulodynia-pvd
Self
Kerr, Breena
“How to Rethink Intimacy When 'Regular' Sex Hurts”
(September 8, 2017)
https://www.self.com/story/how-to-rethink-intimacy-when-regular-sex-hurts
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