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Causes of Painful Sex

Physical and Psychological Reasons for Painful Sex

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Updated May 21, 2014

Engaging in sexual activity shouldn't be painful (unless it's pain you choose to experience and enjoy which is a different story). If you're experiencing painful sex there may be several factors that are contributing to the pain you feel. These might be physical causes or psychological causes, usually it will be some combination of both.

Even though sex is more than intercourse most of the research and clinical interest in painful sex has focused on pain during intercourse.  If you're trying to figure out where to start it can be helpful to consider some of the most common causes of painful sex.

Physical Causes of Painful Sex

Some causes of painful sex may be specific to women's or men's bodies, others are equal opportunity obstacles. Here's an incomplete list of common causes of painful sex:
 


Psychological Causes of Painful Sex

Often people think that a psychological cause is another way of saying "it's all in your head" which is another way of saying it isn't real. Not true. Psychological causes of painful sex still result in very real pain, and very rarely can someone just "get over" a psychological reason for pain during sex. For both men and women there are a variety of reasons why our minds may play a role in sex being painful, here are some of the more common causes:

Coercive sexual experiences. Far too many women and men have experienced sexual assault or abuse. For many people their first experience with sex was something they did not choose. If you’ve never known sex that is consensual and pleasurable, it isn’t surprising that when you have sex (even when you choose to have it with a partner you like or love) your body doesn’t experience it as pleasurable. If you’re interested in learning more on this topic, I highly recommend the book The Survivor’s Guide to Sex which offers hope, support, and concrete guidance for people trying to create a positive sex life after experiencing sexual assault or abuse.

Anticipating pain. If you experienced pain during sex (whether it was from a physical condition, or a wrong position), you may begin to anticipate pain the next time you have sex. If you’re expecting it at least three things can happen. First, you aren’t going to be as tuned into what’s going on in your body, and you may find your arousal is lowered. Along with this, women may have less lubrication, which can cause a different kind of pain during sex. As well, the anticipation can actually make the pain feel more intense. For example your body may be very tense, which may result in a different physical experience of pain or pleasure.

Lack of interest in having sex.A very different situation than sexual assault is the time when you may not be in the mood to have sex, but your partner is. Many of us will have sex even when we’re not 100% into it, and we do this for a variety of reasons. One of the problems with doing this is that if you’re not that interested in having sex, it may result in pain. For women, the most common reason for this is likely lack of vaginal lubrication. If you’re not psychologically aroused at least a little, and you don’t have a lot of vaginal lubrication, sex will most likely be uncomfortable or painful. For men, if they are physically stimulated they may have an erection and be able to engage in intercourse. But if they aren't turned on, it may take a lot longer to ejaculate than it normally would. If there isn’t sufficient lubrication in this scenario the prolonged friction may cause pain.

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