“Why do I feel pain during sex?”

Sex is supposed to feel good! Sex might not be earth-shattering every time and that’s just part of life, but sometimes penetrative vaginal sex can be downright physically painful. Why? There’s no one single answer. A variety of physical and emotional issues can play a role. Here are some possibilities to consider.

Infections. First and foremost, address this issue with your health care provider. Pain during vaginal intercourse can be a symptom of a variety of infections, including yeast infections, chlamydia, bacteria vaginosis, trichomoniasis, and herpes. You can make an appointment with Campus Health to discuss your symptoms with a clinician, who can treat or rule out these possible culprits. Just remember that some STIs can also be asymptomatic, so we also recommend you get routine screening even when you’re feeling fine!

Medical conditions. There are some more specific medical conditions that can make penetration painful, like Vaginismus, when the vaginal muscles involuntarily spasm, and Vulvar Vestibulitis Syndrome, when penetration and contact are painful. UNC Hospital has a Pelvic Pain Clinic and a Vulvar Pain Clinic, with specialists who evaluate, treat, and conduct research about pelvic pain.

Comfort level. Sometimes the problem is emotional, rather than medical. How do you feel about having sex with your partner? How loved? How secure? How trusting? Sometimes the emotional issues in your relationship can affect how comfortable you feel being intimate and how easily you can relax. Addressing those head-on may help to improve sex. Difficult emotions can also arise for those who had a history of sexual abuse or trauma, and if you need help coping, please contact Counseling and Wellness Services at UNC Campus Health.

Not turned on yet. Sometimes penetration is uncomfortable because the vaginal entrance is tight. Arousal can help relax those muscles, so don’t rush through foreplay! Slow down and spend more time turning each other on.

Inadequate lubrication. Sometimes penetration is uncomfortable because the vagina is dry and the friction is irritating. Another reason to spend more time on foreplay — so your vagina can self-lubricate more! If your body doesn’t produce enough natural lubrication on its own, try using lubricants. Just remember the rules of thumb: use water-based lubricants because oil-based lubricants degrade latex. Read the Healthy Heels post Discovering the World of Lube to learn more.

Latex allergy. If you suspect that you’re having a reaction to the latex, try using non-latex condoms (available for free from Campus Health). Go Ask Alice has some great info about latex allergies. You’ll want to have your symptoms evaluated by a clinician to get a definite latex allergy diagnosis.

This isn’t a complete list! Pain during sex can be really frustrating; sometimes it’s easy to figure it out, sometimes it’s not. You can always discuss pain during sex with your health care provider. Quality of sex impacts your quality of life, and we want to encourage you to utilize resources at Campus Health to help make things better.

While you’re figuring this out, remember that vaginal penetration is only one way to experience pleasure and intimacy with your partner. There are many sexual and sensual acts that don’t require vaginal penetration: Kissing! Touching! Massage! Masturbation! Oral sex! Anal sex! Talk to your partner about what you’re both comfortable with and how you can adapt your safer sex strategies to the new acts you want to try. We’ve explored this question in some classic Healthy Heels blog entries: Orgasm Answers? Yes, Please!, More Orgasm Answers: Yes, Please!, and Let’s Talk About Sex.

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