February 3, 2017

Q & A: Penetration Hurts! How Can I Have Sex Without Pain?

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Is my vagina too small to enjoy sex?

Is my vagina too small to enjoy sex?

I’m sorry to hear you’ve had some experiences of painful sex. It’s not that unusual, actually – data from our National Survey of Sexual Health and Behavior repeatedly have shown that about 30% of American women report pain with any given act of vaginal intercourse and about 70% report pain during any given act of anal intercourse. Pain during vaginal intercourse is usually mild and goes away within minutes, but it’s still pain nevertheless and not everyone likes pain as part of sex. For some men, the pain is more severe or longer lasting.

It Might Not Be What They Say

There are a number of reasons why vaginal penetration may be painful. It’s possible that your vagina is smaller than average in size, but just because some men have said that to you doesn’t mean it’s true. Some men just tell partners that their vagina is small – maybe because that’s what they feel they are “supposed” to say. Most vaginas are pretty close in size, according to several studies that have taken vaginal measurements. Even women who have had children and given birth vaginally don’t seem to have a vagina any different in overall size.

A vagina can feel small when it is less well lubricated and a vagina can feel more comfortable and “spacious” (in a good way!) when well lubricated. That is one reason lubricant can be helpful to vaginal penetration and vaginal intercourse, as it can make sex feel more comfortable and pleasurable for both partners. You might try seeing if water-based or silicone-based lubricant helps vaginal intercourse to feel more pleasurable and less painful for you.

If you are approaching menopause, post-menopausal, nursing (breastfeeding), had your ovaries removed, or if you’ve had medical conditions or treatments that have caused vaginal dryness (for example, some cancer treatments can cause vaginal dryness), then vaginal moisturizers – including, possibly, vaginal estrogens – may be helpful to you as well. If you are experiencing vaginal dryness, we recommend you speak with a healthcare provider who can examine you and, if warranted, suggest treatment options for you.

Take Time to Play

Some women also find that it helps if they and their partner spend time engaged in kinds of sex that feel highly arousing to them – and especially prior to vaginal penetration. Sex play that arouses females can increase muscular tension, which can draw the uterus upward and make more space in the vagina. Sexual arousal and excitement can also encourage the body to produce more natural vaginal lubrication.

If intercourse is painful but still something you want to do, choosing positions (such as female on top) that give you more control over the depth and pace of penetration can also be helpful. These tips help many women to have more comfortable, pleasurable intercourse, but if sex remains painful for you or if you’d like to talk with a healthcare provider about painful sex, you can find a provider with expertise in vaginal and vulvar pain through the National Vulvodynia Association (www.nva.org). The NVA’s website also has a number of other resources about chronic vaginal pain and how some women manage it. I hope this is helpful.


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