When Sex is Painful (for Vulva Owners)
“I am a vulva owner and sex is painful”. If you find yourself in this position, let me be the first to tell you that sex should never be painful (unless you are seeking consensual pain, as in the BDSM/kink world). If it is painful, stop! Temporarily at least, until you get the pain issues resolved, lest things get worse before they get better.
So what can be done for sexual pain if you are a vulva owner experiencing this issue? It first comes down to discerning the root cause of the pain. The solution may be as simple as adding some lubrication or taking more time to engage in foreplay to be more “warmed up,” but if the root cause is deeper than that, there may be some additional steps to take to improve the overall experience.
If you are experiencing pain such that you are unable to insert a tampon or finger, let alone a penis or dildo, you may have vaginismus or vulvodynia. These are most accurately diagnosed by a sex medicine doctor. While I am quite a fan of gynecologists, they are not all specially trained in areas of sexual health, and as a result, may not be aware that this could be what’s causing the pain and misdiagnose. A sex medicine doctor will be able to take some extra time to assess the full scope of your physical pain to help determine if it’s vaginismus, another medical issue, or something else altogether.
Before you take that step though, what are some practical things you can do to help with the pain? First, pay attention to your thoughts. Are you already anticipating that this is going to be a painful experience? If so, your body is subconsciously syncing with those thoughts and likely tensing before you even realize it. Take some time to engage in progressive muscle relaxation, do some deep breathing, and create a mantra that works for you that you can replace those negative thoughts with (i.e. “I feel calm and at ease,” or “I wonder what it would be like for this to be a relaxing experience?” or “this is an opportunity for me to explore pleasure.”). Find the mantra that works best for you. Keep the word “pain” out of it and spin it in a way that feels realistic. You don’t have to tell yourself this will be a pain-free experience, just consider telling yourself something that may also be true about the experience.
As mentioned, you can also spend some more time engaging in foreplay to get your body relaxed and ready for intercourse. Consider changing up the normal sexual script you have (i.e. if you normally go from making out, to touching genitals, to diving into intercourse, consider adding some oral sex first, or using a blindfold and having your partner tantalize and tease your body without you seeing, beginning with massage, engaging in some dirty talk, etc.). Get creative! What works best for you may not work best for someone else. And while it may feel awkward/silly at first, you won’t know what feels good until you give it a shot. The more you practice, the less awkward and the more enjoyable it becomes.
Additionally, if sex is painful, add lube! Once you think you’ve added enough, add an extra squirt and you should be good to go! Sometimes we just need some additional moisture to decrease friction and relax the body. You could even ask your partner to give your vulva a massage before going into full intercourse. They can start by gently massaging the exterior, moving into the vagina with one finger at a time for penetration to get it more relaxed/comfortable, and then add the penis/dildo/vibrator, etc. for the full experience.
Other things to consider… are you distracted and thinking about other facets of life and therefore disengaged from sex? Is the environment distracting for you? Too hot, too cold? There are many distractions that can cause folks to keep themselves from being present in the moment. I recommend reading Dr. Emily Nagoski’s book, Come As You Are to dive deeper into how to address getting rid of the distractions and exploring what turns you on.
If you find that none of these things work and there’s still a lot of pain, again, visiting a sex medicine doctor is probably the best option for you. They may refer you to a pelvic floor physical therapist who will give you exercises and engage in activities that will strengthen your pelvic floor such that the pain eventually decreases. They may also refer to you to a sex therapist to help you work on kicking those negative thoughts out of your mind to also help you relax and enjoy the present moment.
Make sure in all of this, you’re communicating to your partner. It’s very likely that if you’re in pain, they’re also not enjoying the experience because they can see the pain on your face (or hear you verbally expressing it). It’s quite likely they’ll want to partner with you to make it as pain-free of an experience as possible. Talk to each other about what you might need from them to help make things more comfortable (do you need them to do verbal check-ins, to slow things down, to add the lubrication? etc.). Again, sex should not be painful so if it is, take some time to pursue the origins of the pain so you can find resolution and hopefully find a more enjoyable sexual experience!
