October 3, 2007

Q&A: Sex Is Painful For My Girlfriend

Dr. Debby Herbenick answers a reader's question about what might be causing painful sex for the female partner in a heterosexual couple.

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Question: My girlfriend and I have been trying to have sex for the past few months. Each time we try the experience is painful for her. Because she has never had sex before, we expected this the first few times, but it has not gotten any better. We always use a condom and lubricant. We have also tried several different positions and this does not help either. Is there anything that we can do to make the experience better for her?

Given the lack of sexuality information available to adolescents and young adults, it is not surprising that so many young women and men expect sex to be painful when they first start having it.

We are often told, “sex will hurt” but we are rarely told how much or how little it will hurt, for how long it will hurt, or how to make it not hurt so much.

Vaginal intercourse – during the first few times a woman has it – is more often uncomfortable than actually painful and the discomfort can frequently be minimized by a few key strategies.

Strategies For Minimizing Discomfort

The first is waiting to have intercourse until both partners are not just ready but actually very excited and enthusiastic about intercourse.

That means not only waiting until you both feel good enough about your relationship to have sex, but it can even mean waiting on a particular day or at a particular time. Some sex therapists advise that it can make intercourse more comfortable and more pleasurable if a couple waits to have sex until each partner absolutely cannot wait any longer for penetration.

Spend Time In Foreplay

Spending time in foreplay can also make sense more comfortable, especially for women, because during the process of sexual arousal muscular contractions pull the uterus upwards, often making the vagina longer and/or wider which can make more room for a partner’s penis, fingers or a sex toy (depending on what you’re doing).

Use Lubricant

Sometimes women and their partners find that using a store-bought lubricant makes intercourse significantly more comfortable and fun. Other times, there are relationship issues or medical issues that are best addressed with a sex therapist (aasect.org) or healthcare provider, respectively.

For example, sometimes women or men hold very shameful or negative feelings about sex and these emotions can get in the way of feeling good about sex or being able to relax enough to have comfortable, pleasurable sex.

Other times, medical conditions such as pain disorders or muscular disorders can make sex painful, as can the relatively uncommon situation of having a hymen (thin layer of tissue) that covers a good deal of the vagina. Additionally, women who are approaching menopause, post-menopausal, nursing (breastfeeding), had their ovaries removed, or who have experienced medical conditions or treatments that cause vaginal dryness may benefit from treatment for vaginal dryness (i.e., vaginal moisturizers and.or hormone therapy). Women who are experiencing vaginal dryness should speak with their healthcare provider for additional information, examination, and possible treatment options (see ACOG for additional information).

Findings from the National Survey of Sexual Health and Behavior (NSSHB) – a US probability survey of sex in America – finds that about 30% of women report experiencing some level of pain (mostly mild, but sometimes more severe) during their most recent experience of vaginal intercourse; pain during anal intercourse is even more common, being reported by about 70% of women. Thus, pain is common – and it’s wise to take a thoughtful, compassionate approach rather than rushing sex that could hurt.

Learn More

You can learn more about some vulvovaginal pain conditions through the web site of The National Vulvodynia Association (www.nva.org) and by reading The V Book: A Doctor’s Guide to Complete Vulvovaginal Health.

Reviewed and updated, with more recent link to ACOG and with link to newer research on painful intercourse, on May 3, 2017.

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