If you’re experiencing pain during sex there may be several factors that are contributing to the pain you feel. While things aren’t always so clear cut, it can help to separate the common physical causes of pain during sex from the psychological ones.
Physical causes of painful sex
For women there are a number of physical conditions that may make sex hurt, including:- Pelvic Inflammatory Disease
- Endometriosis
- Interstitial cystitis
- Vaginismus
- Vulvodynia
- Some sexually transmitted diseases
- Urinary infections
- Vaginal dryness
- Physical injury and chronic pain
For men there are also a number of physical conditions that can make sex hurt, including:
- Some infections (like thrush) can cause soreness and itching
- Some sexually transmitted diseases
- Tight foreskin
Psychological causes of painful sex
A psychological cause of pain during sex doesn’t mean it isn’t “real”. Often people think that psychological cause is like saying “it’s all in your head, just get over it”. Psychological causes of pain 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.
